JP2004081638A

JP2004081638A - Apparatus for lumbago treatment

Info

Publication number: JP2004081638A
Application number: JP2002247947A
Authority: JP
Inventors: Kazuhiro Kondo; 近藤和宏; Toshiki Konishi; 小西俊毅
Original assignee: Howa Machinery Ltd
Current assignee: Howa Machinery Ltd
Priority date: 2002-08-28
Filing date: 2002-08-28
Publication date: 2004-03-18

Abstract

<P>PROBLEM TO BE SOLVED: To provide an apparatus for lumbago treatment which rotates, inverts and swings the waist part of a patient in a circle or an ellipse of an arbitrary shape and size in a state wherein the waist part is pulled. <P>SOLUTION: A pulling device 11 which can pull the lumbar spine of the patient to the foot side is disposed on one end side of a bed 7 provided with a bedstead on a frame 5, while a side locking device 13 which can engage the upper body part of the patient is disposed on the other end side of the bed, with side holding implements 12 interposed. The bedstead is divided into a deck 23 for the upper body part, a deck 25 for the waist part and a deck 27 for the leg part, and the deck 25 for the waist part and the deck 27 for the leg part are so provided on the frame 5 that they can be moved apart from and near to the deck 23 for the upper body part. The deck 25 for the waist part is provided with a waist rotating device 40 which can move the deck 25 two-dimensionally by a lateral movement mechanism that can be moved linearly to the right and the left by a servomotor, by a vertical movement mechanism that can be moved up and down linearly by a servomotor and by a control device that can control the two servomotors. <P>COPYRIGHT: (C)2004,JPO

Description

【０００１】
【発明の属する技術分野】
本発明は、フレームに患者が仰向けに横たわる寝台を設けたベッドと、患者の腰に装具を装着して患者の腰椎を装具牽引機により足元側へ牽引可能な牽引装置と、患者の脇に脇当具を当てて患者の上半身部を係止可能な脇係止装置を備えている腰痛治療装置に関する。
【０００２】
【従来の技術】
古くから、腰痛が慢性化した座骨神経痛、老化に伴なう変形性脊椎症，推間板ヘルニア，脊椎分離症，すべり症などの前段階となる初期の痛み等を取り除く関節モビリゼーションが行われている。一般に、腰痛に対しては、人手によって、腰部を牽引したり、腰部を左右、前後に動かしたり、腰部を左右に揺動させたり、腰部を回転させる等のマッサージを行い、椎間盤間を拡大して腰痛緩和することが行われている。
そして、腰部を機械的に牽引するための装置としては、特開平３−１６５６３号公報、特開平５−４９６６９号公報、特開平８−１９５６１号公報等に記載されている電気式牽引機により腰部を自動牽引する腰痛治療機が実用化されている。また、腰部を機械的に牽引する腰痛治療機の治療効果を増大させるために、特開平５−４９６６９号公報に記載されているように牽引状態の患者の腰部に振動体による振動や加温体による温熱を加えるようにしたり、特開２００１−１６１７６４号公報、特開２００１−１７８７５６号公報に記載されているように腰部を引上げた状態で横揺れさせるようにした腰痛治療機や、特開２０００−２３７２２２号公報に記載されているように臀部用台に臀部を固定させ、臀部用台を牽引しながら患者の背骨軸を中心に回転又は反転揺動するようにした腰痛治療機が提案されている。
【０００３】
【発明が解決しようとする課題】
前記特開平５−４９６６９号公報に記載の腰痛治療機では、牽引状態の患者の腰部に振動や温熱を加えることができるので、牽引治療と振動温熱治療を併用して治療工程や治療時間を短縮できる等の効果を奏するが、牽引治療は単に腰部を装具を介して装具牽引機により足元側へ牽引するものであるので、牽引による腰痛緩和効果が今だ充分でない課題があった。
また、特開２０００−２３７２２２号公報に記載の腰痛治療機では、腰部を牽引する為に臀部用台に腰部を固定するようにしてあるので、臀部用台のローリング移動により腰部が強制的に移動され、患者に拘束感や恐怖感を与える問題がある。また、中間部が支承されている脚の下端部をローリング手段により回転又は反転するようにしているので、脚の上端部に固着された臀部用台が回転又は反転されるときに左右に傾倒（傾動）し、患者に不安感を与える問題がある。また、臀部用台を支える脚の下端部をローリング手段の偏心出力軸を用いて回転又は反転するようにしているので、腰部を回転又は反転させる高さ位置の調整が面倒である。また、臀部用台を回転又は反転させるものであるから、腰部を左右移動量に対して上下移動量が小さくなる楕円運動や左右揺動等の運動を行わせることができない操作上の問題があり、左右変位量を大きくすると上下変位量も同じように大きくなって腰部に無理な負担をかける危険性がある。しかも、牽引機で牽引される臀部用台に臀部を固定させ、臀部用台と脚部用台を牽引機で牽引して患者の腰部を牽引するので、患者の腰部に作用する実際の牽引力を正しく把握することが困難で、牽引力の設定を誤り易い問題がある。また、偏心出力軸の偏心量を変更して臀部用台の回転半径を調整すると、その調整量だけ臀部用台の回動スタート位置が上下方向にずれてしまい、別の機構で臀部用台の高さを元に戻さなければならない面倒な作業を必要とする操作上の大きな問題がある。
【０００４】
本発明は、上記問題点を解消し、装具牽引機により牽引される装具を患者の腰部に装着して患者の腰部を正確な牽引力により効率よく牽引することができ、しかも、患者の腰部を載置する腰部用台を傾倒（傾動）することなくそのままの姿勢で、患者に拘束感や恐怖感を与えることなく、円や楕円に回転、反転させたり、左右又は上下に移動させたりでき、また、腰部用台の回転や反転の半径や左右上下移動量を容易に調整できると共に、同じ機構で腰部用台の高さを容易に調整したり元に戻すことができる腰痛治療装置を提供するものである。
【０００５】
【課題を解決するための手段】
上記目的を達成すべく、請求項１に記載の発明は、フレームに患者が仰向けに横たわる寝台を設けたベッドと、患者の腰に装具を装着して患者の腰椎を装具牽引機により足元側へ牽引可能な牽引装置と、患者の脇に脇当具を当てて患者の上半身部を係止可能な脇係止装置を備えた腰痛治療装置において、寝台を、患者の上半身部を載せる上半身部用台と、患者の腰部を載せる腰部用台と、患者の下肢部を載せる脚部用台とに分割し、腰部用台と脚部用台をフレームに上半身部用台に対して遠近移動可能に設け、脚部用台には腰部用台をそのままの姿勢で上下左右へ二次元移動可能な腰回動装置を設けて成ることを特徴としている。
また、請求項２に記載の発明は、患者の脇に脇当具を当てて患者の上半身部を係止可能な脇係止装置をフレームに設け、上半身部用台をフレームに寝台の長手方向へ移動かつ固定可能に設けたことを特徴としている。
