WO2004105676A1

WO2004105676A1 - Angiological boot comprising pneumatic plantar chamber for the generation of pressure pulses

Info

Publication number: WO2004105676A1
Application number: PCT/MX2003/000045
Authority: WO
Inventors: J. Magdiel Trinidad Vasquez
Original assignee: Trinidad Vasquez J Magdiel
Priority date: 2003-05-28
Filing date: 2003-05-28
Publication date: 2004-12-09
Also published as: AU2003228128A1

Abstract

The invention relates to an angiological boot. The inventive boot comprises: a system for generating energy pressure pulses (air) by means of a pneumatic chamber which is provided in the plantar region and which uses the locomotion or walking motion of the user as an energy source; and a compression system which is intended for the ankle and calf region at the lower extremity of the patient suffering from lymphatic or arterial venous insufficiency, whereby said compression can be calibrated and quantified according to the severity of the lesion. There are two embodiments of the invention, namely: a first embodiment comprising a single part with projecting elements which are fixed in a criss-cross manner, and a second embodiment comprising adjustable semi-rigid bands.

Description

ANGIOLOGICAL BOOT WITH PLANTAR PNEUMATIC CHAMBER FOR THE GENERATION OF PRESSURE IMPULSES

A N T E C E D E N T E S Technical sector

Blood from the lower extremities returns to the heart through a system of deep veins (intramuscular) and another of superficial veins (subcutaneous), interconnected by perforating veins (they pierce the fascination of the leg). These two systems have one-way valves that direct blood flow to the heart, which, when closed, prevent blood from flowing back into the calf veins; likewise, communicating or perforating veins have valves that direct blood from the superficial venous system to the deep system. In this way, the blood that circulates in the veins of the lower extremity returns to the heart driven mainly by the force of the patient's weight when he steps, that is, the blood that comes from the sole of the foot passes to the veins of the calf with the impulse of the footfall of the patient, there the blood receives a second impulse and is sent to the veins of the thigh, finally the contracture of the thigh propels the blood towards the abdomen. With this, the force of the blood opens the valves of the aforementioned veins, allowing it to flow to the heart, and that with the same force and weight, the blood closes the valves that, as said, are unidirectional, avoiding so blood reflux occurs. In healthy patients, venous blood normally returns from the prefixed parts of the body to the heart, by the "venous pump" system that involves numerous factors: the venous tone itself, the presence of efficient venous valves, pumping through the sole plantar venous of the foot, the contraction of the calf muscles, the propulsion force of the systolic ejection, the aspiration force of the right atrium, diaphragmatic movements and the proximity of arterial pulsations; all these mechanisms together form the venous pump of returned.

Prior art For the treatment of venous insufficiency such as venous edema or lymphatic edema, the most common is to combine compression systems with different therapeutic methods such as manual lymphatic drainage, which is a combination of drainage maneuvers away from edema areas. and uptake, which increase tissue extrinsic pressure in the affected area; As for compression systems, there is the application of compression energy to the leg and foot provided by elastic stockings or elastic bandages, bandages or the plaster boot, whose objective of this method is twofold: to reduce undesirable reflux in the superficial veins and protect the veins from excessive distention, this treatment is the most common to relieve venous insufficiency, such as edema, varicose veins and / or varicose ulcers, however they have the following drawbacks:

Now, specifically in the aforementioned compression systems, none of the known devices for the treatment of venous insufficiency determines or quantifies the value of the pressure that the patient receives at the time of its application; likewise, as the elastic fiber loses strength, the pressure it provides is less than that initially administered, consequently there is a loss of the therapeutic effect, that is, loss of the initial compression energy, having the need to use a second or more garments compression as required.

