ES2955606B2 - DEVICE FOR MEASURING MOVEMENTS OF THE VERTEBRAL COLUMN AND MEASUREMENT PROCEDURE - Google Patents

Description

DESCRIPTION

DEVICE FOR MEASURING MOVEMENTS OF THE VERTEBRAL COLUMN AND

MEASUREMENT PROCEDURE

OBJECT OF THE INVENTION

The present invention relates to a device intended to achieve a measurement of the physiological movements of flexion, extension, right lateral inclination, left lateral inclination, right rotation and left rotation of the cervical spine, the dorsal spine, the lumbar spine and the spine. entire spine simultaneously, being able to relate them to each other to be able to make a complete assessment of a patient's spine in a quick, valid and effective way.

Furthermore, the invention also refers to the procedure for measuring these movements using the measuring device.

The invention finds special application in the field of the industry related to devices for measuring the physiological movements of the spine in the healthcare or physiotherapy sector.

BACKGROUND OF THE INVENTION AND TECHNICAL PROBLEM TO BE SOLVED

In the state of the art, there are different tools that measure the physiological movements of the spine in isolation. Among them are inclinometers, goniometers and, in general, all types of tools with the capacity to measure the physiological movements of the spine.

In particular, in the cervical spine, what is most used is the so-called CROM, a tool that measures the three cervical movements. The CROM is an evolution of inclinometers, which have a very outdated protocol and validity.

Subsequently, new isolated methods have emerged throughout history that in several scientific articles are classified according to the method of obtaining the measurement degrees.

One of these articles is. Analysis of the Active Measurement Systems of the Thoracic Range of Movements of the Spine: A Systematic Review and a Meta-Analysis.Sensos, by Esteban-González P, Sánchez-Romero EA, Villafañe JH, which can be found at https:// doi.org/10.3390/s22083042.

Also interesting are the studies on cervical and lumbar tools developed by Arshad R, Pan F, Reitmaier S, Schmidt H, on the one hand, in Effect of age and sex on lumbar lordosis and the range of motion. A systematic review and meta-analysis and, on the other hand, in The effect of age and sex on the cervical range of motion - A systematic review and meta-analysis, articles that can be found, respectively, at the internet addresses https: //doi.org/10.1016/jJbiomech.2018.11.022 and at https://doi.org/10.1016/jJbiomech.2018.04.047.

The methods can be through mechanical devices, electromechanical devices, three-dimensional optical motion analysis, accelerometer tracking devices, ultrasound tracking devices and mobile phone applications.

These tools can measure one or more physiological movements, but of isolated spines. Some are used only for the thoracic spine, others for the lumbar spine, they can even be used to measure both spines, but not simultaneously, but in isolation.

In addition to all this, it should be noted that each of the tools has its own protocols and uses specific initial measurement positions, which makes it very complicated to compare some results with others due to measurement biases.

In this way, with the currently existing techniques, different tools must be used for the total measurement of the physiological movements of the different spines of the spinal column, which is not representative, practical, or effective, so this type of measurements is usually done through dynamic resonances, fluoroscopy or dynamic x-rays, which are invasive measurement mechanisms that radiate the patient and cannot be performed continuously.

Therefore, since the vertebral column is a group formed by three spines (cervical, dorsal, and lumbar) that are directly related to each other, it is vitally important to measure physiological movements simultaneously so that it is possible to relate them to each other and be able to make a complete assessment of the patient's spine.

The device of the present invention makes it possible to achieve a measurement of the physiological movements of the cervical spine, the dorsal spine, the lumbar spine and the entire vertebral column simultaneously, in a valid, fast and effective manner without the need to irradiate the patient. These movements include flexion, extension, lateral inclination to the right and left, and rotation to the right and left.

On the other hand, the uses of this novel device are very varied, and it can be used to expand the field of research on the spine, carry out a rapid and effective assessment of patients in medical and physiotherapy consultations or diagnose spinal diseases early, among others. .

DESCRIPTION OF THE INVENTION

The device of the present invention aims to be able to measure the different physiological movements (rotation, inclination and flexion-extension) of the spinal column, in a complete manner, and of the cervical, dorsal and lumbar spines. All of this simultaneously, quickly and efficiently. Additionally, it also measures pelvic rotation.