また、請求項３に記載の発明は、腰回動装置を、サーボモータの回転によって左右方向へ直線移動可能な左右移動機構とサーボモータの回転によって上下方向へ直線移動可能な上下移動機構とを組合わせた直交移動装置と、直交移動装置の両サーボモータの回転を制御して腰部用台を回動可能な制御装置とで構成したことを特徴としている。
また、請求項４に記載の発明は、脚部用台に左右移動体を左右移動可能に設け、左右移動体と脚部用台の間に左右移動体を左右移動可能な移動装置を設けて左右移動機構を構成し、左右移動体に上下移動体を上下移動可能に設け、上下移動体と左右移動体の間に上下移動体を上下移動可能な移動装置を設けて上下移動機構を構成し、上下移動体の上部に腰部用台を固着したことを特徴としている。
また、請求項５に記載の発明は、上下移動機構の移動装置にボールネジを備え、左右移動体と上下移動体の間に上下移動体が急激落下しないように上向きの付勢力を加える付勢装置を設けたことを特徴としている。
また、請求項６に記載の発明は、制御装置に、左右移動機構の左右移動量と上下移動機構の上下移動量を入力する移動量入力手段と、腰部用台の基準高さ位置を入力する高さ入力手段と、上下移動機構の上下移動と左右移動機構の左右移動を同期作動させて腰部用台が入力された大きさで回転するように制御する回転制御手段と、上下移動機構を腰部用台の腰回動スタート位置の高さが入力された基準高さとなるように制御する高さ制御手段を備えて成ることを特徴としている。
【０００６】
【発明の実施の形態】
以下、本発明に係る腰痛治療機の実施形態を詳述する。図１〜図１０は、本発明の腰痛治療装置の一形態で、図１は側面図、図２は平面図、図３は正面図、図４は図１の腰回動装置部分の拡大図、図５は図４の右側から見た正面図、図６は図５図の平面図、図７〜１０は断面図である。
【０００７】
図１、２において、本発明の腰痛治療装置１は、患者Ｗが仰向けに横たわる寝台３をフレーム５に設けたベッド７と、患者Ｗの腰に装具８を装着して患者の腰椎を装具牽引機９により足側へ牽引可能な牽引装置１１と、患者の脇に脇当具１２を当てて患者の上半身部を係止可能な脇係止装置１３から構成されている。
ベッド７において、フレーム５は、２本の平行な長いレール部材１５の両端部どうしを連結部材１６で連結して矩形の台枠１７を構成し、両連結部材の中央部分から下向きに支持杆１８を固着し、これらの支持杆１８にパイプ材をコ字状に曲げて形成した一対の支持脚１９の中間部を平面形状がく字状になるように当接させて固着すると共に支持脚１９の上側脚部１９ａをレール部材１５に固着し、各支持脚１９の下側脚部１９ｂに高さ調整可能な支持具２０を装着して構成してある。レール部材１５には枠内側に案内溝１５ａが全長に亘って形成されている
【０００８】
寝台３は、患者Ｗの上半身部を載せる矩形の上半身部用台２３と、患者Ｗの腰部を載せる矩形の腰部用台２５と、患者Ｗの下肢部を載せる矩形の脚部用台２７とに分割されている。上半身部用台２３と脚部用台２７には、各角部付近の下面に夫々ローラ２９を回転自在に支持しているローラ支持具３０が取着されている。各ローラ支持具３０のローラ２９は対応する側のレール部材１５の案内溝１５ａに案内移動可能に嵌合され、脚部用台２７が上半身部用台２３に対して遠近移動可能に設けてある。上半身部用台２３は、図示しない引張りスプリングによって頭部側へ付勢され、通常は図１に示す待機位置に位置決めされるようになっている。また、上半身部用台２３と脚部用台２７は、夫々図示しないロック手段によって、図１に示す待機位置にロックできるようになっている。
【０００９】
腰部用台２５の上面には、患者Ｗの腰部の左右位置を安定させるための左右一対のクッション部材（弾性部材）から成る位置決め部材２６が取着されている。また，脚部用台２７には、腰部用台２５側端部の中央部に一対の平行な補強枠３１を固着し、両補強枠３１の端部に下方へ張出す支持枠３７が夫々固着されている。両支持枠３７には後記するように腰部用台２５をそのままの姿勢で上下左右へ二次元移動可能な腰回動装置４０が装着されている。従って、腰部用台２５も上半身部用台２３に対して遠近移動可能に設けられている。
【００１０】
次に、腰回動装置４０は、図４〜図１０に示すように構成されている。この腰回動装置４０は、サーボモータ４１の回転によって左右方向へ直線移動可能な左右移動機構４２とサーボモータ５１の回転によって上下方向へ直線移動可能な上下移動機構５２とを組合わせた直交移動装置６０と、両サーボモータ４１、５１の回転を制御する制御装置６９とで構成されている。
直交移動装置６０の左右移動機構４２は、両支持枠３７に両端部を固着した左右方向の上下一対の並行な直線ガイドバー４３と、これらの２本の直線ガイドバー４３に左右移動自在に設けてある左右移動体４４と、左右移動体４４と支持枠３７（脚部用台２７に固定）の間に左右移動体４４を左右移動可能に設けた移動装置３５を備えている。
【００１１】
左右移動体４４は、円形窓３９を設けた正方形の移動板４７の各コーナ部に夫々摺動ブロック４８を一体に設け、上下の摺動ブロック４８間に移動板４７から脚部側へ張出す垂直板４７ａを一体に設けると共に、左右の摺動ブロック４８間に移動板４７から頭部側へ張出す水平板４７ｂを一体に設けて構成してある。左右移動体４４は鋳物によって一体成形すると良い。各摺動ブロック４８に左右方向の孔を脚部側へ偏らせて形成し、各左右方向の孔に嵌合固着したスリーブ４９ａを直線ガイドバー４３に摺動自在に嵌合させてある。
【００１２】
移動装置３５は次のように構成されている。左右移動体４４の一方の垂直板４７ａには、図７に示すように直線ガイドバー４３間の位置にナット体４５を左右方向軸線を中心に回転自在に支承する支承体５０を固着し、ナット体４５に螺合した送りねじ軸４６の一端部を支持枠３７に固着してある。ナット体４５と送りねじ軸４６はボールネジを構成し、ナット体４５内の多数のボールが送りねじ軸４６のねじ溝に嵌合して小さい摩擦で円滑に相対移動するようになっているが、ボールネジ以外の構成でも構わない。また、左右移動体４４の一方の垂直板４７ａには、ナット体４５を正逆回転させるサーボモータ４１を固定的に支持している支持ブラケット５３を固着してある。サーボモータ４１の駆動軸に設けた駆動プーリ４１ａとナット体４５に設けた従動プーリ４５ａにはタイミングベルト３８を懸回し、サーボモータ４１によりナット体４５を正逆回転させると、ナット体４５が左右移動体４４を左右移動させるようにしてある。タイミングベルト３８部分は安全カバーで覆われている。
【００１３】
次に、直交移動装置６０の上下移動機構５２は、左右移動体４４に上下移動自在に設けられた上下移動体５４と、上下移動体５４と左右移動体４４の間に上下移動体５４を上下移動可能に設けた移動装置３６と、左右移動体４４と上下移動体５４の間に上下移動体５４が停電等の際に急激落下しないように上向きの付勢力を加える付勢装置３３とを備えている。
上下移動体５４は、左右移動体４４の各摺動ブロック４８に頭部側へ偏らせて形成した上下方向の孔に嵌合固着したスリーブ４９ｂに上下摺動自在に嵌合されている上下方向の左右一対の並行な直線ガイドバー５５と、左右一対の直線ガイドバー５５の下端部に固着されて両者を連結している連結部材５６と、左右一対の直線ガイドバー５５の上端部に一体に固着されて両者を連結している連結部材兼用の台取付部材５７とで枠組みして構成されている。台取付部材５７の上部は、腰部用台２５の中央部下面に固着されている。
【００１４】
移動装置３６は次のように構成されている。左右移動体４４の下側の水平板４７ｂには、直線ガイドバー５５間の位置にナット体５８を上下方向軸線を中心に回転自在に支承する支承体５９を固着し、ナット体５８に螺合した送りねじ軸６１の下端部を上下移動体５４の下側の連結部材５６に固着してある。ナット体５８と送りねじ軸６１はボールネジを構成しているが、ボールネジ以外の構成でも構わない。また、左右移動体４４の下側の水平板４７ｂには、両直線ガイドバー５５間の位置にナット体５８を正逆回転させるためのサーボモータ５１を固定的に支持している支持ブラケット６２を固着してある。サーボモータ５１の駆動軸に設けた駆動プーリ５１ａとナット体５８に設けた従動プーリ５８ａにはタイミングベルト６３を懸回し、サーボモータ５１によりナット体５８を正逆回転させると、ナット体５８が上下移動体５４を上下移動させるようにしてある。タイミングベルト６３部分は安全カバーで覆われている。
付勢装置３３は、左右移動体４４の下側の摺動ブロック４８と上下移動体５４の台取付部材５７との間に左右一対のガススプリング３４を介在させて構成してある。ガススプリング３４は本体３４ａを台取付部材５７に、プランジャ３４ｂを摺動ブロック４８に連結し、プランジャ３４ｂを突出させようとする力によって台取付部材５７に上向きの適宜大きさの付勢力を作用させるようにしてある。付勢装置３３は、コイルスプリングやウエイトを利用したものでも良い。