Technical problem and solution

The blood of the patient who is standing or walking, with the impulse of the muscular contracture flows to the heart, this natural system of the organism is called "venous pump", however, due to the force of gravity, said blood tends reflux, which is naturally prevented if the vein valves are closed permanently. Now, if these vein valves do not close well, blood reflux occurs that stagnates in the leg veins, causing what is considered poor circulation or venous insufficiency. Stagnation produces venous hypertension forming edema due to venous insufficiency, the leg veins dilate and become varicose, blood and plasma flow, the tissues become they inflame, cause fatigue and eventually venous ulceration. Likewise, as already mentioned, the increase in venous pressure causes Venous edema, which can be compensated by the lymphatic system, however, once the capillary ultrafiltrate exceeds the maximum capacity of this "security system", it will be observed lymphatic insufficiency, this is characterized by disability. from the lymphatic system to drain excess proteins and lymph, resulting in lymphatic edema.

From the above, considering that for the optimal functioning of the body's natural "venous pumping" system, one of the main factors is the pumping of the plantar venous sole of the foot and the contraction of the calf muscles, This has led to the development of the present invention, which consists of an angiological boot, in whose design it has a system for generating pressure energy impulses by means of a pneumatic chamber provided in the plantar area of the boot, with the object of producing precisely pressure force (air) to be directed to the ankle and calf area as compression energy. To achieve this, it is necessary to take 'Locomotion' as an energy source and take advantage of it in the treatment of angiological diseases, that is, considering that the primary objective of human locomotion is the translation of the body from one point to another by means of the biped march and that said locomotions is a dynamic execution in which certain movements of regular succession occur, it is possible to obtain benefit from the application of this sequence of movements in regular succession, which can be from one extremity from the distal point to the proximal one or vice versa, this, since the typical forward gait can be divided into two basic positions, the position phase and the swing phase, in the position phase the foot is in contact with the ground and carries the entire weight of the body, and It starts when the heel touches the floor and ends when the thick toe is raised at the end of the step; the position phase can itself be subdivided into three tiers. mpos: heel shock, middle position and impulse, these three times of the position phase originate the pulses of pressure energy (air) that will be directed to the compression chambers provided by this invention, which is also described later in the swing phase, which is when the foot does not touch the floor and the weight of the body is carried by the opposite extremity, the compression is released in the chambers described below; is phase begins when the thick toe leaves the floor and ends when the swing of the leg is suspended in the forward motion.

Advantages of the invention

The present invention is capable of generating pressure energy by means of a plantar pneumatic chamber to generate air pulses and provide sufficient compression energy to improve the operation of "venous pumping" and facilitate blood return to the heart, as well as to determine that This pressure and compression can be quantified and graduated according to the degree of the patient's injury, and can be provided constantly by means of the accessories that compose it.

D E S C R I P C I Ó N

This invention presents the realization of an angiological boot, which has a pressure energy impulse generation system (air) by means of a pneumatic chamber provided in its plantar area and a compression energy system for the ankle area and calf in the lower extremity of the patient suffering from lymphatic or arterial venous insufficiency, said compression can be quantified and graduated according to the degree of injury.

The novel features that make up the present invention are clearly described with the following description, accompanying the following illustrations that show the parts that make up the angiological boot, which are:

FIGURE 1.- It is a front view of the interior part of the angiological boot totally open in its design modality in one piece with cross-holding extensions, where the compression chambers that have contact with the patient's leg can be seen. , as well as the air supply valves connected to the pneumatic chamber provided in the sole of the boot. FIGURE 2.- Is a front view in relation to figure 1, where the angiological boot is placed on the leg using its support extensions, as well as, graduating and quantifying the compression force by means of a dynamometer.

FIGURE 3.- It is a front view in relation to figure 1, where the angiological boot is shown, compressing the patient's leg.

FIGURE 4.- It is a side view in relation to the previous figure, where the angiological boot is shown as compressing the leg and foot of the patient.

FIGURE 5.- Is a front view of the interior part of the angiological boot fully open in its design modality with adjustable semi-rigid bands, where the compression chambers that contact the patient's leg, as well as the valves can be seen. of air supply connected to the pneumatic chamber provided in the plantar area of the boot.

FIGURE 6.- Is a front view in relation to figure 5, where the angiological boot is shown as it is passing the adjustable semi-rigid bands through the anchor hooks, as well as, graduating and quantifying the compression force by means of a dynamometer.

