US20090017995A1 - Knee manipulating device - Google Patents
Knee manipulating device Download PDFInfo
- Publication number
- US20090017995A1 US20090017995A1 US11/777,658 US77765807A US2009017995A1 US 20090017995 A1 US20090017995 A1 US 20090017995A1 US 77765807 A US77765807 A US 77765807A US 2009017995 A1 US2009017995 A1 US 2009017995A1
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- United States
- Prior art keywords
- bar
- mounting bar
- receiver
- seating portion
- angled
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H1/00—Apparatus for passive exercising; Vibrating apparatus ; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
- A61H1/02—Stretching or bending or torsioning apparatus for exercising
- A61H1/0237—Stretching or bending or torsioning apparatus for exercising for the lower limbs
- A61H1/024—Knee
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- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
- A63B21/00181—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices comprising additional means assisting the user to overcome part of the resisting force, i.e. assisted-active exercising
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- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
- A63B21/16—Supports for anchoring force-resisters
- A63B21/1609—Supports for anchoring force-resisters for anchoring on a chair
-
- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
- A63B21/40—Interfaces with the user related to strength training; Details thereof
- A63B21/4001—Arrangements for attaching the exercising apparatus to the user's body, e.g. belts, shoes or gloves specially adapted therefor
- A63B21/4011—Arrangements for attaching the exercising apparatus to the user's body, e.g. belts, shoes or gloves specially adapted therefor to the lower limbs
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- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
- A63B21/40—Interfaces with the user related to strength training; Details thereof
- A63B21/4023—Interfaces with the user related to strength training; Details thereof the user operating the resistance directly, without additional interface
- A63B21/4025—Resistance devices worn on the user's body
-
- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B21/00—Exercising apparatus for developing or strengthening the muscles or joints of the body by working against a counterforce, with or without measuring devices
- A63B21/40—Interfaces with the user related to strength training; Details thereof
- A63B21/4041—Interfaces with the user related to strength training; Details thereof characterised by the movements of the interface
- A63B21/4047—Pivoting movement
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- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B23/00—Exercising apparatus specially adapted for particular parts of the body
- A63B23/035—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously
- A63B23/03575—Apparatus used for exercising upper and lower limbs simultaneously
- A63B23/03583—Upper and lower limbs acting simultaneously on the same operating rigid member
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/12—Driving means
- A61H2201/1253—Driving means driven by a human being, e.g. hand driven
- A61H2201/1261—Driving means driven by a human being, e.g. hand driven combined with active exercising of the patient
- A61H2201/1269—Passive exercise driven by movement of healthy limbs
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/16—Physical interface with patient
- A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
- A61H2201/1628—Pelvis
- A61H2201/1633—Seat
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/16—Physical interface with patient
- A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
- A61H2201/1635—Hand or arm, e.g. handle
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/16—Physical interface with patient
- A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
- A61H2201/164—Feet or leg, e.g. pedal
- A61H2201/1642—Holding means therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2203/00—Additional characteristics concerning the patient
- A61H2203/04—Position of the patient
- A61H2203/0425—Sitting on the buttocks
- A61H2203/0431—Sitting on the buttocks in 90°/90°-position, like on a chair
-
- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B2208/00—Characteristics or parameters related to the user or player
- A63B2208/02—Characteristics or parameters related to the user or player posture
- A63B2208/0228—Sitting on the buttocks
- A63B2208/0233—Sitting on the buttocks in 90/90 position, like on a chair
-
- A—HUMAN NECESSITIES
- A63—SPORTS; GAMES; AMUSEMENTS
- A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
- A63B23/00—Exercising apparatus specially adapted for particular parts of the body
- A63B23/035—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously
- A63B23/04—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for lower limbs
- A63B23/0494—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for lower limbs primarily by articulating the knee joints
Definitions
- This invention is a medical device designed to improve the mobility of the adult knee following reconstructive surgery of the knee.
- a device for patient powered manipulation of the knee includes a seating platform to be positioned on a chair.
- a mounting bar is attached to the platform, this bar having a pivot axis.
- the location of the pivot axis is adjustable so that it conforms to the length of the patient's thigh.
- An angled bar is rotatably coupled to the mounting bar at the pivot axis, the angled bar having a hand grasp at its upper end and a leg contact pad at its lower end.
- the position of the leg contact pad is adjustable along the lower end of the angled bar to fit the length of the patient's leg, and a portion of the leg contact pad can rotate to roll along the patient's leg to reduce the friction effect on the patient's skin where the leg contact pad engages the leg.
- This device can be configured to accomplish both knee flexion (bending) and knee extension (straightening) depending on the position of the leg pad in front of or behind the shin, respectively.
- the patient pushes on the handle to accomplish knee flexion or pulls on the handle for knee extension.