従って、腰回動装置４０は、直交移動装置６０の左右移動機構４２と上下移動機構５２によって腰部用台２５をそのままの姿勢で上下左右へ二次元移動可能に構成されている。また、上記腰回動装置４０では、直線ガイドバーとスリーブを用いて左右上下に案内するように構成しているので、製造コストを低くすることができる。また、左右移動機構４２の移動板４７を挟んで、脚部側に、左右方向への案内部分（摺動ガイドバー４３）と左右方向への移動装置３５を配設し、頭部側に、腰部用台２５の上下方向への案内部分（摺動ガイドバー５５）と上下方向への移動装置３６を配設しているので、摺動ガイドバー４３に対する腰部用台２５の上下移動位置の張出量を小さくできて、腰部用台２５の上下左右移動を円滑にかつ安定させることができる。
【００１５】
両サーボモータ４１、５１の回転を制御する制御装置６９は、後記する装具牽引機９の本体１０に組み込まれている。この制御装置６９は、腰部用台２５の基準高さ位置（腰回動スタート位置）を設定する高さ設定手段７１と、左右移動機構４２の左右移動量と上下移動機構５２の上下移動量を設定する移動量設定手段７３と、左右移動機構４２の左右移動と上下移動機構５２の上下移動を同期作動させて腰部用台２５が設定された大きさの中心距離で正逆転するように制御する回転制御手段７５と、左右移動機構４２と上下移動機構５２による腰部用台２５の回転速度を１回転当たりの時間で設定する速度設定手段７７と、上下移動機構５２を腰部用台２５の高さを設定された基準高さ位置になるように制御する高さ制御手段７９を備えている。
【００１６】
また、制御装置６９は、腰回動装置４０による腰回動を装具牽引機９による牽引操作を行っている間に休止時間をあけて所定時間ずつ例えば２回行うことができるように、最初に牽引のみを行う第１回牽引時間と、次に牽引を行いながら腰回動を行う第１回腰回動時間と、次に牽引のみを行う第２回牽引時間と、次に牽引を行いながら腰回動を行う第２回腰回動時間と、最後に牽引のみを行う第３回牽引時間とを夫々プログラム設定可能な作動設定手段８０を備えている。腰回動時間は腰部を１回転（又は１揺動）させる時間及び正逆転回数と交互回転か順次回転かの区別で設定する。なお、制御装置６９は、公知の設定器や制御回路やプログラム等によって構成できるので、具体的な構成の説明を省略する。
【００１７】
次に、図１、２において、患者の上半身部を係止可能な脇係止装置１３は、フレーム５の端部に水平に固着した支承軸８１の両端部に夫々支承体８２を支承軸８１の軸線を中心に回動可能でかつ摩擦保持可能に装着し、それらの支承体８２に夫々肩押えアーム８３の一端部を支承体８２の回動軸線に対して直角な軸線を中心にして回動可能でかつ摩擦保持可能に装着し、肩押えアーム８３の他端部に柔軟なクッシヨン材でできた脇当具１２を装着して構成してある。肩押えアーム８３は、支承体８２を介して、脇当具１２が上半身部用台２３の上面に当接又は近接した位置から上側へ９０度程度回動した位置との間で人手により容易に上下回動でき、また脇当具１２が互いに接近した位置から上半身部用台２３の側端部までの間で人手により容易に左右回動できるようになっている。
【００１８】
また、図１、２において、患者Ｗの腰椎を足側へ牽引可能な牽引装置１１は公知のものを示しており、ベッド７のフレーム５の一端部に固着されている公知の装具牽引機９と、装具牽引機９により牽引可能で、先端部に係止金具９１を取着してあるワイヤーから成る牽引紐９２と、患者Ｗの腰に装着可能で、先端部に係止金具９１を係止するための係止具９３を取着してある装具８とを備えている。装具８は、公知のように、上側が開放されている弾性変形可能なＣ字形の腰当板８ａと、腰当板８ａに連結されて開放部を閉じて締め付ける締付バンド８ｂと、腰当板８ａを左右部分で引張るための引張り部材８ｃを備えているが、これに特定されるものではない。
【００１９】
装具牽引機９は、本体１０がフレーム５の脚部用台２７側（足側）に固定的に配置され、滑車９４に懸回された牽引紐９２を図示しない公知のリールウインチ等を使って巻回し、患者Ｗの腰に装着した装具８を患者Ｗの足側へ略水平方向へ引っ張ることができるようになっている。装具牽引機９で牽引紐９２を牽引する力は、本体１０に設けた制御盤９８により、例えば０〜９５０Ｎの任意の値に設定できるようにしてある。一般的に、患者Ｗの体重の約１／３を目安として牽引が行われ、約２００Ｎ〜５００Ｎの範囲で引っ張られる。なお、図１において、１００は膝載置具、１０１は枕を示す。
【００２０】
次に上記腰痛治療機１の作用について説明する。運転に先立って、装具牽引機９で牽引する力を制御盤９８により例えば２５０Ｎに設定する。また、制御装置６９の高さ設定手段７１により、腰部用台２５の基準高さ位置を患者Ｗに適した大きさ例えば４０ｍｍに設定し、移動量設定手段７３により腰部を回転させるための左右移動機構４２の左右移動量と上下移動機構５２の上下移動量を例えば４０ｍｍと３０ｍｍに設定し、速度設定手段７７により腰部用台２５の回転速度を１回転当たりの時間で例えば３０秒と設定する。また、制御装置６９の作動設定手段８０により最初に牽引のみを行う第１回牽引時間を例えば２分と設定し、次に腰回動を行う第１回腰回動時間を正逆回転回数で例えば交互に各３回合計６回（３分）と設定し、次に牽引のみを行う第２回牽引時間を例えば２分と設定し、次に腰回動を行う第２回腰回動時間を正逆回転回数で例えば交互に各４回合計８回（４分）と設定し、最後に牽引のみを行う第３回牽引時間を例えば２分と設定する。
【００２１】
次に、上半身部用台２３と脚部用台２７を図１の待機位置にロックした状態で、かつ、脇係止装置１３の肩押えアーム８３を上方へ回動させて脇当具１２を上半身部用台２３の上方空間から略外れた位置へ上向きに起立させた状態で、患者Ｗを上半身部用台２３と腰部用台２５と脚部用台２７の寝台３の上に仰向けに寝かせ、その後脇係止装置１３の肩押えアーム８３を患者Ｗ側へ傾動させて脇当具１２を患者Ｗの脇に当てると共に肩を押える。この場合、患者Ｗの身長の大小により脇当具１２が患者Ｗの脇に当たらないときは、上半身部用台２３と脚部用台２７のロックを外して上半身部用台２３を移動させて脇当具１２を患者Ｗの脇に当接させる。また、患者Ｗの腰部に牽引装置１１の装具８を装着する。
【００２２】
次に、上半身部用台２３と脚部用台２７のロックを外した状態で、始動スイッチを入れると、高さ制御手段７９により上下移動機構５２のサーボモータ５１を作動させて腰部用台２５の高さを設定された基準高さ位置まで４０ｍｍ上昇させる。次に、牽引装置１１の装具牽引機９が作動して牽引紐９２を牽引し、装具８によって患者Ｗの腰部を設定した２５０Ｎの牽引力で牽引する。その結果、患者の腰痛が発生している腰あたりの脊椎が伸ばされる。患者Ｗの腰部が装具８によって直接牽引されるので、患者Ｗの腰部は正確な牽引力で牽引される。
【００２３】
この腰部の牽引動作を２分間継続すると、その牽引動作を継続した状態で、直交移動装置６０のサーボモータ４１、５１が回転制御手段７５により駆動され、腰部用台２５を設定された大きさである横軸が４０ｍｍ縦軸が３０ｍｍの楕円に設定された速度である１回転当たり３０秒のゆっくりとした速度で交互に正逆転させる。その結果、患者の脊椎が牽引力により伸ばされた状態で患者の脊椎が回動されることにより、関節面に円滑なスベリを生じ、腰部の関節の動きが良くなる。また、脊椎が伸ばされることで腰部の骨と骨の間に隙間ができ、その隙間を利用してゆっくりと関節を回動させることができ、関節に無理な力を加えることなくかつ傷みを加えることなく関節面に滑りを生じさせることができる。この腰回動装置４０による腰部の回転動作を設定された時間である交互に正逆転を各３回合計６回行うとサーボモータ４１、５１の回動が停止され、腰部の回転動作を停止する。
【００２４】
その後、牽引動作のみを２分間行った後、再び腰回動装置４０の直交移動装置６０のサーボモータ４１、５１が回転制御手段７５により駆動され、腰部用台２５を設定された大きさである横軸が４０ｍｍ縦軸が３０ｍｍの楕円で設定された速度である１回転当たり３０秒のゆっくりとした速度で回転させる。この腰回動装置４０による腰部の回転動作を設定した時間である８回転行うとサーボモータ４１、５１の回動が停止し、腰部の回転動作を停止する。その後、牽引動作のみを２分間行った後、装具牽引機９による牽引動作が停止して腰部の牽引を停止し、その後、高さ制御手段７９により上下移動機構５２のサーボモータ５１を作動させ、腰部用台２５の高さを４０ｍｍ下降させて上半身部用台２３と同じ元の高さ位置に戻す。なお、必要に応じて、以上の動作を休憩時間をあけて繰返しても良い。牽引動作を終えた後は、上半身部用台２３と脚部用台２７を図１の待機位置にロックし、患者Ｗの腰部から装具８を外した後、患者Ｗがベッドから降りることで、一連の操作を終了する。
