ARMMOVEMENTRESTRAININGANDPERMISSIONCORDFORP.docx
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ARMMOVEMENTRESTRAININGANDPERMISSIONCORDFORP.docx
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ARMMOVEMENTRESTRAININGANDPERMISSIONCORDFORP
ARMMOVEMENTRESTRAININGANDPERMISSIONCORDFORPATIENTSRECEIVINGCARDIACPACEMAKERSANDSIMILARIMPLANTS
RELATEDAPPLICATIONS
ThisapplicationclaimsprioritytoU.S.ProvisionalPatentApplicationSer.No.60/836,075,filed7Aug.2006(Aug.7,2006).
BACKGROUNDOFTHEINVENTION
1.FieldoftheInvention
Thepresentinventionrelatestoanapparatusforrestrainingarmmotionaftersurgicalimplantationofamedicaldeviceinthechestofapatient.
Moreparticularly,thepresentinventionrelatesanapparatusforrestrainingarmmotionaftersurgicalimplantationofamedicaldeviceinthechestofapatient,wheretheapparatusincludesawaistmember,aresilientmemberandawristmember.Thewaistmemberisadaptedtodetachableattachafirstendoftheresilientmembertothepatient'swaist(belt,pantloop,etc.),whilethewristmemberisadaptedtoattachasecondendoftheresilientmembertothepatient'swristorforearm.
2.DescriptionoftheRelatedArt
Afterimplantsurgeryinthechestcavitysuchastheimplantationofacardiacpacemaker,thepatientisinstructedtodonormalexerciseswithbotharms,butnottoraisethepatient'sleftarmaboveshoulderlevel(inrarecases,thepacemakerleadsarepositionedinthepatient'srightarmandthepatient'srightarmshouldnotberaisedaboveshoulderlevel).Thepatientisthengivenatraditionalsling.However,aslinginnowaypermitsnormalmotionorrestrainsthepatientfromraisinghis/herleftarmaboveshoulderlevel.
Thus,thereisaneedintheartforasimpleandeasyapparatusthatcanbeusedbyapatientreceivingachestimplantthatconstrainsthepatient'sleftarmfrombeingraisedaboveshoulderlevelduringwakingandsleepinghours,yetpermitnormalarmactive.
SUMMARYOFTHEINVENTION
Thepresentinventionprovidesawaistmember,aresilientmemberandawristmember.Thewaistmemberisadaptedtodetachableconstrainafirstendoftheresilientmembertothepatient'swaist,whilethewristmemberisadaptedtoconstrainthesecondendoftheresilientmembertothepatient'swristorforearm.
BRIEFDESCRIPTIONOFTHEDRAWINGS
Theinventioncanbebetterunderstoodwithreferencetothefollowingdetaileddescriptiontogetherwiththeappendedillustrativedrawingsinwhichlikeelementsarenumberedthesame.
FIGS.1A&Bdepictsideandtopviewsofanembodimentofanapparatusofthisapplication.
FIGS.2A&Bdepictsideandtopviewsofanotherembodimentofanapparatusofthisapplication.
FIGS.3A&Bdepictsideandtopviewsofanotherembodimentofanapparatusofthisapplication.
FIGS.4A&Bdepictsideandtopviewsofanotherembodimentofanapparatusofthisapplication.
FIGS.5A&Bdepicttopviewsofanotherembodimentofanapparatusofthisapplication.
FIGS.6A-Ddepictpicturesofanembodimentofanapparatusofthisinventioninoperation.
DETAILEDDESCRIPTIONOFTHEINVENTION
Theinventorshavefoundthatasimpleapparatuscanbeconstructedforbetterrestraintofarmmotionafterthesurgicalimplantationofadeviceinapatient'schestsuchasacardiacpacemaker,cardioverterdefibrillators(ICD),orothersimilardevices.Theapparatusallowsapatientnearnormalandfullrangeofmotionofoneofthepatient'sarms(inmostcasestherightarmandinrarecasestheleftarm),whilegreatlyreducingthepatient'sabilitytoinadvertentlyperformarmmovementswiththeotherarmthatcouldleadtopostimplantationcomplications.Generally,theapparatusisadaptedtorestrictthepatientfromraisingtheotherarmtoalevelaboveshoulderleveltherebyreducingapotentialforpullingtheleadsorelectrodesfromoroutoftheheartmuscle.Theapparatuscanbeaunitarystructure,atwopiecestructureoramulti-piecestructure,includingawaistengagingportionormemberandawristorforearmengagingportionormemberwitharesilientportionormemberinterconnectingthewaistandwritportionsormembers.Ofcourse,iftheapparatusisaunitaryconstruction,thenthewaistandwritportionscanberesilientaswell.