- a thigh strap holds the thigh to the seating platform so that full knee extension is possible.
- FIG. 1 is a perspective view of one embodiment of a knee manipulation device in accordance with the present disclosure.
- FIG. 2 is an exploded perspective view of a component of the device shown in FIG. 1 .
- FIG. 2A is an elevation view illustrating a range of motion of the component shown in FIG. 2 .
- FIG. 3 is a perspective detail view of a portion of the device of FIG. 1 .
- FIG. 4 is a partial elevation view of the device of FIG. 1 , illustrating adjustability of a mounting bar.
- FIG. 5 is a partial perspective view of a leg pad of the device of FIG. 1 .
- FIG. 6 is an elevation view illustrating use of the device of FIG. 1 to extend (straighten) a leg.
- FIG. 7 is an elevation view illustrating use of the device of FIG. 1 to flex (bend) a leg.
- FIG. 1 depicts one embodiment of a knee manipulating device 10 .
- a seating platform 12 is made from rugged molded plastic to support the weight of a user, with a top surface 14 and bottom surface 16 , a forward edge 20 , a back edge 18 , and side edges 22 and 24 .
- a centerline 26 extends along the seating platform 12 , generally between the side edges 22 , 24 .
- the bottom surface 16 has appropriate surface texturing to allow the seating platform 12 to be stable on a surface such as a chair.
- the top surface 14 is contoured to allow stable and comfortable seating on the seating platform 12 .
- a receptacle 28 molded into the seating platform 12 extends upward from the top surface 14 and is aligned with the centerline 26 .
- the receptacle 28 is open at one end 30 and is closed at an opposite end 32 to enhance the rigidity of the receptacle 28 .
- end 32 may be partially or fully opened if rigidity were provided by other rigidity enhancing features such as gussets or increased wall thickness of receptacle 28 .
- End 30 is open at its lower end so that the motion of angled bar 50 is not restricted in flexion and extension.
- Receptacle 28 has an internal channel 34 with a rectangular cross section.
- a series of holes 38 is arrayed along the top surface 36 of the receptacle 28 . The holes 38 extend from the outside surface of receptacle 28 to the internal channel 34 .
- a mounting bar 40 is inserted into internal channel 34 and extends forward from the seating platform 12 .
- the mounting bar 40 has a rectangular cross section slightly smaller than the cross section of channel 34 , so that the mounting bar 40 and the channel 34 have a sliding fit.
- the matching rectangular shapes of channel 34 and mounting bar 40 prevent rotation of the mounting bar 40 and provide a sufficiently large surface area to distribute torque that may be applied to the mounting bar 40 during its intended use, as will be described below.
- One end 41 of the mounting bar 40 has a hole 42 ( FIG. 4 ) on its top surface.
- the extended length L 1 , L 2 , ( FIG. 4 ) of the mounting bar 40 may be adjusted to the size of a patient using the device 10 .
- the series of holes 38 along a top area 36 of receptacle 28 may be replaced with a single hole, and the end 41 of mounting bar 40 may include a plurality of holes for selective alignment with the hole in receptacle 28 to facilitate adjustment of mounting bar 40 in a manner similar to that described above.
- various other hardware such as for example, clamps, screws, telescoping ratchet or collet assemblies, or other devices suitable to adjustably couple mounting bar 40 relative to seating platform 12 may alternatively be used.
- Mounting bar 40 has a pivot axis 48 ( FIG. 2 ) where it attaches to an angled bar 50 .
- angled bar 50 is also made of rectangular tubing, although a solid rectangular bar, or a tube or bar of other cross sectional shape, could alternatively be used.
- Angled bar 50 comprises first and second portions 51 , 53 disposed at an angle ⁇ relative to one another. In the embodiment shown angle ⁇ is about 135 degrees. In this arrangement the device can provide both full extension and full flexion of a patient's leg for therapeutic purposes, as demonstrated in FIGS. 6 and 7 . While this embodiment utilizes an angle ⁇ of approximately 135 degrees, angles ranging between approximately 120 and approximately 150 degrees may also be used.
- a strap 80 is made of one piece of VELCRO® type material. This material has a surface with hooks and a surface with loops. The loops surface is secured with screws and washers (not shown) against the bottom surface 16 of the seating platform 12 . The contour and recesses of bottom surface 16 are such that the screw heads and strap do not bear the load of the patient's weight, and thereby forcefully contact and damage a surface such as a chair.
- this strap 80 is one piece of material, uniformly covered with hooks and loops, it will be understood that various other configurations for this strap, and methods of attachment, can be used. For example the strap could be two pieces, and have hooks and loops only on specific areas. Alternatively, buckles snaps, or other fastening devices could be used instead of hooks and loops.
- Fastening to seating platform 12 can be by any suitable method such as riveting, bonding, or molding within the structure of the seating platform 12 .