【００２５】
次に、図１１〜図１３は腰回動装置の異なる実施形態を示すもので、図１１は腰回動装置部分の側面図、図１２は図１１の右側から見た正面図、図１３は図１２図の平面図である。この腰回動装置１４０は、直交移動装置１６０の左右移動機構１４２と上下移動機構１５２に直線転動装置（リニアガイドレール）を利用している。
直交移動装置１６０の左右移動機構１４２は、両支持枠３７に支持基板３７ａを固着し、その支持基板３７ａに左右方向の上下一対の直線ガイドレール１４３を並行に固着し、これらの直線ガイドレール１４３に左右移動体１４４が左右移動可能に設けられている。左右移動体１４４は、直線ガイドレール１４３に案内される左右一対の移動ブロック１４８に移動板１４７を固着して構成してある。左右移動体１４４と支持枠３７（脚部用台２７に固定）の間に左右移動体１４４を左右移動可能に設けた移動装置１３５は、移動板１４７の両直線ガイドレール１４３の間に左右方向の送りねじ軸１４６を回転自在に支承する一対の支承体１５０と送りねじ軸１４６を回転駆動するサーボモータ１４１を支持する支持ブラケット１５３を固着し、送りねじ軸１４６に螺合したナット体１４５を移動板１４７に固着して構成してあり、送りねじ軸１４６を回転させることで移動板１４７を左右移動させるようにしてある。
【００２６】
直交移動装置１６０の上下移動機構１５２は、前記移動板１４７に上下方向の左右一対の直線ガイドレール１５５を並行に固着し、これらの直線ガイドレール１５５に上下移動体１５４を上下移動可能に設けてある。上下移動体１５４は、直線ガイドレール１５５に案内される上下一対の移動ブロック１５６に移動板１５７を固着して構成してある。
上下移動体１５４と左右移動体１４４の間に上下移動体１５４を上下移動可能に設けた移動装置１３６は、移動板１５７の両直線ガイドレール１５５の側方に上下方向の送りねじ軸１６１を回転自在に支承する一対の支承体１５９と送りねじ軸１６１を回転駆動するサーボモータ１５１を支持する支持ブラケット１６２を固着し、送りねじ軸１６１に螺合したナット体１５８を移動板１５７に固着し、その移動板１５７には腰部用台２５の中央部下面に下向きに装着した台取付杆１６３を固着して構成してあり、送りねじ軸１６１を回転させることで腰部用台２５を上下移動させるようにしてある。
従って、腰回動装置１４０は、直交移動装置１６０の左右移動機構１４２と上下移動機構１５２によって腰部用台２５をそのままの姿勢で上下左右へ二次元移動可能に構成されている。
【００２７】
なお、上記例示では、腰回動装置４０，１４０によって腰部を交互に正逆転する場合を示したが、腰部を設定回数正転した後、設定回数逆転するように順次正逆転するようにしても良い。また、牽引動作中に腰回動装置を２回作動させる場合を示したが、腰回動装置４０、１４０を１回又は３回以上作動させるようにする等任意に変更しても良い。また、腰回動装置４０、１４０によって腰部を楕円回転させる場合を示したが、円回転させたり、左右に反転揺動させたり、左右移動（上下移動量を零にする）させるようにしても良い。
【００２８】
【発明の効果】
以上のように、請求項１の発明は、フレームに患者が仰向けに横たわる寝台を設けたベッドと、患者の腰に装具を装着して患者の腰椎を装具牽引機により足元側へ牽引可能な牽引装置と、患者の脇に脇当具を当てて患者の上半身部を係止可能な脇係止装置を備えた腰痛治療装置において、寝台を、患者の上半身部を載せる上半身部用台と、患者の腰部を載せる腰部用台と、患者の下肢部を載せる脚部用台とに分割し、腰部用台と脚部用台をフレームに上半身部用台に対して遠近移動可能に設け、脚部用台には腰部用台をそのままの姿勢で上下左右へ二次元移動可能な腰回動装置を設けたので、患者の腰部を正確な牽引力により効率よく牽引でき、しかも、その牽引状態で腰部用台を傾動させることなくそのままの姿勢で回転させたり揺動させることができ、患者の腰部を患者に拘束感や恐怖感を与えることなく安全に回転、揺動できて患者の腰痛を効率良く緩和できる。
【００２９】
また、請求項２の発明は、患者の脇に脇当具を当てて患者の上半身部を係止可能な脇係止装置をフレームに設け、上半身部用台をフレームに寝台の長手方向へ移動かつ固定可能に設けているので、身長の異なる患者であっても、脇係止装置の脇当具を患者の脇に正確に当てることができ、しかも、上半身部用台をフレームに固定することで、患者がベッドに安全に乗り降りできる利点がある。
また、請求項３の発明は、腰回動装置を、サーボモータの回転によって左右方向へ直線移動可能な左右移動機構とサーボモータの回転によって上下方向へ直線移動可能な上下移動機構とを組合わせた直交移動装置と、直交移動装置の両サーボモータの回転を制御して腰部用台を回動可能な制御装置とで構成したので、腰部用台を所望の大きさの円や楕円に容易に回転させたり、反転させたり、左右又は上下に揺動させたりでき、腰部の移動操作を簡易、迅速にできる。
【００３０】
また、請求項４の発明は、脚部用台に左右移動体を左右移動可能に設け、左右移動体と脚部用台の間に左右移動体を左右移動可能な移動装置を設けて左右移動機構を構成し、左右移動体に上下移動体を上下移動可能に設け、上下移動体と左右移動体の間に上下移動体を上下移動可能な移動装置を設けて上下移動機構を構成し、上下移動体の上部に腰部用台を固着したので、腰部の上下動に要する動力を小さくできる。
また、請求項５の発明は、上下移動機構の移動装置にボールネジを備え、左右移動体と上下移動体の間に上下移動体が急激落下しないように上向きの付勢力を加える付勢装置を設けているので、停電や故障等の際に腰部用台が急激に落下するのを阻止でき、患者の腰部を安全に保つことができる。
また、請求項６の発明は、制御装置に、左右移動機構の左右移動量と上下移動機構の上下移動量を入力する移動量入力手段と、腰部用台の基準高さ位置を入力する高さ入力手段と、上下移動機構の上下移動と左右移動機構の左右移動を同期作動させて腰部用台が入力された大きさで回転するように制御する回転制御手段と、上下移動機構を腰部用台の腰回動スタート位置の高さが入力された基準高さとなるように制御する高さ制御手段を備えているので、腰部用台を回転、揺動させる為の腰部用台の左右上下の移動量を容易に調整できると共に、同じ機構で腰部用台の高さを容易に調整したり元に戻すことができ、取扱いを容易にできる。
【図面の簡単な説明】
【図１】図１は腰痛治療装置の側面図である。
【図２】図２は図１の腰痛治療装置の平面図である。
【図３】図３は図１の右側から見た正面図である。
【図４】図４は図１の腰回動装置部分の拡大図である。
【図５】図５は図４の右側から見た正面図である。
【図６】図６は図５図の平面図である。
【図７】図７は図４のＶＩＩ−ＶＩＩ線拡大断面図である。
【図８】図８は図６のＶＩＩＩ−ＶＩＩＩ線拡大断面図である。
【図９】図９は図５のＩＸ−ＩＸ線拡大断面図である。
【図１０】図１０は図５のＸ−Ｘ線拡大断面図である。
【図１１】図１１は腰回動装置の異なる実施態様を示す側面図である。
【図１２】図１２は図１１の右側から見た正面図である。
【図１３】図１３は図１２図の平面図である。
【符号の説明】
１　腰痛治療装置
３　寝台
５　フレーム
７　ベッド
８　装具
９　装具牽引機
１１　牽引装置
１２　脇当具
１３　脇係止装置
２３　上半身部用台
２５　腰部用台
２７　脚部用台
３３　付勢装置
３５　移動装置
３６　移動装置
４０　腰回動装置
４１　サーボモータ
４２　左右移動機構
４４　左右移動体
５１　サーボモータ
５２　左右移動機構
５４　左右移動体
６０　直交移動装置
６９　制御装置[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention provides a bed provided with a bed on which a patient lies on his / her back, a brace attached to a patient's waist, a traction device capable of towing a patient's lumbar spine to a foot side by a brace traction machine, and an armpit beside a patient. The present invention relates to a low back pain treatment device including an armpit locking device capable of locking an upper body part of a patient by applying the device.