It is a measuring device that is not harmful to the subject, that is active, completely mechanical in operation and, therefore, is not radiological, since it does not radiate. Added to this is the advantage of the short time required to carry out the measurements, unlike the rest of the existing devices, and the obtaining of very precise values of the movements examined.

In order to achieve the objectives and avoid the drawbacks mentioned above, the present invention describes a device for measuring spinal column movements that comprises a structure made up of a rear part, two sides and a base.

The rear part comprises a calibrated beam and a longitudinal rail along which three graduated arcs are capable of sliding and each of the arches incorporates a rail along which, in turn, a graduated ring is capable of sliding, each one being Graduated rings intended to be attached to a specific part of a patient's body.

A blade of a pelvic restraint intended to be attached to the patient is fixed to each of the sides.

The base incorporates a support, with the ability to rotate, in which there are fixings and stops. In this way, when a patient places himself on the device, he stands up on the support, inserting his feet into the fixations and resting his heels on the stops, leaving the patient perfectly positioned and fixed on the device.

With this configuration, the combination of the attachment of the graduated rings and the blades of the pelvic support to the patient allows the determination of rotation, inclination, flexion and extension of both different parts of the spine and of the entire spine .

On the other hand, the base can incorporate wheels that can even be connected to a motor through a mechanism, so that transportation and handling is more practical.

Preferably, each of the sides comprises a vertical slot crossed by a positioning bar, fixed to each of the blades, so that the pelvic support is adjustable in height. Furthermore, the device may comprise two positioning bars attached to each blade, each bar passing through a vertical slot. In this way, although the device is more complex, the pelvic support gains stability.

Furthermore, the calibrated beam preferably incorporates fixing means to stably position the graduated arcs. These fixing means may consist, for example, of a spring that pushes the graduated arch against the longitudinal groove or of a fixing screw that presses the graduated arch against the graduated beam.

For their part, the graduated rings preferably comprise return means so that, without being subjected to stress, they are positioned centered with respect to the graduated arches and always allow a measurement to begin in a centered position.

The graduated ring may also comprise a pair of extenders, one end of which is fixed in a sliding slot of the graduated ring, and the other end being fixed to a pad intended to be fixed to the patient's body.

Furthermore, the graduated ring is circumferentially graduated from an origin position marking 0 degrees to 360 degrees in at least one direction and, preferably, in both directions.

The extenders, like the graduated rings, preferably also comprise return means so that, without being subjected to stress, they are positioned at the 0 degree mark of the graduated rings.

Although the two extenders may be attached to a single pad, preferably each extender is attached to a pad comprising two straps located in alignment, such that the junction of the straps of one pad with the straps of the other pad creates a solid fixation of the graduated ring to the patient's body. The straps are joined by any of the known methods, such as buckles or Velcro, for example, and can be tensioned as needed.

In addition, the invention also describes the procedure for measuring movements of the spinal column using the described device where, once the patient is positioned in the support, with the feet located in the fixations and in contact with the stops, it comprises the following steps:

a) Place the three graduated arches in superior, medial and inferior positions at the level of the first lumbar vertebra, the first dorsal vertebra and the occipital tuberosity, respectively;

b) Fix the graduated rings to the patient's body;

c) Activate the central fixation system;

d) Ask the patient to rotate to both sides as much as possible;

e) Write down the largest marks shown by the extensors of the upper, middle and lower rings;

f) Fix the paddles at the height of the patient's iliac spines;

g) Ask the patient to rotate to both sides as much as possible;

h) Write down the largest marks shown by the extenders of the three graduated rings;

i) Deactivate the central fixation system;

j) Ask the patient to lean laterally towards both sides as much as possible;

k) Write down the major marks shown by the three graduated arcs;

l) Release the fixation of the pelvic restraint blades;

m) Rotate the support ninety degrees to place the patient in a lateral position; n) Fix the two blades of the pelvic support on the anterior superior iliac spines and the sacrum, respectively;

o) Ask the patient to perform maximum flexion and extension; p) Write down the major marks shown by the three graduated arcs;

BRIEF DESCRIPTION OF THE FIGURES

To complete the description of the invention and in order to help a better understanding of its characteristics, in accordance with a preferred example of its embodiment, a set of drawings is attached where, with an illustrative and non-limiting nature, they have been represented the following figures:

- Figure 1 represents a front view of the device of the invention.