Figure 7 is a front view in relation to Figure 5, which ^shows' as the boot is closed compressing the patient's leg using the anchoring hooks.

FIGURE 8.- It is a side view in relation to the previous figure, where the angiological boot is shown as compressing the leg and foot of the patient. The present invention consists of an angiological boot (see Figures 1 and 5) whose main functions are, first of all, the generation of pressure impulses by means of a pneumatic chamber (1) provided in its plantar area taking advantage of "human locomotion" or walk as an energy source, and secondly, direct said pressure impulses towards the compression chambers (2 and 3) provided on the inside of the boot that has contact with the patient's leg, precisely exerting compression energy on the ankle and calf area; the angiological boot has two design modalities, one consists of its one-piece design with cross-holding extensions (4) (see figures 1, 2, 3 4), and the other modality consists of its design of adjustable semi-rigid bands (5) (see figures 5, 6, 7 and 8); In both modalities, the angiological boot is made up of a pneumatic chamber provided in the plantar area (1), which is divided into two sections or subchambers (see Figures 1 and 5) located: one in the back area or the heel ( 6), which is attached to the lower compression chamber (2) through an opening forming a single unit, and the other in the area in front or metatarsus (7) of the sole of the foot, which in turn is attached to the upper compression chambers (3) by means of opening also forming a single unit, in this way, the plantar pneumatic chamber (1) is connected to the compression chambers (2 and 3) provided on the inside of the boot and that has contact with the leg, with this system, the pressure impulses generated in the section or sub-chamber located in the heel (6) are directed to the lower compression chamber (2), performing said compression force on the ankle, and the pressure pulses generated in the section or metatarsal subchamber (7) are directed to the upper compression chambers (3) making said compression force on the calf, in this way, the compression energy exerted on the patient's limb is distal to proximal to the heart, in other words, from the bottom (ankle area) to the top (calf area), helping the "venous pumping" system that the human body has; likewise, for supplying air to the sections or subchambers (6 and 7) of the plantar pneumatic chamber (1), the angiological boot has two air supply valves (8), one for each section or subchamber (6 and 7). The angiological boot in its one-piece design modality (see figure 1), made with non-elastic material so that it does not lose compression force, has support extensions (4), which cross-close on the leg of the patient (see figure 2) covering the ankle and calf area completely and firmly (see figure 3 and 4), thus exerting initial compression on it. This compression can be graduated and quantified by means of a dynamometer (9) (see figure 2), depending on the severity that venous insufficiency requires.

As for the modality of design of adjustable semi-rigid bands (5) of the angiological boot (see figure 5), it consists of the integration of a series of individual bands (5) of non-elastic material so that they do not lose compression force, with a length according to the perimeter of the leg (see figure 6), which are joined in a line of common origin by means of anchor rectangles (10) arranged in series, the center of which is divided into two slits (a and b), in the smallest slit (a) is born the adjustable band (5), it passes through the integration bands (11), hugging the end and then, passing through the largest slit (b) of the anchoring rectangle, thus closing the circle said band joining itself by means of the sailboat (see figures 7 and 8), the integration bands (11) are movable and can be in variable number of 3 or 4 depending on the thickness of the leg; they are distinguished in a vertical position, placed around the perimeter of the leg according to the site to be compressed, with the aim of integrating all the adjustable bands (5) in a single unit, as well as integrating the efforts made in the adjustable bands (5) and individualize them at the same time.