[0002]
[Prior art]
For a long time, joint mobilization has been carried out to remove the early stage of pain such as sciatica with chronic back pain, osteoporotic spondylopathy associated with aging, herniated disc, spondylolysis, and spondylolisthesis. ing. In general, for back pain, massage such as pulling the waist by hand, moving the waist left and right, back and forth, swinging the waist left and right, rotating the waist, etc. Back pain has been alleviated.
As a device for mechanically pulling the lumbar region, an electric traction machine described in JP-A-3-16563, JP-A-5-49669, JP-A-8-19561, etc. Has been put into practical use. Further, in order to increase the therapeutic effect of a low back pain treatment machine that mechanically pulls the lower back, vibrations caused by a vibrating body and a heating body are applied to the lower back of a patient in a traction state as described in JP-A-5-49669. Or a back pain treatment machine in which the lower back is pulled up as described in JP-A-2001-161765 and JP-A-2001-178756. As described in Japanese Patent Publication No. 237222, a low back pain treatment device has been proposed in which the buttocks are fixed to the buttocks table, and are rotated or inverted around the spine axis of the patient while pulling the buttocks table. I have.
[0003]
[Problems to be solved by the invention]
In the low back pain treatment machine described in JP-A-5-49669, vibration and heat can be applied to the lumbar region of a patient in a traction state, so that the traction treatment and the vibration heat treatment are used in combination to shorten the treatment process and the treatment time. Although such effects can be achieved, since the traction treatment simply involves pulling the lower back to the foot side by the brace traction machine via the brace, there is a problem that the lumbar pain relief effect is still insufficient.
Further, in the low back pain treatment machine described in Japanese Patent Application Laid-Open No. 2000-237222, the lower back is fixed to the buttocks table to pull the lower back, so the lower back is forcibly moved by rolling movement of the buttocks table. There is a problem that gives the patient a sense of restraint and fear. In addition, since the lower end of the leg on which the intermediate portion is supported is rotated or inverted by rolling means, when the buttocks table fixed to the upper end of the leg is rotated or inverted, it tilts left and right ( Tilting) and give patients anxiety. Further, since the lower ends of the legs supporting the buttocks table are rotated or inverted using the eccentric output shaft of the rolling means, adjustment of the height position at which the waist is rotated or inverted is troublesome. In addition, since the buttocks table is rotated or inverted, there is an operational problem that the waist cannot be exercised such as elliptical movement or left / right swing in which the vertical movement is smaller than the horizontal movement. On the other hand, when the lateral displacement is increased, the vertical displacement is similarly increased, and there is a risk of imposing an excessive burden on the waist. In addition, the buttocks are fixed to the buttocks table pulled by the towing machine, and the buttocks table and leg table are towed by the towing machine to pull the patient's waist, so the actual tractive force acting on the patient's waist is reduced. There is a problem that it is difficult to correctly grasp the traction force and the traction force is easily set incorrectly. In addition, when the eccentric amount of the eccentric output shaft is changed to adjust the rotation radius of the buttocks table, the rotation start position of the buttocks table is shifted in the vertical direction by the adjustment amount, and another mechanism is used to adjust the buttocks table. There is a major operational problem that requires tedious work that must be restored to its original height.
[0004]
The present invention solves the above-mentioned problems, and allows the orthosis to be pulled by the orthosis traction machine to be attached to the patient's waist so that the patient's waist can be efficiently towed by accurate traction, and the patient's waist can be placed on the lower back. Without tilting (tilting) the lumbar base to be placed, the patient can rotate, flip, or move left and right or up and down in a circle or ellipse without giving the patient a feeling of restraint or fear, The present invention provides a low back pain treatment device that can easily adjust the radius of rotation or inversion of the waist base and the amount of left / right up / down movement, and can easily adjust or return the height of the waist base with the same mechanism. It is.
[0005]
[Means for Solving the Problems]
In order to achieve the above object, the invention according to claim 1 provides a bed provided with a bed on which a patient lies on his / her back, a brace attached to the patient's waist, and the patient's lumbar spine toward the foot side by a brace traction machine. In a low back pain treatment device having a towable device and a side locking device capable of locking a patient's upper body by applying a side abutment to a side of the patient, the bed is used for an upper body on which the patient's upper body is placed. The base is divided into a pedestal, a lumbar base for placing the patient's waist, and a leg pedestal for placing the patient's lower limb, and the lumbar base and the leg pedestal can be moved in the frame relative to the upper body base. The leg base is provided with a waist rotation device capable of two-dimensionally moving up, down, left, and right with the waist base in the same posture.
The invention according to claim 2 is characterized in that a frame is provided with a side locking device capable of locking an upper body part of a patient by applying a side support to a side of a patient, and a table for an upper body part being mounted on the frame in a longitudinal direction of the bed. It is characterized in that it is provided so as to be movable and fixed.
According to a third aspect of the present invention, the waist rotation device includes a left-right moving mechanism capable of linearly moving in the left-right direction by the rotation of the servomotor and an up-down moving mechanism capable of linearly moving in the vertical direction by the rotation of the servomotor. It is characterized by comprising a combined orthogonal movement device and a control device capable of controlling the rotation of both servo motors of the orthogonal movement device to rotate the waist base.
According to a fourth aspect of the present invention, a left and right moving body is provided on the leg base so as to be movable left and right, and a moving device capable of moving the left and right moving body left and right is provided between the left and right moving body and the leg base. A left-right moving mechanism is configured, a vertical moving body is provided on the left-right moving body so as to be vertically movable, and a moving device capable of moving the vertical moving body up and down is provided between the vertical moving body and the left-right moving body to constitute a vertical moving mechanism. A waist base is fixed to the upper part of the vertical moving body.
According to a fifth aspect of the present invention, there is provided an urging device that includes a ball screw in a moving device of a vertical moving mechanism, and applies an upward urging force so that the vertical moving body does not suddenly fall between the left and right moving body and the vertical moving body. It is characterized by having provided.
According to a sixth aspect of the present invention, in the control device, a moving amount input means for inputting a left / right moving amount of the left / right moving mechanism and a vertical moving amount of the up / down moving mechanism, and a reference height position of the waist base are input. Height input means, rotation control means for controlling the waist base to rotate at the input size by synchronizing the vertical movement of the vertical movement mechanism and the horizontal movement of the horizontal movement mechanism, and It is characterized by comprising height control means for controlling the height of the waist rotation start position of the platform to be the input reference height.
[0006]
BEST MODE FOR CARRYING OUT THE INVENTION
Hereinafter, an embodiment of a low back pain treatment machine according to the present invention will be described in detail. 1 to 10 show an embodiment of a low back pain treatment apparatus according to the present invention. FIG. 1 is a side view, FIG. 2 is a plan view, FIG. 3 is a front view, and FIG. 5, FIG. 5 is a front view seen from the right side of FIG. 4, FIG. 6 is a plan view of FIG. 5, and FIGS.
[0007]
1 and 2, a low back pain treatment apparatus 1 of the present invention includes a bed 7 having a frame 5 on which a bed 3 on which a patient W lies lies on the back, and a brace 8 attached to the waist of the patient W to brace the lumbar spine of the patient. The device 9 includes a traction device 11 that can be pulled to the foot side by the machine 9 and a side locking device 13 that can lock the upper body of the patient by applying a side support 12 to the side of the patient.
In the bed 7, the frame 5 is formed by connecting both ends of two parallel long rail members 15 with a connecting member 16 to form a rectangular underframe 17, and supporting rods 18 extending downward from the central portions of both connecting members. The intermediate portions of a pair of support legs 19 formed by bending a pipe material into a U-shape are fixed to these support rods 18 so that the plane shape of the pair of support legs 19 is abutted and fixed. The upper leg 19a is fixed to the rail member 15, and the lower leg 19b of each support leg 19 is provided with a height-adjustable support 20. A guide groove 15a is formed in the rail member 15 inside the frame over the entire length.
[0008]
The couch 3 includes a rectangular upper body stand 23 on which the upper body of the patient W is placed, a rectangular waist table 25 on which the waist of the patient W is placed, and a rectangular leg stand 27 on which the lower limb of the patient W is placed. Has been split. A roller support 30 that rotatably supports the roller 29 is attached to the lower surface near each corner of the upper body stand 23 and the leg stand 27. The roller 29 of each roller support 30 is fitted in the guide groove 15a of the corresponding rail member 15 so as to be able to guide and move, and the leg base 27 is provided so as to be movable toward and away from the upper body stand 23. . The upper body stand 23 is urged toward the head by a tension spring (not shown), and is normally positioned at the standby position shown in FIG. The upper body stand 23 and the leg stand 27 can be locked to the standby position shown in FIG. 1 by locking means (not shown).