- Figure 2 represents a side view of the device of the invention.

- Figure 3 represents a view of the device of the invention with a person measuring a rotation movement of the spinal column.

- Figure 4 represents a view of the device of the invention with a person measuring an inclination movement of the spinal column.

- Figure 5 represents a view of the device of the invention with a person measuring a flexion movement of the spinal column.

- Figure 6 represents a perspective view of the foot support base with the fixing system and the stop.

- Figure 7 represents a plan view of the system for fixing the measuring ring to the patient without fixing it, showing the mooring movement.

- Figure 8 represents a plan view of the fixation system of Figure 7 once it is fixed to the patient.

Below is a list of the references used in the figures:

1. Rear part.

2. Sides.

3. Calibrated beam.

4. Longitudinal rail.

5. Pelvic restraint paddles.

6. Positioning bars.

7. Vertical slot.

8. Support.

9. Stops.

10. Fixings.

11. Graduated arches.

12. Graduated hoops.

13. Extenders.

14. Pads.

15. Straps.

DESCRIPTION OF A PREFERRED EMBODIMENT OF THE INVENTION

As represented in the figures, the size of the device is the height of a person. It is made up of several components, as described below.

As can be seen in Figures 1 and 2, the device is made up of a structure formed by a rear part (1), two sides (2), as a recess, and a base intended to accommodate the patient.

The rear part (1) incorporates a calibrated beam (3), vertical, centered with respect to the two sides (2) and that incorporates a longitudinal rail (4).

The sides (2) incorporate a pelvic support, responsible for immobilizing the pelvis and thus obtaining isolated rotations of the spinal column.

The pelvic support is formed by two blades (5), aligned with each other and fixed to each of the sides (2) by means of positioning bars (6) that are introduced more or less into the respective sides (2) so that the blades (5) can be adjusted to the patient. However, the fixing of the positioning bars (6) on the sides (2) is not done through a hole but through a vertical slot (7), so that the positioning bars (6) can slide vertically and the fastening The pelvic floor can be moved craniocaudally to fit the patient's pelvis regardless of the patient's height.

In addition, the vertical slots (7) are calibrated, so that the position used by a patient of the blades (5) of the pelvic support is referenced and the configuration is recorded for future measurements of this same patient.

Preferably, the positioning bars (6) of each of the sides (2) are joined, so that the movement of the blades (5), and therefore of the pelvic support, is the same.

On the other hand, the blades (5) incorporate a lashing system to attach to the patient and are preferably padded to be able to exert pressure on the body without causing discomfort.

For its part, as represented in Figure 6, the base incorporates a support (8) with a pair of footprints located centrally with respect to the calibrated beam (3). The footprints incorporate stops (9) in the rear area to define the position of the patient regardless of the size of the foot and fixings (10) intended to fix the patient's feet to the device. The support (8) has the ability to rotate 90 degrees to the right, so that the measurement of flexion-extensions can be carried out, as shown in Figure 5.

The key elements of the device through which the measurements are carried out are the graduated arches (11) and the graduated rings (12), responsible for measuring the movements of the spinal column.

The graduated arches (11) are inserted in the longitudinal rail (4) of the calibrated beam (3), centrally, and can move vertically, so that they can be located in a suitable position depending on the height of the patient. in order to measure respectively the movements of the cervical, dorsal and lumbar spines.

For their part, the graduated rings (12) are fixed to the patient in predetermined areas and are inserted in slots that incorporate the respective graduated arcs (11), and can slide to both sides along their entire length.

In this way, the function of the graduated rings (12) is to measure the rotation movements of the patient, while the function of the graduated arcs (11) is to measure the flexion-extension movements and lateral inclinations of the patient. The centered position of the arcs (11) determines the zero position of the graduation, which coincides with the longitudinal rail (4), dividing the graduation towards the two ends.