For a better understanding of the application of the angiological boot, in the case of its one-piece modality (see figure 2), once the boot is placed on the foot and leg, the holding extensions (4) are passed in crossed shape around the ankle and calf, in this way, the boot adjusts to the entire perimeter of the external area of the limb (see figures 3 and 4), performing the compression force required according to the degree of disease, this compression can be graduated and quantified by means of a dynamometer (9) (see figure 2) when adjusting the extensions on the patient's leg. In the case of its modality of design of adjustable semi-rigid bands (5) of the angiological boot (see figure 5), its application consists in that, once placed on the foot and leg, the adjustable bands (5) are positioned to the limb contour passing the tips through the major slits (b) of the anchoring rectangles (10), they are pulled by means of a dynamometer (9) hooked in a perforation provided at the tip of all the bands (see figure 6 ), traveling and adjusting the perimeter of the leg until reaching the required limit and thus generating the desired and graduated compression force (see figures 7 and 8), immediately, the contact site with the rectangle of origin is marked on the bands, This mechanic is repeated in all the adjustable bands (5) and can be started from the proximal adjustable band to the distal or vice versa adjustable band, with the aim of completing the compression force in the entire outer area of the leg.

In both angiological boot design modalities, compression is perfectly achieved in the retromaleolar space, that is, in the internal and external canal of the achilles tendon and the internal and external malleoles respectively, allowing the boot to be able to compress any point on the perimeter of the ankle, and of the entire leg itself, in this way, the patient is instructed and forced that each time he uses the boot, he must generate only the effort required to adjust either the adjustment extensions or the adjustable semi-rigid bands according to the design of the boot, in the previously graduated and quantified mark.

Once the angiological boot is adjusted on the patient's leg, in whatever its design modality (see Figures 1 and 5), the graduated and quantified pressure impulses are generated, which originate through the pneumatic chamber ( 1) provided in the plantar area of the boot (see figures 1, 2, 5 and 6), for this, air is previously supplied through the feeder valves (8), concentrating in the two subchambers or sections (6 and 7). ) of the plantar pneumatic chamber (1), the patient when making the walk, the first contact with the ground is made with the section that covers the back or the heel (6) of the foot, which, when receiving the Contact generates the first pressure impulse itself that directs the lower compression chamber (2) that covers the ankle area, also, with the continuity of the patient's passage, the section that covers the front or metatarsal part of the foot (7 ) when it receives contact with the ground, it generates the second pressure impulse itself that directs the upper compression chambers (3) that cover the calf area, since these provide opening to each other, thus, the angiological boot self-generates impulses of pressure continuously and constantly taking advantage of the "locomotion" or walk as an energy source, in order to direct said pressure impulses generating constant, graduated and quantified compression energy in the patient's limb, the duration of which depends on the duration of the footfall, magnitude of the patient's weight and the volume of air contained in the pneumatic chamber (1).

The pressure pulses generated by the pneumatic chamber (1) can be directed to the different extremities of the patient's body to generate compression force therein; Said pressure and compression force pulses can be of the following forms and methods according to the extremity or extremities where the compression is channeled, which are:

IPSILATERAL COMPRESSION.- It is generated when the angiological boot is placed on the same limb that suffers from venous insufficiency.

SIMULTANEOUS COMPRESSION TO BOTH LIMBS.- It is when two angiological boots are used on both lower extremities or legs, but with the characteristics that the plantar pneumatic chambers (1) are cross-connected to the compression chambers (2 and 3) of the boot.

ASSISTED COMPRESSION.- It is generated when an angiological boot is placed on a relative and the pneumatic plantar chamber (1) is connected to another boot placed on the patient's leg when he is at rest or cannot walk, thus, the relative generates the pressure impulses directing them to the boot placed on the patient's leg and thus generating the compression energy in it. DISTANT COMPRESSION.- It is when the angiological boot is used on an upper limb or arm of the patient, connected to one or two boots placed on the same person, in this way the boot or boots generate pressure impulses to be directed to the chambers compression (2 and 3) that have contact with the arm.

Also, based on the technical characteristics contained in the angiological boot, 'when the treatment of venous insufficiency that is in use by the pneumatic chamber (1) is not necessary or when it is not required, this invention can be used as a compression garment, but with the advantages and novelties already mentioned, being that the compression can be graduated and quantified according to medical indication.