- mounting bar 40 is accomplished by aligning hole 52 through the mounting bar 40 with a hole 54 through the angled bar 50 .
- a roll pin 56 inserted through holes 52 and 54 couples the bars 40 and 50 and keeps them aligned.
- the roll pin 56 is just one option for coupling mounting bar 40 and angled bar 50 at pivot axis 48 . It will be understood that various other devices, such as for example cylindrical roller bearings or bushings, or other devices suitable to rotatably couple the two bars may alternatively be used.
- Mounting bar 40 has a notch 58 on its top surface and a notch 60 on its bottom surface.
- these two notches 58 , 60 allow the angled bar 50 sufficient rotational excursion to permit full movement, as seen in FIG. 2A , corresponding with flexion and extension of a leg, as seen in FIGS. 6 and 7 .
- the area near the notches 58 , 60 is isolated by appropriate pinch guards 62 and 63 ( FIG. 3 ).
- Pinch guard 62 is attached to and rotates with angled bar 50 and is shaped to pass through notches 58 , 60 in mounting bar 40 .
- the clearance space between mounting bar 40 and guard 62 is very small to prevent objects such as fingers from entering.
- Two guards 63 are attached to device 10 , one on each side of mounting bar 40 . Pinch guards 63 remain stationary relative to mounting bar 40 while angled bar 50 passes between them.
- angled bar 50 has a hole 64 ( FIG. 2 ) to which a handle 66 can be fitted and held, such as by a fastener pin 67 .
- Handle 66 is preferably padded and able to be gripped by both hands of a patient. In the embodiment shown, handle 66 has a small diameter so that it does not prematurely contact a patient's legs or abdomen and thereby prevent the device from moving through its full range of motion as shown in FIGS. 6 and 7 .
- handle 66 may alternatively comprise various other structure and configurations.
- handle 66 could comprise a strap that could be used pulling, but not for pushing.
- the lower end 55 of the angled bar 50 has a series of holes 68 to facilitate adjustment of a leg pad 70 according to the length of a patient's shin.
- the leg pad 70 comprises a hard, plastic, cylindrical axle 75 surrounded by a cylindrical plastic bushing 76 covered by a cylindrical foam pad 78 .
- the bushing 76 and foam pad 78 are retained on the cylindrical axle 75 by a retainer 79 attached to one end 73 of the axle 75 .
- On the other end 77 of the axle 75 is channel 74 that includes a retained and spring-loaded pin 72 .
- the leg pad 70 can be selectively positioned along the angled bar 50 by extracting pin 72 from one of the holes 68 and then sliding leg pad 70 up or down the angled bar to a new hole 68 .
- Leg pad 70 may also be fully removed from the angled bar 50 by extracting the pin 72 from the holes 68 and sliding the leg pad 70 off the angled bar 50 .
- the leg pad 70 can then be rotated (as shown in phantom lines 70 a ) and reassembled for use on the opposite side of angled bar 50 for use with a patient's other leg.
- the bushing 76 on cylindrical axle 75 permits easy rotation of the cylindrical foam pad 78 . This arrangement reduces any chafing or discomfort that might be encountered when the leg pad 70 travels up and down a patient's leg as the device 10 is used to mobilize and manipulate the knee.
- FIG. 6 depicts use of the device 10 to extend the knee, as shown by the arrow in the figure.
- the patient places the device 10 on a surface, usually a chair 81 , sufficiently high to allow the knees to flex fully without the patient's feet being constrained by the floor.
- the leg pad 70 is positioned on the side of the angled bar 50 towards the leg having the knee to be manipulated.
- the patient sits on the seating platform 12 with the receptacle 28 and the mounting bar 40 situated between the thighs.
- the mounting bar 40 is adjusted so that the pivot axis 48 is approximately aligned with the axis of rotation of the knee to permit maximum application of torque through the knee when the device 10 is used.
- the patient straps the leg to be exercised in extension to the seating platform 12 by taking both ends of strap 80 and connecting them together such that the loop portion, being relatively smooth, contacts the patient's leg while the hook portion, being relatively rough, does not make contact with the patient's leg.
- This strap 80 constrains the thigh so that, when force is exerted to extend the knee, the knee straightens rather than the thigh coming off of the seat 12 .
- the leg pad 70 is placed behind the shin.
- the patient pulls on the handle 66 to straighten the knee.
- the primary purpose of the use of the device 10 in extension mode is passive extension of the knee, motivated by the patient's arms.
- the patient is in full control of the device and can exert force to move his knee up to his own tolerance of discomfort.