It is important to keep in mind that the graduated arches (11) incorporate a central fixing system, which has not been represented in the figures, and which is activated to fix the graduated rings (12) and thus prevent their displacement by the graduated arches ( 11) in the patient's rotation movements.

The rings (12) incorporate a return system, so that, without being subjected to stress, they are positioned centrally in the arches (11).

As already mentioned, all the movements measured are of the total spine and the cervical, dorsal and lumbar spines. In addition, pelvic rotation movement can also be measured in rotation.

As shown in Figure 7, each of the graduated rings (12) incorporates a marker configured by a pair of extenders (13). In the example embodiment shown, each extender (13) is formed by a set of springs.

Each of the extenders (13) has one of the ends fixed in the graduated ring (12), with the capacity to move along it along a slot. The other end is located towards the center of the ring (12) and incorporates a pad (14) intended to be fixed to the patient. The pads (14) of each extender (13) are joined together by straps (15) hugging the area of the patient's body to secure it with the graduated ring (12). Figure 8 represents the position of the extenders (13) with the pads (14) already attached by the straps (15) hugging the part of the patient's body where the ring (12) is located.

Thus, the extenders (13) are aligned, located at 180 degrees between them with respect to the graduated ring (12).

The ring (12) also incorporates a return system so that, without being subjected to stress, the extenders (13) are positioned at a point of origin of the graduated ring (12), where the zero mark of the graduation is located to reach up to 360 degrees along the entire circumference of the ring (12).

This measurement can be carried out using a sensor located at the first ends of the extenders (13) that slide along the ring (12) or, simply, using an indicator that marks the initial and final positions of the extenders (13).

This ensures that the pads (14) adapt to the three reference areas: on the head, at the level of the occipital tuberosity; on the shoulders, at the level of the shoulder girdle and in the lumbar area, at the level of the first lumbar vertebra, just below the twelfth rib.

In this way, a turn of the patient with the pelvic restraint in place will record the rotation of the total spine and the rotations of the cervical, dorsal and lumbar spine. However, if a turn measurement is performed without the pelvic hold in place, the patient's turn will record the pelvic rotation.

As already indicated, the graduated rings (12) are fixed to the respective graduated arches (11), which extend from a zero marking to the two sides of the calibrated beam (3), through which it can slide with the aim to be able to perform measurements of inclination and flexion-extension of the spine and the different spines. The ring incorporates a positioning system so that, without being subjected to stress, it remains aligned with the beam in the zero position of the arc (11).

To measure the lateral inclinations, as represented in Figure 4, the pelvic support is fixed, with the central fixation system deactivated and the patient will perform the lateral inclination movements. The three rings (12) will slide through the respective graduated arches (11) and the total vertebral inclination and the cervical, dorsal and lumbar inclinations will be obtained.

To measure flexion-extension, as shown in figure 5, the support (8) must be rotated 90 degrees so that the patient is positioned, with the pelvic support fixed, not on the sides but in front and behind, at the level of the anterior superior iliac spines and the sacrum respectively. Thus, with the patient positioned on his side, he will first perform the flexion movement and then the extension movement. In the same way as in lateral inclinations, the rings (12) will move through the respective arches (11) and the total vertebral movement and the cervical, dorsal and lumbar movement can be recorded, both for flexion and extension.

The device is intended to carry out measurements on the patient while standing, standing, in certain positions that are located in the first dorsal vertebra, in the twelfth dorsal and in the first lumbar. To do this, the patient can have marks made on the spinal column in the aforementioned areas, incorporate into the device a way to locate these vertebrae for the positioning of the measuring elements or perform manual positioning.

With the described configuration of the device of the invention, the measurement method is as indicated below.

The order of measurements begins with rotations, followed by inclinations and finally flexion-extensions.

Initially, the patient is searched for the first dorsal vertebra and the first lumbar vertebra and marked with a demographic pencil.

Once these positions have been determined, the patient is placed on the device, between the two sides (2) and with the feet in the footprints of the base, resting the heels against the rear stops (9) to be fixed to the device with the fixings. (10).