[0009]
A positioning member 26 composed of a pair of left and right cushion members (elastic members) for stabilizing the left and right positions of the waist of the patient W is attached to the upper surface of the waist table 25. Further, a pair of parallel reinforcing frames 31 is fixed to the center of the waist base 25 side end of the leg base 27, and support frames 37 projecting downward at the ends of both reinforcing frames 31 are respectively fixed. Have been. As will be described later, a waist rotation device 40 capable of two-dimensionally moving the waist base 25 up, down, left, and right with the same posture is mounted on both support frames 37. Therefore, the waist base 25 is also provided so as to be able to move toward and away from the upper body base 23.
[0010]
Next, the hip rotation device 40 is configured as shown in FIGS. This waist rotation device 40 is an orthogonal movement that combines a left-right movement mechanism 42 that can move linearly in the left-right direction by rotation of a servomotor 41 and an up-down movement mechanism 52 that can move linearly in the vertical direction by rotation of a servomotor 51. It comprises a device 60 and a control device 69 for controlling the rotation of both servomotors 41 and 51.
The right and left moving mechanism 42 of the orthogonal moving device 60 is provided with a pair of left and right parallel straight guide bars 43 fixed at both ends to both support frames 37, and is provided on these two straight guide bars 43 so as to be movable left and right. A left and right moving body 44 and a moving device 35 provided between the left and right moving body 44 and the support frame 37 (fixed to the leg base 27) so as to be able to move the left and right moving body 44 left and right.
[0011]
The left and right moving bodies 44 are provided with sliding blocks 48 integrally at respective corners of a square moving plate 47 provided with a circular window 39, and project from the moving plate 47 to the leg side between the upper and lower sliding blocks 48. A vertical plate 47a is provided integrally, and a horizontal plate 47b projecting from the moving plate 47 to the head side is provided integrally between the left and right sliding blocks 48. The left and right moving bodies 44 may be integrally formed by casting. In each sliding block 48, a hole in the left-right direction is formed so as to be deviated toward the leg portion, and a sleeve 49a fitted and fixed in each hole in the left-right direction is slidably fitted to the linear guide bar 43.
[0012]
The moving device 35 is configured as follows. As shown in FIG. 7, a support 50 for rotatably supporting the nut body 45 about the left-right axis is fixed to one of the vertical plates 47a of the left-right moving body 44 at a position between the linear guide bars 43. One end of a feed screw shaft 46 screwed to the body 45 is fixed to the support frame 37. The nut body 45 and the feed screw shaft 46 constitute a ball screw, and a large number of balls in the nut body 45 are fitted into the screw grooves of the feed screw shaft 46 and move relatively smoothly with small friction. A configuration other than the ball screw may be used. A support bracket 53 for fixedly supporting the servomotor 41 for rotating the nut body 45 in the forward and reverse directions is fixed to one vertical plate 47a of the left and right moving body 44. When the timing belt 38 is suspended around the drive pulley 41a provided on the drive shaft of the servomotor 41 and the driven pulley 45a provided on the nut body 45, and the nut body 45 is rotated forward and reverse by the servo motor 41, The moving body 44 is moved left and right. The timing belt 38 is covered with a safety cover.
[0013]
Next, the vertical moving mechanism 52 of the orthogonal moving device 60 moves the vertical moving body 54 between the vertical moving body 54 and the left and right moving body 44 up and down. A movable device 36 movably provided, and an urging device 33 for applying an upward urging force between the left and right moving bodies 44 and the up and down moving bodies 54 so that the up and down moving bodies 54 do not drop suddenly in the event of a power failure or the like. ing.
The vertical moving body 54 is vertically slidably fitted to a sleeve 49b fitted and fixed in a vertical hole formed in each sliding block 48 of the left and right moving body 44 so as to be biased toward the head. A pair of right and left parallel linear guide bars 55, a connecting member 56 fixed to the lower ends of the pair of right and left linear guide bars 55 and connecting the two, and an upper end of the pair of left and right linear guide bars 55 integrally. The frame is constituted by a base mounting member 57 which is also fixed and serves as a connecting member that connects the two. The upper part of the base mounting member 57 is fixed to the lower surface of the central part of the waist base 25.
[0014]
The moving device 36 is configured as follows. A support body 59 for rotatably supporting the nut body 58 about the vertical axis is fixed to the horizontal plate 47b on the lower side of the left and right moving body 44 at a position between the linear guide bars 55, and screwed to the nut body 58. The lower end of the feed screw shaft 61 is fixed to the lower connecting member 56 of the vertical moving body 54. Although the nut body 58 and the feed screw shaft 61 form a ball screw, a structure other than a ball screw may be used. A support bracket 62 fixedly supporting a servomotor 51 for rotating the nut body 58 in the forward and reverse directions is provided between the two linear guide bars 55 on the lower horizontal plate 47b of the left and right moving body 44. It is stuck. When a timing belt 63 is suspended around a drive pulley 51a provided on the drive shaft of the servomotor 51 and a driven pulley 58a provided on the nut body 58, and the nut body 58 is rotated forward and reverse by the servomotor 51, the nut body 58 is moved up and down. The moving body 54 is moved up and down. The timing belt 63 is covered with a safety cover.
The biasing device 33 is configured by interposing a pair of left and right gas springs 34 between a slide block 48 below the left and right moving body 44 and a table mounting member 57 of the vertically moving body 54. The gas spring 34 connects the main body 34a to the base mounting member 57 and connects the plunger 34b to the slide block 48, and applies an upwardly appropriate biasing force to the base mounting member 57 by a force for projecting the plunger 34b. It is like that. The urging device 33 may use a coil spring or a weight.
Therefore, the waist rotation device 40 is configured to be capable of two-dimensionally moving the waist base 25 up, down, left, and right in the same posture by the left and right movement mechanism 42 and the up and down movement mechanism 52 of the orthogonal movement device 60. Further, since the waist rotation device 40 is configured to be guided right and left and up and down by using the linear guide bar and the sleeve, the manufacturing cost can be reduced. Further, a guide portion (sliding guide bar 43) in the left-right direction and a moving device 35 in the left-right direction are disposed on the leg side with the moving plate 47 of the left-right moving mechanism 42 interposed therebetween. Since the vertical guide portion (sliding guide bar 55) of the waist table 25 and the vertical moving device 36 are provided, the vertical moving position of the waist table 25 with respect to the sliding guide bar 43 is stretched. The amount of protrusion can be reduced, and the vertical and horizontal movement of the waist base 25 can be smoothly and stably performed.
[0015]
A control device 69 for controlling the rotation of the two servomotors 41 and 51 is incorporated in the main body 10 of the equipment traction machine 9 described later. The control device 69 controls the height setting means 71 for setting a reference height position (waist rotation start position) of the waist base 25, the left / right movement amount of the left / right movement mechanism 42 and the up / down movement amount of the up / down movement mechanism 52. The movement amount setting means 73 to be set and the horizontal movement of the horizontal movement mechanism 42 and the vertical movement of the vertical movement mechanism 52 are operated synchronously to control the waist table 25 to rotate forward and reverse at a set center distance. Rotation control means 75, speed setting means 77 for setting the rotation speed of the waist base 25 by the left and right moving mechanism 42 and the vertical moving mechanism 52 in time per rotation, and the height of the waist base 25 by the vertical moving mechanism 52 Is provided with a height control means 79 for controlling the reference height position to a set reference height position.
[0016]
In addition, the control device 69 initially performs the waist rotation by the waist rotation device 40 twice a predetermined time, for example, with a pause time while the towing operation by the brace traction machine 9 is performed. A first towing time in which only towing is performed, a first torsion rotating time in which the torso is rotated next while performing towing, a second towing time in which only towing is performed next, and An operation setting means 80 is provided which can program a second hip rotation time for performing hip rotation and a third traction time for performing only traction last. The waist rotation time is set based on the time required to make one rotation (or one swing) of the waist, the number of forward / reverse rotations, and the distinction between alternate rotation and sequential rotation. In addition, since the control device 69 can be configured by a known setting device, control circuit, program, or the like, a detailed description of the configuration is omitted.
[0017]
Next, in FIGS. 1 and 2, the armpit locking device 13 capable of locking the upper body of the patient is provided with support bodies 82 at both ends of a support shaft 81 fixed horizontally to the end of the frame 5. Are mounted so as to be rotatable and frictionally holdable about the axis of the support body 82, and one end of the shoulder holding arm 83 is respectively rotated around the support body 82 about an axis perpendicular to the rotation axis of the support body 82. It is mounted so as to be movable and capable of holding friction, and the other end of the shoulder holding arm 83 is provided with a side support member 12 made of a flexible cushioning material. The shoulder holding arm 83 can be easily and manually moved between the position where the armpit support 12 abuts on or approaches the upper surface of the upper body part base 23 and the position where the armrest 12 is rotated upward by about 90 degrees through the support body 82. It can be turned up and down, and it can be easily turned left and right by hand between the position where the armrests 12 approach each other and the side end of the upper body stand 23.