- a physiotherapist can assist the patient by pushing on the handle 66 in addition to the pulling effort of the patient. After the physiotherapist has shown the patient how to use the device 10 in this manner, a family member can be instructed to assist the patient similarly to gain extension more rapidly. Later in the rehabilitation process the patient may move the leg pad 70 to in front of the shin, and may use his hands to resist active (thigh muscle motivated) extension of the knee to thereby strengthen the knee extending muscles.
- FIG. 7 depicts the use of the device 10 for accomplishing knee flexion.
- the leg pad 70 is positioned in contact with the front of the shin.
- the mounting bar 40 is again adjusted so that pivot axis 48 is approximately at the axis of rotation of the knee.
- the primary purpose of the use of the device 10 in flexion mode is passive (motivated by the patient's arms) flexion of the knee.
- the patient is in full control of the device 10 and can exert force to flex his knee up to his own tolerance of discomfort.
- a physiotherapist can assist the patient by pulling on the handle 66 in addition to the pushing effort of the patient.
- a family member can be instructed to carry out the same assistive measures to gain flexion more rapidly.
- the unique angle ⁇ of the angled bar 50 allows the knee to be fully flexed without exceeding the reach of the patient.
- the device 10 can also be used as an exerciser for the muscles that straighten the knee (knee extensors) and flex the knee (knee flexors).
- the patient may use his hands on the handle 66 to resist active (thigh muscle motivated) extension of the knee which allows for strengthening of the knee straightening muscles. This may be important in the later phases of rehabilitation in which strength is needed for walking, and in particular, in ascending and descending steps.
- the device 10 can be utilized as an exerciser for the muscles that bend the knee (knee flexors).
- the patient uses his hands on the handle 66 to resist active (hamstring muscle motivated) flexion of the knee which allows for strengthening of the knee bending muscles. This also is of significance later in the rehabilitation process.
- the embodiment shown and described herein has been made from hollow tube of rectangular cross section which is one type of a non-circular cross section that could be used.
- a similar device could be constructed from circular tubing; however, rectangular cross sections or other non-circular cross sections provide an abundance of surfaces to resist twisting motion on the angled bar 50 and mounting bar 40 which could cause loosening or breakage or otherwise impair the use of the components.
- the embodiment shown and described herein has included notches 58 , 60 in the top and bottom surfaces of mounting bar 40 so that the angled bar 50 can rotate within the mounting bar 40 .
- one skilled in the art could achieve appropriate rotatable coupling between the mounting bar 40 and the angled bar 50 in a variety of ways with a variety of materials that are within the scope of this invention.
- hinges could be used where the two bars 40 , 50 rotatably couple.
- solid bars instead of hollow tubing, solid bars could be used and then the angled bar 50 could sit beside the mounting bar 40 , and appropriate offsets in the seat 12 , receptacle 28 , or bars 40 , 50 would provide for the comfort of the patient.
Abstract
A device for exercising and manipulating a knee after reconstructive knee surgery has a seating portion and an angled bar pivotally coupled to the seating portion. A leg pad is provided at one end of the angled bar and a handle is provided at the other end. Manipulation of the handle rotates the angled bar through a pivot axis to move the leg pad and thereby manipulate or exercise the knee.
Description
- This invention is a medical device designed to improve the mobility of the adult knee following reconstructive surgery of the knee.
- After major knee operations, principally total knee replacement, regaining knee mobility is of primary importance. Customarily, this is a rather prolonged process. A physiotherapist instructs the patient to bend and straighten his knee, and, ordinarily assists in this process manually. The foremost goal in this process is to gain full knee straightening (extension), as this is required for patients to walk properly. Of almost equivalent importance is regaining knee bending (flexion) as this is necessary to allow patients to ascend and descend steps, sit properly with the knee bent appropriately, and to rise from the sitting position.
- There are many existing devices for carrying the knee through its range of motion which includes flexion and extension and which are primarily designed to increase muscle power and flexibility. These are commonly used in gyms and are not useful for patients recuperating from rehabilitative knee surgery as they are large, prohibitively expensive, and involve applying high levels of force to the knee.
- There are also devices designed specifically for post-operative use to regain flexion and extension after reconstructive knee surgery. These are generally referred to as continuous passive motion machines (CPM) and are applied to the supine patient following surgery. These machines are expensive, provoke pain during use, and are heavy and not readily transportable. There are also devices as described in U.S. Pat. No. 4,784,121 to Brooks that are patient controlled and designed to be used in a sitting position. The device of Brooks, however, does not fully straighten the knee. There remains a need for a device that overcomes these and other drawbacks of the prior art and provides an effective tool for mobilizing the post-operative knee after reconstructive surgery.