The first measurement will be the patient's total vertebral rotation along with pelvic rotation, as represented in figure 3. To do this, the pelvis is left free, that is, without placing the pelvic support and the three graduated arches are positioned (eleven). The first at the level of the mark of the first lumbar vertebra, the second at the level of the first dorsal vertebra, in the shoulder girdle, and the last in the head, at the level of the occipital tuberosity.

It must be taken into account that the central fixation system must be activated, that is, fixed, to prevent the rings (12) from sliding along the arches (11) in the rotation movement of the patient.

Next, the patient is asked to rotate his entire body to the right as much as possible. With this movement, the extenders (13) will indicate the degrees reached in the graduated rings (12). The same operation is carried out to the left. Since the pelvis is free, the patient's connection to the device is located at the fixation (10) of the feet, so the spine is free to rotate completely along with the pelvic rotation, which is the connection of the internal rotation of the ipsilateral hip and external rotation of the contralateral hip. In this way, measurements of total vertebral rotation plus pelvic rotation are obtained, which is reflected in the upper graduated ring (12).

The second measurement to be performed is the vertebral rotation along with its respective cervical rotation, dorsal rotation and lumbar rotation. To do this, the blades (5) of the pelvic support are fixed at the level of the upper anterior iliac spines, so that the patient's body is immobilized at a lower level from this area, preventing pelvic rotation from taking place.

Once again, the patient is asked to turn right and left and the values marked on the graduated rings (12) are taken towards both directions of rotation. It is observed that the postero-superior iliac spine does not detach, meaning that, when the pelvis is fixed, the turn is only vertebral rotation.

The upper graduated ring (12) will measure total vertebral rotation, the medial graduated ring (12) will measure dorsolumbar rotation and the lower graduated ring (12) will measure lumbar rotation. With these three values, the measurements of the rotations of the different spines of the spine can be calculated, obtaining the total vertebral rotation, pelvic rotation, cervical rotation, dorsal rotation and lumbar rotation, all of them towards both sides, right and left.

The lateral inclinations are then measured, as shown in Figure 4. Since the patient is with the pelvic support in place, the feet placed in the fixations (10) and the graduated rings (12) adjusted, the patient to lean as far as possible to the right and left.

Similar to rotations, the upper graduated arch (11) will measure the total vertebral inclination, the medial arch (11) will measure the dorsolumbar inclination and the lower graduated arch (11) will measure the lumbar inclination. With these three values, the measurements of the inclinations of the different spines of the spine can be calculated, obtaining the total vertebral inclination, the cervical inclination, the dorsal inclination and the lumbar inclination towards both sides, right and left.

Finally, the blades (5) are released from the pelvic restraint. Then, the support (8) is rotated 90 degrees to place the patient in a lateral position, as mentioned above, in such a way that the patient is facing one side (2) of the device as represented in the figure. 5. Then, the blades (5) of the pelvic support are placed in such a way that one of the two blades (5) fixes the two anterior superior iliac spines and the other blade (5) fixes the sacrum. The patient is then asked to perform flexion and extension. The upper graduated arch (11) will measure total vertebral flexion and total vertebral extension, the middle graduated arch (11) will measure thoracolumbar flexion and extension and the lower graduated arch (11) will measure lumbar flexion and extension. With these three values, the measurements of the flexion/extension of the different spines of the spine can be calculated, obtaining the total vertebral flexion/extension, cervical flexion/extension, dorsal flexion/extension and lumbar flexion/extension.

In this way, the following measurements can be obtained with the device:

a) Vertebral rotation total right pelvic rotation

b) Vertebral rotation Total left pelvic rotation

c) Total right vertebral rotation

d) Total left vertebral rotation

e) Right cervical rotation

f) Left cervical rotation

g) Right dorsal rotation

h) Left dorsal rotation

i) Right lum bar rotation

j) Left lum bar rotation

k) Total right vertebral inclination

l) Total left vertebral inclination

m) Right cervical inclination

n) Left cervical inclination

o) Right dorsal inclination

p) Left dorsal inclination

q) Right lum bar inclination

r)Left lum bar inclination

s) Total vertebral flexion

t)Cervical flexion

u) Dorsiflexion

v) Lumbar flexion

w) Total vertebral extension

x) Cervical extension

y) Dorsal extension

z) Lumbar extension

Claims (10)