Claims

1.- Angiological Boot with Plantar Pneumatic Chamber for the Generation of Pressure Impulses, applied in the treatment of lymphatic or arterial venous insufficiency, providing compression energy in a constant, graduated and quantified way to improve the functioning of the "natural venous pumping" and facilitate the blood return to the heart, WHICH CHARACTERIZES because for its application it is integrated from a pneumatic chamber provided in its plantar area whose function is the generation of pressure impulses taking advantage of the "human locomotion" or walk as a source of energy, which they are directed towards the compression chambers provided in the inner part of the boot that has contact with the patient's leg exerting precisely on this limb the compression force, the plantar pneumatic chamber is divided into two sections or subchambers: one in the area of back or heel which is attached to the lower compression chamber by means of an opening forming a single unit, and the other in the front or metatarsal area of the sole of the foot which in turn is attached to the upper compression chambers by means of an opening also forming a single unit, also, the angiological boot It has two air supply valves, one for each section or subchamber, by which said air is supplied to the plantar pneumatic chamber, in this way, the pressure pulses generated in the section or subchamber located in the heel are directed to the lower compression chamber performing said compression force on the ankle, and the pressure pulses generated in the section or subchamber of the foot metatarsus are directed to the upper compression chambers, performing said compression force on the calf; With this system, the compression energy that is exerted is distal to the heart, that is, from the bottom (ankle area) to the top (calf area) helping the "venous pumping" system available to the human organism.

2.- Angiological Boot with Plantar Pneumatic Chamber for the Generation of Pressure Impulses, according to Claim 1, CHARACTERIZED by the fact that it has two design modalities, which: one consists of its design of a single piece with cross fastening extensions, made with non-elastic material so that it does not lose compression force, the fastening extensions are closed crosswise on the patient's leg covering the ankle and calf area completely and firmly, thus exercising , the initial compression on it; and the other modality consists in its design of adjustable semi-rigid bands, the bands are individual made of non-elastic material so that they do not lose compression force, with a length according to the perimeter of the leg, these are combined in a line of common origin by means of anchoring rectangles arranged in series, in which the adjustable band is born, to pass through the integration bands, hugging the limb and thus closing the circle joining said band itself by means of the sailboat, the integration bands are movable and can be in variable number of 3 or 4 depending on the thickness of the leg; they are distinguished in an upright position, placed around the perimeter of the leg according to the site that is to be compressed, with the aim of integrating all the adjustable bands in a single unit, as well as integrating the efforts made in the adjustable bands and individualizing them at the same time. In both designs of the angiological boot, the compression exerted on the patient's limb can be graded and quantified by means of a dynamometer, depending on the severity that the venous insufficiency requires.

3.- Angiological Boot with Plantar Pneumatic Chamber for the Generation of Pressure Impulses, according to Claim 1, CHARACTERIZED by the fact that the pressure impulses generated by the pneumatic chamber can be directed to the different extremities of the patient's body to generate in them compression force that can be as: ipsilateral compression, which is generated when the angiological boot is placed on the same limb that suffers from venous insufficiency, simultaneous compression to both limbs, which is when two angiological boots are used on both lower limbs or legs, but with the characteristic that, the pneumatic chambers are cross-connected to the compression chambers of the boot, assisted compression, which is generated when an anglographic boot is placed in a relative and the pneumatic chamber is connected to another boot placed on the patient's leg when at rest or unable to walk, from this Thus, the family member generates the pressure impulses by directing them to the boot placed on the patient's leg and thus generating the compression energy in it, distal compression, which is when the angiological boot is used on an upper limb or arm of the patient, connected to one or two boots placed on the same person, in this way the boots or boots generate the pressure impulses to be directed to the compression chambers that have contact with the arm.

4.- Angiological Boot with Plantar Pneumatic Chamber for the Generation of Pressure Impulses, according to Claim 1, CHARACTERIZED by the fact that the boot can be used as a compression garment when it is not necessary or when the treatment does not require it of venous insufficiency, that the pneumatic chamber is in use, however, based on the technical and novel characteristics that the boot contains, the compression exerted can be graduated and quantified according to medical indication.