- In one embodiment, a device for patient powered manipulation of the knee includes a seating platform to be positioned on a chair. A mounting bar is attached to the platform, this bar having a pivot axis. The location of the pivot axis is adjustable so that it conforms to the length of the patient's thigh. An angled bar is rotatably coupled to the mounting bar at the pivot axis, the angled bar having a hand grasp at its upper end and a leg contact pad at its lower end. The position of the leg contact pad is adjustable along the lower end of the angled bar to fit the length of the patient's leg, and a portion of the leg contact pad can rotate to roll along the patient's leg to reduce the friction effect on the patient's skin where the leg contact pad engages the leg. This device can be configured to accomplish both knee flexion (bending) and knee extension (straightening) depending on the position of the leg pad in front of or behind the shin, respectively. The patient pushes on the handle to accomplish knee flexion or pulls on the handle for knee extension. A thigh strap holds the thigh to the seating platform so that full knee extension is possible. These and other features and advantages of this invention will be displayed and become more readily apparent in the following accompanying drawings. Detailed description of the principles and features of this invention will follow.
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FIG. 1 is a perspective view of one embodiment of a knee manipulation device in accordance with the present disclosure. -
FIG. 2 is an exploded perspective view of a component of the device shown inFIG. 1 . -
FIG. 2A is an elevation view illustrating a range of motion of the component shown inFIG. 2 . -
FIG. 3 is a perspective detail view of a portion of the device ofFIG. 1 . -
FIG. 4 is a partial elevation view of the device ofFIG. 1 , illustrating adjustability of a mounting bar. -
FIG. 5 is a partial perspective view of a leg pad of the device ofFIG. 1 . -
FIG. 6 is an elevation view illustrating use of the device ofFIG. 1 to extend (straighten) a leg. -
FIG. 7 is an elevation view illustrating use of the device ofFIG. 1 to flex (bend) a leg. -
FIG. 1 depicts one embodiment of aknee manipulating device 10. Aseating platform 12 is made from rugged molded plastic to support the weight of a user, with atop surface 14 andbottom surface 16, aforward edge 20, aback edge 18, andside edges seating platform 12, generally between theside edges bottom surface 16 has appropriate surface texturing to allow theseating platform 12 to be stable on a surface such as a chair. Thetop surface 14 is contoured to allow stable and comfortable seating on theseating platform 12. - A
receptacle 28 molded into theseating platform 12 extends upward from thetop surface 14 and is aligned with the centerline 26. Thereceptacle 28 is open at oneend 30 and is closed at anopposite end 32 to enhance the rigidity of thereceptacle 28. However, alternatively,end 32 may be partially or fully opened if rigidity were provided by other rigidity enhancing features such as gussets or increased wall thickness ofreceptacle 28.End 30 is open at its lower end so that the motion ofangled bar 50 is not restricted in flexion and extension.Receptacle 28 has aninternal channel 34 with a rectangular cross section. A series ofholes 38 is arrayed along thetop surface 36 of thereceptacle 28. Theholes 38 extend from the outside surface ofreceptacle 28 to theinternal channel 34. - A
mounting bar 40, made of rectangular tubing in this embodiment, is inserted intointernal channel 34 and extends forward from theseating platform 12. Themounting bar 40 has a rectangular cross section slightly smaller than the cross section ofchannel 34, so that themounting bar 40 and thechannel 34 have a sliding fit. The matching rectangular shapes ofchannel 34 and mountingbar 40 prevent rotation of themounting bar 40 and provide a sufficiently large surface area to distribute torque that may be applied to themounting bar 40 during its intended use, as will be described below. Oneend 41 of themounting bar 40 has a hole 42 (FIG. 4 ) on its top surface. By aligninghole 42 with one of the series ofholes 38 onreceptacle 28, and inserting apin 44 into the alignedholes FIG. 4 ) of themounting bar 40 may be adjusted to the size of a patient using thedevice 10. As an alternative to the above adjustment feature ofmounting bar 40, the series ofholes 38 along atop area 36 ofreceptacle 28 may be replaced with a single hole, and theend 41 ofmounting bar 40 may include a plurality of holes for selective alignment with the hole inreceptacle 28 to facilitate adjustment ofmounting bar 40 in a manner similar to that described above. It will be appreciated that various other hardware, such as for example, clamps, screws, telescoping ratchet or collet assemblies, or other devices suitable to adjustably couplemounting bar 40 relative toseating platform 12 may alternatively be used. -
Mounting bar 40 has a pivot axis 48 (FIG. 2 ) where it attaches to anangled bar 50. In this embodimentangled bar 50 is also made of rectangular tubing, although a solid rectangular bar, or a tube or bar of other cross sectional shape, could alternatively be used.Angled bar 50 comprises first andsecond portions FIGS. 6 and 7 . While this embodiment utilizes an angle α of approximately 135 degrees, angles ranging between approximately 120 and approximately 150 degrees may also be used. - A