1. Device for measuring spinal column movements, characterized because it comprises a structure made up of a) a rear part (1) that comprises a calibrated beam (3) and a longitudinal rail (4) along which three graduated arches (11) are capable of sliding and each of the arches (11) incorporates a rail along the that, in turn, a graduated ring (12) is capable of sliding, each of the graduated rings (12) being intended to be fixed to a specific part of a patient's body, b) two sides (2), where two blades (5) of a pelvic restraint intended to be fixed to the patient are fixed, and c) a base that incorporates a support (8), with the capacity to rotate, in which there are fixings (10) and stops (9) intended to fix and position the patient's feet with respect to the device, where, The combination of fixing the graduated rings (12) and the blades (5) of the pelvic support to the patient allows the rotation, inclination, flexion and extension of both different parts of the spine and the spine to be determined. complete vertebral 2. Device for measuring spinal column movements, according to claim 1, characterized in that each of the sides (2) comprises a vertical slot (7) crossed by a positioning bar (6), fixed to each of the blades ( 5), so that the pelvic support is height adjustable. 3. Device for measuring spinal column movements, according to claim 1, characterized in that the calibrated beam (3) incorporates fixing means to stably position the graduated arches (11). 4. Device for measuring movements of the spinal column, according to claim 1, characterized in that the graduated rings (12) comprise return means so that, without being subjected to effort, they are positioned centered with respect to the graduated arches (11). . 5. Device for measuring movements of the spinal column, according to claim 1, characterized in that the graduated ring (12) comprises a pair of extenders (13) with one end fixed in a slot of the graduated ring (12), with the ability to slide , and the other end fixed to a pad (14) intended to be fixed to the patient's body. 6. Device for measuring spinal column movements, according to claim 5, characterized in that the graduated ring (12) is graduated circumferentially from an origin position that marks 0 degrees to 360 degrees in both directions. 7. Device for measuring movements of the spinal column, according to claim 5, characterized in that the extenders (13) comprise return means so that, without being subjected to effort, they are positioned at the 0 degree mark. 8. Device for measuring spinal column movements, according to claim 5, characterized in that each pad (14) comprises two straps (15) located in alignment, so that the union of the straps (15) of a pad (14) with the straps (15) of the other pad (14) creates a solid fixation of the graduated ring (12) to the patient's body. 9. Device for measuring movements of the spinal column, according to claim 1, characterized in that the graduated arcs (11) are positioned respectively at the height of the first lumbar vertebra, the first dorsal vertebra, and the occipital tuberosity to control, respectively, the movements of the cervical spine, the dorsal spine and the lumbar spine. 10. Procedure for measuring spinal column movements, according to the device of claims 1 to 9, characterized in that, once the patient is positioned on the support, with the feet located in the fixations (10) and in contact with the stops (9), includes the following stages: a) Place the three graduated arches (11) in superior, medial and inferior positions at the level of the first lumbar vertebra, the first dorsal vertebra and the occipital tuberosity, respectively; b) Fix the graduated rings (12) to the patient's body; c) Activate the central fixation system; d) Ask the patient to rotate to both sides as much as possible; e) Write down the largest marks shown by the extenders (13) of the upper and lower rings; f) Fix the paddles (5) at the height of the patient's iliac spines; g) Ask the patient to rotate to both sides as much as possible; h) Write down the largest marks shown by the extenders (13) of the three graduated rings (12); i) Deactivate the central fixation system; j) Ask the patient to lean laterally towards both sides as much as possible; k) Write down the major marks shown by the three graduated arcs (11); l) Release the fixation of the blades (5) of the pelvic restraint; m) Rotate the support (8) ninety degrees to place the patient in a lateral position; n) Fix the two blades (5) of the pelvic support on the anterior superior iliac spines and the sacrum, respectively; o) Ask the patient to perform maximum flexion and extension; p) Write down the major marks shown by the three graduated arcs (11);