[0018]
1 and 2, there is shown a known traction device 11 capable of towing the lumbar spine of the patient W to the foot side, and a known orthosis traction machine 9 fixed to one end of the frame 5 of the bed 7. And a pulling cord 92 made of a wire which can be pulled by the orthosis pulling machine 9 and has a locking fitting 91 attached to the distal end, and a locking fitting 91 which can be attached to the waist of the patient W and has a distal end. And a brace 8 to which a locking member 93 for stopping is attached. As is well known, the orthosis 8 includes an elastically deformable C-shaped waist pad 8a having an open upper side, a tightening band 8b connected to the waist pad 8a to close and tighten the opening. Although a tension member 8c for pulling the plate 8a at the left and right portions is provided, the invention is not limited to this.
[0019]
The orthosis traction machine 9 has a main body 10 fixedly disposed on the side of the leg base 27 (foot side) of the frame 5 and a traction cord 92 suspended around a pulley 94 using a known reel winch or the like (not shown). The brace 8 that is wound and attached to the waist of the patient W can be pulled substantially horizontally to the foot side of the patient W. The force for pulling the pull cord 92 by the equipment pulling machine 9 can be set to an arbitrary value of, for example, 0 to 950 N by a control panel 98 provided on the main body 10. Generally, the traction is performed with about 1/3 of the weight of the patient W as a guide, and the traction is performed in the range of about 200N to 500N. In FIG. 1, 100 indicates a knee rest and 101 indicates a pillow.
[0020]
Next, the operation of the low back pain treatment machine 1 will be described. Prior to the operation, the force to be pulled by the equipment pulling machine 9 is set to, for example, 250 N by the control panel 98. Further, the height setting means 71 of the control device 69 sets the reference height position of the lumbar base 25 to a size suitable for the patient W, for example, 40 mm, and the movement amount setting means 73 moves the lumbar left and right to rotate. The horizontal movement amount of the mechanism 42 and the vertical movement amount of the vertical movement mechanism 52 are set to, for example, 40 mm and 30 mm, and the rotation speed of the waist base 25 is set to, for example, 30 seconds per rotation by the speed setting means 77. In addition, the first towing time in which only towing is performed first is set to, for example, 2 minutes by the operation setting means 80 of the control device 69, and the first torsion time in which hip rotation is performed next is determined by the number of forward and reverse rotations. For example, alternately three times each for a total of six times (3 minutes), a second towing time for performing only towing is set to, for example, 2 minutes, and a second waist rotating time for performing next hip rotation. Are set alternately, for example, four times each for a total of eight times (four minutes), and the third towing time for performing only towing at the end is set to, for example, two minutes.
[0021]
Next, in a state in which the upper body stand 23 and the leg stand 27 are locked in the standby position in FIG. The patient W is laid on his or her back on the bed 3 of the upper body stand 23, the waist stand 25, and the leg stand 27 in a state of standing upright to a position substantially out of the space above the upper body stand 23. After that, the shoulder holding arm 83 of the armpit locking device 13 is tilted toward the patient W side so that the armpit abutment tool 12 contacts the side of the patient W and presses the shoulder. In this case, when the armrest 12 does not hit the side of the patient W due to the height of the patient W, the upper body stand 23 and the leg stand 27 are unlocked and the upper body stand 23 is moved. The armrest device 12 is brought into contact with the side of the patient W. Further, the brace 8 of the traction device 11 is mounted on the waist of the patient W.
[0022]
Next, when the start switch is turned on in a state where the upper body stand 23 and the leg stand 27 are unlocked, the height control means 79 operates the servo motor 51 of the up-down movement mechanism 52 to cause the waist stand 25 to move. Is raised by 40 mm to the set reference height position. Next, the orthosis traction machine 9 of the traction device 11 operates to pull the traction cord 92, and the orthosis 8 pulls the waist of the patient W with the set traction force of 250 N. As a result, the spine around the lower back where the patient has low back pain is lengthened. Since the waist of the patient W is towed directly by the brace 8, the waist of the patient W is towed with an accurate traction force.
[0023]
When this waist traction operation is continued for 2 minutes, the servo motors 41 and 51 of the orthogonal movement device 60 are driven by the rotation control means 75 in a state where the traction operation is continued, and the waist table 25 is set to the set size. Certain horizontal and vertical axes are alternately rotated forward and backward at a slow speed of 30 seconds per rotation, which is a speed set to an ellipse of 40 mm and a vertical axis of 30 mm. As a result, the patient's spine is rotated while the patient's spine is stretched by the traction force, so that a smooth slippage is produced on the joint surface, and the motion of the joint of the lumbar region is improved. In addition, a gap is created between the bones of the lumbar region by extending the spine, and the joint can be slowly rotated by using the gap, so that the joint is not subjected to excessive force and is damaged. It is possible to cause a slip on the joint surface without causing any slip. When the rotation operation of the waist by the hip rotation device 40 is alternately performed forward and reverse three times each for a set time, a total of six times, the rotation of the servo motors 41 and 51 is stopped, and the rotation operation of the waist is stopped. .
[0024]
Then, after only the towing operation is performed for 2 minutes, the servo motors 41 and 51 of the orthogonal movement device 60 of the waist rotation device 40 are driven again by the rotation control means 75, and the waist base 25 is set to the set size. The rotation is performed at a slow speed of 30 seconds per rotation, which is a speed set by an ellipse having a horizontal axis of 40 mm and a vertical axis of 30 mm. When the rotation of the waist by the waist rotation device 40 is performed eight times, which is the set time, the rotation of the servo motors 41 and 51 is stopped, and the rotation of the waist is stopped. Thereafter, after performing only the towing operation for 2 minutes, the towing operation by the orthosis towing machine 9 is stopped to stop the waist traction, and then the servo motor 51 of the vertical movement mechanism 52 is operated by the height control means 79, The height of the waist base 25 is lowered by 40 mm and returned to the same original height position as the upper body stand 23. The above operation may be repeated with a break time if necessary. After the towing operation is completed, the upper body stand 23 and the leg stand 27 are locked in the standby position in FIG. 1, the brace 8 is removed from the waist of the patient W, and the patient W gets off the bed. End a series of operations.
[0025]
11 to 13 show different embodiments of the waist rotation device, FIG. 11 is a side view of the waist rotation device portion, FIG. 12 is a front view as viewed from the right side of FIG. 11, and FIG. FIG. 13 is a plan view of FIG. 12. The waist rotation device 140 uses a linear rolling device (linear guide rail) for the right and left movement mechanism 142 and the up and down movement mechanism 152 of the orthogonal movement device 160.
The right and left moving mechanism 142 of the orthogonal moving device 160 fixes the support substrate 37a to both support frames 37, and fixes a pair of upper and lower linear guide rails 143 in the left and right direction in parallel to the support substrate 37a. A left and right moving body 144 is provided to be able to move left and right. The left and right moving body 144 is configured by fixing a moving plate 147 to a pair of left and right moving blocks 148 guided by a linear guide rail 143. A moving device 135 in which the left and right moving body 144 is provided so as to be able to move left and right between the left and right moving body 144 and the support frame 37 (fixed to the leg base 27) is provided between the two linear guide rails 143 of the moving plate 147. A pair of support bodies 150 that rotatably support the feed screw shaft 146 and a support bracket 153 that supports a servomotor 141 that rotationally drives the feed screw shaft 146 are fixed, and a nut body 145 screwed to the feed screw shaft 146 is fixed. The moving plate 147 is fixed to the moving plate 147, and the moving plate 147 is moved left and right by rotating the feed screw shaft 146.
[0026]
The vertical moving mechanism 152 of the orthogonal moving device 160 has a pair of left and right linear guide rails 155 in the vertical direction fixed to the moving plate 147 in parallel, and a vertical moving body 154 is provided on these linear guide rails 155 so as to be vertically movable. is there. The vertical moving body 154 is configured by fixing a moving plate 157 to a pair of upper and lower moving blocks 156 guided by a linear guide rail 155.
A moving device 136 having a vertically movable body 154 provided between the vertically movable body 154 and the left and right movable body 144 so as to be vertically movable, rotates a vertical feed screw shaft 161 to the side of both linear guide rails 155 of the movable plate 157. A pair of support members 159 that freely support and a support bracket 162 that supports a servomotor 151 that rotationally drives the feed screw shaft 161 are fixed, and a nut body 158 screwed to the feed screw shaft 161 is fixed to the moving plate 157. The moving plate 157 is configured such that a mounting rod 163 mounted downward is fixed to the lower surface of the central portion of the waist base 25, and the waist base 25 is moved up and down by rotating the feed screw shaft 161. It is.