strap 80 is made of one piece of VELCRO® type material. This material has a surface with hooks and a surface with loops. The loops surface is secured with screws and washers (not shown) against thebottom surface 16 of theseating platform 12. The contour and recesses ofbottom surface 16 are such that the screw heads and strap do not bear the load of the patient's weight, and thereby forcefully contact and damage a surface such as a chair. Although thisstrap 80 is one piece of material, uniformly covered with hooks and loops, it will be understood that various other configurations for this strap, and methods of attachment, can be used. For example the strap could be two pieces, and have hooks and loops only on specific areas. Alternatively, buckles snaps, or other fastening devices could be used instead of hooks and loops. Fastening toseating platform 12 can be by any suitable method such as riveting, bonding, or molding within the structure of theseating platform 12. - With reference to
FIGS. 2 and 2A , the attachment of mountingbar 40 toangled bar 50 is accomplished by aligning hole 52 through the mountingbar 40 with ahole 54 through theangled bar 50. Aroll pin 56 inserted throughholes 52 and 54 couples thebars roll pin 56 is just one option forcoupling mounting bar 40 and angledbar 50 atpivot axis 48. It will be understood that various other devices, such as for example cylindrical roller bearings or bushings, or other devices suitable to rotatably couple the two bars may alternatively be used. Mountingbar 40 has anotch 58 on its top surface and anotch 60 on its bottom surface. In the embodiment shown, these twonotches angled bar 50 sufficient rotational excursion to permit full movement, as seen inFIG. 2A , corresponding with flexion and extension of a leg, as seen inFIGS. 6 and 7 . In the fully assembleddevice 10, the area near thenotches FIG. 3 ).Pinch guard 62 is attached to and rotates withangled bar 50 and is shaped to pass throughnotches bar 40. The clearance space between mountingbar 40 andguard 62 is very small to prevent objects such as fingers from entering. Twoguards 63 are attached todevice 10, one on each side of mountingbar 40. Pinch guards 63 remain stationary relative to mountingbar 40 while angled bar 50 passes between them. - With reference to
FIGS. 1 and 2 , angledbar 50 has a hole 64 (FIG. 2 ) to which ahandle 66 can be fitted and held, such as by afastener pin 67.Handle 66 is preferably padded and able to be gripped by both hands of a patient. In the embodiment shown, handle 66 has a small diameter so that it does not prematurely contact a patient's legs or abdomen and thereby prevent the device from moving through its full range of motion as shown inFIGS. 6 and 7 . It will be appreciated that handle 66 may alternatively comprise various other structure and configurations. For example, handle 66 could comprise a strap that could be used pulling, but not for pushing. - As seen in
FIG. 5 , thelower end 55 of theangled bar 50 has a series ofholes 68 to facilitate adjustment of aleg pad 70 according to the length of a patient's shin. Theleg pad 70 comprises a hard, plastic,cylindrical axle 75 surrounded by a cylindricalplastic bushing 76 covered by acylindrical foam pad 78. Thebushing 76 andfoam pad 78 are retained on thecylindrical axle 75 by aretainer 79 attached to oneend 73 of theaxle 75. On theother end 77 of theaxle 75 ischannel 74 that includes a retained and spring-loadedpin 72. Theleg pad 70 can be selectively positioned along theangled bar 50 by extractingpin 72 from one of theholes 68 and then slidingleg pad 70 up or down the angled bar to anew hole 68.Leg pad 70 may also be fully removed from theangled bar 50 by extracting thepin 72 from theholes 68 and sliding theleg pad 70 off theangled bar 50. Theleg pad 70 can then be rotated (as shown in phantom lines 70 a) and reassembled for use on the opposite side ofangled bar 50 for use with a patient's other leg. Although this embodiment uses a retained spring-loadedpin 72 and a series ofholes 68, it will be appreciated that various other fastening hardware, for example, nuts, bolts, and clamps, may be used to attach the leg-engagingpad 70 at a variety of positions on the lower component of theangled bar 50. - In use, the
bushing 76 oncylindrical axle 75 permits easy rotation of thecylindrical foam pad 78. This arrangement reduces any chafing or discomfort that might be encountered when theleg pad 70 travels up and down a patient's leg as thedevice 10 is used to mobilize and manipulate the knee. -
FIG. 6 depicts use of thedevice 10 to extend the knee, as shown by the arrow in the figure. The patient places thedevice 10 on a surface, usually achair 81, sufficiently high to allow the knees to flex fully without the patient's feet being constrained by the floor. Theleg pad 70 is positioned on the side of theangled bar 50 towards the leg having the knee to be manipulated. The patient sits on theseating platform 12 with thereceptacle 28 and the mountingbar 40 situated between the thighs. The mountingbar 40 is adjusted so that thepivot axis 48 is approximately aligned with the axis of rotation of the knee to permit maximum application of torque through the knee when thedevice 10 is used. The patient straps the leg to be exercised in extension to theseating platform 12 by taking both ends ofstrap 80 and connecting them together such that the loop portion, being relatively smooth, contacts the patient's leg while the hook portion, being relatively rough, does not make contact with the patient's leg. Thisstrap 80 constrains the thigh so that, when force is exerted to extend the knee, the knee straightens rather than the thigh coming off of theseat 12. As seen inFIG. 6 theleg pad 70 is placed behind the shin. The patient pulls on thehandle 66 to straighten the knee. The primary purpose of the use of thedevice 10 in extension mode is passive extension of the knee, motivated by the patient's arms. The patient is in full control of the device and can exert force to move his knee up to his own tolerance of discomfort. In the early phases of the patient's rehabilitation, a physiotherapist can assist the patient by pushing on thehandle 66 in addition to the pulling effort of the patient. After the physiotherapist has shown the patient how to use thedevice 10 in this manner, a family member can be instructed to assist the patient similarly to gain extension more rapidly. Later in the rehabilitation process the patient may move theleg pad 70 to in front of the shin, and may use his hands to resist active (thigh muscle motivated) extension of the knee to thereby strengthen the knee extending muscles. The unique angle α of theangled bar 50 coupled with securing the thigh to theseating platform 12 using thestrap 80, allows the leg to be fully straightened before thehandle 66 reaches the abdomen or thighs, yet the angle α is not so small that the user is unable to reach thehandle 66 to initiate extension. -
FIG. 7 depicts the use of thedevice 10 for accomplishing knee flexion. In this mode, theleg pad 70 is positioned in contact with the front of the shin. The mountingbar 40 is again adjusted so thatpivot axis 48 is approximately at the axis of rotation of the knee. To flex the knee, the patient pushes forward on thehandle 66. The primary purpose of the use of thedevice 10 in flexion mode is passive (motivated by the patient's arms) flexion of the knee. The patient is in full control of thedevice 10 and can exert force to flex his knee up to his own tolerance of discomfort. In the early phases of the rehabilitation, a physiotherapist can assist the patient by pulling on thehandle 66 in addition to the pushing effort of the patient. After a physiotherapist has shown the patient how to use thedevice 10 in this manner, a family member can be instructed to carry out the same assistive measures to gain flexion more rapidly. The unique angle α of theangled bar 50 allows the knee to be fully flexed without exceeding the reach of the patient. - The
device 10 can also be used as an exerciser for the muscles that straighten the knee (knee extensors) and flex the knee (knee flexors). The patient may use his hands on thehandle 66 to resist active (thigh muscle motivated) extension of the knee which allows for strengthening of the knee straightening muscles. This may be important in the later phases of rehabilitation in which strength is needed for walking, and in particular, in ascending and descending steps. Further, thedevice 10 can be utilized as an exerciser for the muscles that bend the knee (knee flexors). The patient uses his hands on thehandle 66 to resist active (hamstring muscle motivated) flexion of the knee which allows for strengthening of the knee bending muscles. This also is of significance later in the rehabilitation process. - The embodiment shown and described herein has been made from hollow tube of rectangular cross section which is one type of a non-circular cross section that could be used. A similar device could be constructed from circular tubing; however, rectangular cross sections or other non-circular cross sections provide an abundance of surfaces to resist twisting motion on the
angled bar 50 and mountingbar 40 which could cause loosening or breakage or otherwise impair the use of the components. - The embodiment shown and described herein has included
notches bar 40 so that theangled bar 50 can rotate within the mountingbar 40. However, one skilled in the art could achieve appropriate rotatable coupling between the mountingbar 40 and theangled bar 50 in a variety of ways with a variety of materials that are within the scope of this invention. For example, hinges could be used where the twobars angled bar 50 could sit beside the mountingbar 40, and appropriate offsets in theseat 12,receptacle 28, or bars 40, 50 would provide for the comfort of the patient. - While the present invention has been illustrated by the description of one or more embodiments thereof, and while the embodiments have been described in considerable detail, they are not intended to restrict or in any way limit the scope of the appended claims to such detail. Additional advantages and modifications will readily appear to those skilled in the art, including substitution of materials, shapes, and attachment options. Some other options contemplated but not shown are to build the device into a chair or similar seating arrangement, and/or to provide a backrest. Also, although the mounting
bar 40 andangle bar 50 are shown in their shortest versions possible with the bars only long enough to position the end holes 42, 52, 64, and 68 where they are required, the bars could also be longer than shown. The invention in its broader aspects is not limited to specific details, representative apparatus, and method and illustrative examples shown and described. Various features described herein may be used alone or in any combination. Accordingly, departures may be made from such details without changing the general inventive concept.