Accordingly, the waist rotation device 140 is configured to be capable of two-dimensionally moving the waist base 25 up, down, left, and right in the same posture by the left and right movement mechanism 142 and the up and down movement mechanism 152 of the orthogonal movement device 160.
[0027]
In the above example, the waist rotation devices 40 and 140 alternately rotate the waist forward and backward. However, the waist may be rotated forward and backward a set number of times and then sequentially rotated forward and backward so as to reverse the set number of times. good. Although the case where the hip rotation device is operated twice during the towing operation has been described, it may be arbitrarily changed such that the hip rotation devices 40 and 140 are operated once or three or more times. Also, the case where the waist is rotated elliptically by the waist rotation devices 40 and 140 has been described. However, the waist may be rotated circularly, reversed and swung left and right, or moved left and right (the vertical movement amount is set to zero). good.
[0028]
【The invention's effect】
As described above, the invention of claim 1 provides a bed provided with a bed on which a patient lies on his / her back, and a traction device in which a brace is attached to the patient's waist and the patient's lumbar spine can be pulled toward the foot by a brace traction machine. An apparatus and a back pain treatment device having an armpit locking device capable of locking a patient's upper body by applying a armrest to a patient's side, comprising: a couch; an upper body table on which the patient's upper body is placed; Is divided into a lumbar base for placing the lower back of the patient and a leg base for placing the lower limb of the patient, and the lumbar base and the leg base are provided on the frame so as to be movable in a distance with respect to the upper body base. The pedestal is equipped with a waist rotation device that can move the lumbar base two-dimensionally up, down, left and right with the posture as it is, so that the patient's lumbar can be efficiently towed with accurate traction force, and for the lumbar part in the traction state Rotate or swing the table in the same posture without tilting It is possible, the patient's lumbar region safely rotated without giving a restraining feel or fear in the patient, can be efficiently alleviate the patient's low back pain can swing.
[0029]
Further, according to the invention of claim 2, a side locking device capable of locking an upper body portion of a patient by applying a side support to a side of the patient is provided on the frame, and the upper body portion table is moved to the frame in the longitudinal direction of the bed. And because it is provided so as to be fixable, even for patients of different heights, it is possible to accurately apply the armrests of the armpit locking device to the patient's side, and to fix the upper body base to the frame. This has the advantage that the patient can safely get on and off the bed.
According to a third aspect of the present invention, the waist rotation device is combined with a left-right moving mechanism capable of linearly moving in the left-right direction by the rotation of the servomotor and a vertical movement mechanism capable of linearly moving in the vertical direction by the rotation of the servomotor. The waist base can be easily formed into a circle or an ellipse of a desired size because the orthogonal movement apparatus and the control apparatus capable of rotating the waist base by controlling the rotation of both servomotors of the orthogonal movement apparatus are easily configured. It can be rotated, flipped, swung right and left or up and down, and the moving operation of the waist can be performed simply and quickly.
[0030]
According to a fourth aspect of the present invention, a left and right moving body is provided on the leg base so as to be movable left and right, and a moving device capable of moving the left and right moving body left and right is provided between the left and right moving body and the leg base. A vertical moving body is provided on the left and right moving body so as to be vertically movable, and a moving device capable of vertically moving the vertical moving body is provided between the vertical moving body and the left and right moving body to constitute a vertical moving mechanism. Since the waist base is fixed to the upper part of the moving body, the power required to move the waist up and down can be reduced.
According to a fifth aspect of the present invention, the moving device of the vertical moving mechanism is provided with a ball screw, and an urging device for applying an upward urging force between the left and right moving body and the vertical moving body so as not to drop suddenly is provided. As a result, it is possible to prevent the lumbar base from dropping abruptly in the event of a power outage or failure, and to keep the patient's lumbar area safe.
According to a sixth aspect of the present invention, there is provided a movement amount input means for inputting the left and right movement amount of the left and right movement mechanism and the up and down movement amount of the up and down movement mechanism to the control device, and a height for inputting a reference height position of the waist base. Input means, rotation control means for synchronizing the up-down movement of the up-down movement mechanism and the left-right movement of the left-right movement mechanism to control the waist table to rotate at the input size, and the up-down movement mechanism for the waist table Height control means for controlling the height of the waist rotation start position to be the input reference height, so that the waist table can be rotated and swung up, down, left, right, up and down. The amount can be easily adjusted, and the height of the lumbar base can be easily adjusted or restored by the same mechanism, so that handling can be facilitated.
[Brief description of the drawings]
FIG. 1 is a side view of a low back pain treatment device.
FIG. 2 is a plan view of the low back pain treatment apparatus of FIG. 1;
FIG. 3 is a front view as viewed from the right side of FIG. 1;
FIG. 4 is an enlarged view of a waist rotation device part of FIG. 1;
FIG. 5 is a front view as viewed from the right side of FIG. 4;
FIG. 6 is a plan view of FIG. 5;
FIG. 7 is an enlarged sectional view taken along line VII-VII of FIG. 4;
FIG. 8 is an enlarged sectional view taken along line VIII-VIII of FIG.
FIG. 9 is an enlarged sectional view taken along line IX-IX of FIG. 5;
FIG. 10 is an enlarged sectional view taken along line XX of FIG. 5;
FIG. 11 is a side view showing a different embodiment of the hip rotation device.
FIG. 12 is a front view as viewed from the right side of FIG. 11;
FIG. 13 is a plan view of FIG. 12;
[Explanation of symbols]
1 back pain treatment device
3 sleeper
5 frames
7 beds
8 Orthotics
9 Orthotics traction machine
11 Traction device
12 Side armor
13 Side locking device
23 Upper body stand
25 Waist base
27 Leg base
33 biasing device
35 Moving device
36 Moving equipment
40 Hip rotation device
41 Servo motor
42 Left and right moving mechanism
44 Left and right moving body
51 Servo motor
52 Left and right moving mechanism
54 left and right moving body
60 Cartesian moving device
69 control device

Claims

A bed with a bed on which the patient lies on its back, a traction device that can be attached to the patient's waist and the lumbar spine of the patient can be pulled to the foot side by an orthosis traction machine, and a side abutment beside the patient In a low back pain treatment device provided with an armpit locking device capable of locking a patient's upper body, a bed, an upper body table on which the patient's upper body is placed, a lower table for placing the patient's waist, and a lower leg of the patient The base is divided into a base for the legs and a base for the waist and a base for the legs are provided on the frame so that it can be moved far and near with respect to the base for the upper body. A low back pain treatment device provided with a waist rotation device capable of two-dimensionally moving up, down, left and right.

The frame is provided with a side locking device capable of locking an upper body part of a patient by applying a side support to a side of a patient, and a base for the upper body part is provided on the frame so as to be movable and fixed in a longitudinal direction of the bed. The low back pain treatment device according to 1.

An orthogonal moving device combining a left and right moving mechanism capable of linearly moving the waist rotation device in the left and right direction by the rotation of the servo motor and an up and down moving mechanism capable of linearly moving the waist rotating device in the vertical direction by the rotation of the servo motor; 3. The low back pain treatment apparatus according to claim 1, wherein said low back pain treatment apparatus comprises a control device capable of controlling the rotation of the two servo motors to rotate the waist base.

A left and right moving body is provided on the leg base so that it can move left and right, and a moving device that can move the left and right moving body left and right is provided between the left and right moving body and the leg base to constitute a left and right moving mechanism. An up-down moving body is provided so as to be able to move up and down, and a moving device is provided between the up-down moving body and the left-right moving body so that the up-down moving body can be moved up and down. The low back pain treatment device according to claim 3, which is fixed.

5. The low back pain treatment according to claim 4, wherein a ball screw is provided in the moving device of the up-down moving mechanism, and an urging device is provided between the left-right moving body and the up-down moving body to apply an upward urging force so that the up-and-down moving body does not drop suddenly. apparatus.

A moving amount input means for inputting a left / right moving amount of the left / right moving mechanism and a vertical moving amount of the vertical moving mechanism to the control device; a height input means for inputting a reference height position of the waist base; Rotation control means for controlling the movement of the waist base to rotate at the input size by synchronizing the movement and the lateral movement of the left / right movement mechanism, and the height of the waist rotation start position of the waist base for the up / down movement mechanism 4. The low back pain treatment apparatus according to claim 3, further comprising height control means for controlling the reference height to become the input reference height.