Claims (20)
1. A device for manipulating the knee comprising:
a seating portion;
a mounting bar coupled to said seating portion to extend between the legs of a person on said seating portion, said mounting bar extending forward from said seating portion and having a pivot axis, said mounting bar adjustably attached to said seating portion such that said pivot axis can be approximately aligned with the user's knee;
an angled bar rotatably coupled to said mounting bar at said pivot axis, said angled bar having an upper component above said pivot axis and a lower component below said pivot axis;
a handle attached to said upper component of said angled bar; and
a leg engaging pad attached to said lower component of said angled bar;
wherein said device extends the knee of the user to a substantially straight orientation when the user sits on said seating portion and pulls on said handle.
2. The device of claim 1 , wherein said angled bar presents an angle between said upper component and said lower component in the range of approximately 120 degrees to approximately 150 degrees.
3. The device of claim 2 further comprising:
a receiver on said seating portion, said receiver having a plurality of holes;
at least one aperture in said mounting bar;
a pin sized to be received by a selected one of said plurality of holes and a selected one of said apertures in said mounting bar to adjustably attach said mounting bar to said seating portion.
4. The device of claim 2 further comprising:
a receiver on said seating portion, said receiver having at least one hole;
a plurality of apertures in said mounting bar;
a pin sized to be received by a selected one of said plurality of apertures in said mounting bar, and a selected one of said holes in said receiver, to adjustably attach said mounting bar to said seating portion.
5. The device of claim 1 wherein said angled bar presents an angle between said upper component and said lower component of about 135 degrees.
6. The device of claim 1 , wherein said leg engaging pad is adjustable to be located on one of oppositely facing sides of said lower component for engaging either leg of the user.
7. The device of claim 1 , wherein said leg engaging pad is adjustable along said lower component of said angled bar to conform to a length of the user's leg.
8. The device of claim 1 , wherein said leg engaging pad comprises an axle and a foam pad overlying said axle, said foam pad rotatably coupled to said axle.
9. The device of claim 1 , further comprising a strap coupled to said seating portion for securing at least one of said user's legs to said seating portion.
10. The device of claim 1 , wherein said handle is attached proximate an end of said upper component of said angled bar.
11. The device of claim 1 , wherein said pivot axis is proximate an end of said mounting bar.
12. The device of claim 1 , further comprising at least one pinch guard proximate said pivot axis.
13. A device for manipulating the knee comprising:
a seating portion having a centerline, a forward edge, a receiver on top of said centerline proximate said forward edge, said receiver having at least one receiver hole;
a first pin sized to be received into said receiver hole;
a mounting bar having a first end with at least one first hole, and a second end, said mounting bar slidable in said receiver such that said first hole in said first end can be aligned with said receiver hole in said receiver and said first pin can be inserted through a selected receiver hole in the receiver and a selected first hole, said mounting bar extending forward from said seating portion so that said second end is exterior to said receiver;
an angled bar rotatably coupled to said second end of said mounting bar, said angled bar having an upper component and a lower component disposed at an angle of approximately 120 degrees to approximately 150 degrees to said upper component, and further comprising a handle on said upper component, and a leg engaging pad on said lower component;
whereby a user's knee is manipulated by the user when said handle is pushed or pulled when the user's leg is in contact with said leg engaging pad.
14. The device of claim 13 , wherein said angle is about 135 degrees.
15. The device of claim 13 , further comprising a second pin, a hole in said second end of said mounting bar sized to receive said second pin, and a hole in said angled bar adapted to rotate around said second pin to rotatably couple said angled bar to said mounting bar.
16. The device of claim 13 , wherein said mounting bar has a non-circular cross section.
17. The device of claim 16 , wherein said cross section of said mounting bar is rectangular.
18. The device of claim 13 , wherein said mounting bar comprises a hollow tube of rectangular cross section, said mounting bar further comprising a top notch and a bottom notch proximate said second end to allow said upper component of said angled bar and said lower component of said angled bar to rotate about said pivot axis within said hollow tube.
19. The device of claim 13 , wherein said leg engaging pad is adjustable along said lower component of said angled bar.
20. The device of claim 19 , wherein said lower component of said angled bar further comprises a plurality of holes, and said leg engaging pad further comprises a retained pin sized to engage said plurality of holes, and a spring biased to engage said retained pin in said plurality of holes.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
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US11/777,658 US20090017995A1 (en) | 2007-07-13 | 2007-07-13 | Knee manipulating device |
Applications Claiming Priority (1)
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US11/777,658 US20090017995A1 (en) | 2007-07-13 | 2007-07-13 | Knee manipulating device |
Publications (1)
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US20090017995A1 true US20090017995A1 (en) | 2009-01-15 |
Family
ID=40253637
Family Applications (1)
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US11/777,658 Abandoned US20090017995A1 (en) | 2007-07-13 | 2007-07-13 | Knee manipulating device |
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