Thepresentinventionrelatesbroadlytoanarmrestraintincludingawaistengagingmemberorportion,awristorforearmengagingmemberorportionandaresilientchordorbandmemberorportioninterconnectingthewaistandwristportionsormembers,wheretheapparatusisadaptedtopermitnearlyfullnormalrangeofmotionwhilerestrainingone'sabilitytoraisetheconstrainedarmaboveshoulderlevel.Theapparatuscanbemadeindifferentsizesorcanbeadjustablesothatonesizefitsall.Bandadjustmentcaneitherbymadebymanufacturingasetofapparatusesofthisinventionwithdifferentlengthbands,bandshavingdifferentelasticproperties,anddifferentsizesandtypesofengagingmemberstoaccommodatedifferentpatienttypes.
Thepresentinventionisradicallydifferentvisuallyandfunctionallyfromanarmsling.Itismuchmoreprotectiveofpatientswhohaverecentlyreceivedacardiacimplantdevice.Theapparatusofthisinventionphysicallyremindspatientstoavoidhabitual/life-longarmmovements,ordangerousarmmovementswhilesleepingthatcanthreatenthepatient'shealthand/ordamagetherecentlyimplantedcardiacdevice.Theapparatusalsofacilitatesarmmovementsthathastenhealthyrehabilitation.
Thepresentinventionsupplementspost-operativeadvice,care,limitationsandboundariesthatpatientsshouldfollowafterreceivingacardiacpacemakerorcardioverterdefibrillator(ICD).Thefactthatpost-operativeadvicefromrenownedinstitutionsvaryagreatdealwithrespecttothelengthoftimeapatientneedstoguardagainstpullingouttheirimplantleadsfromtheirheartmuscle(thislengthoftimevariesfrom1to8weeks),suggeststhatcarefulandsustainedattentionandresearchhavenotbeengiventopost-operativecare.Itislikelythatthisresearchvacuumaccountsforthecontinuingissuingoftraditionarmslingstosuchpatientsthatarecounterproductivetoandunderminethetwomainandconstantly-repeatedaimsofpost-operativecare,e.g.,armrestraintandhealth-promotingarmmovements.Thepresentapparatuswasadaptedtobehighlyprotectiveandusefulforallpersonswhoreceivecardiacpacemakerandimplantabledefibrillators(ICDs).Itmightalsoprovehighlyusefulforothertypesofpost-surgicalpatients,e.g.,offeringarm-handrestraintsforpatientswhohavehadeyesurgeryandarewarnednottotoughtheireyes.
Introduction
Afterreceivingacardiacpacemaker,apatientisnormallytold,atcheckoutfromthehospital,torestrictthemovementofonearm,inmostcasestheleftarm,inordertokeepfrompullingoutthewireleadsofthepacemakerembeddedinthepatient'sheartmuscle.Apacemakerisimplantedinthechestareanexttoanon-dominantarm.Therefore,right-handedpersonshavethepacemakerplacedinthechestareaproximatetotheleftarm,whileleft-handedpersonshavethepacemakerimplantedinthechestareaproximatetotherightarm.
Becausetheseleadsareattachedtothepacemakerthatisplacedinthechestmostoftenproximatetothepatients'leftarm,patientsarewarnedthatraisingthatarmaboveshoulderlevelorpickingupanythingweighingmorethanabout5poundsforseveralweekscouldpulltheleads/electrodesoutofthepatient'sheartmuscle,therebythreateningthepatient'shealthandrequiringthepacemakeroperationtoberepeated.
Severalweeksofrestrictedmovementenabletheleadstobecomesecurelyattachedandembeddedintheheartmuscle.Similarrestrictionsaregivenforothertypesofimplantablecardiacdevices.Whilethelengthoftimeforconstrainedarmmotionvaries,thelengthoftimegenerallyisbetween1and8weeksdependingonthehospitalwheretheimplantationwasperformed.
Thesedirectivesregardingwhatpatientsshouldnotdoaregiventothehundredsofthousands(perhapsmillions)ofpersonseachyearwhoreceivepacemakersandothertypesofsurgicallyimplanteddevices.Atthesametime,patientsaretoldwhattheycanandshoulddo.Theyshouldresumemostoftheirnormal,non-strenuousactivitieswiththearmnearesttothesurgicalsite.TheClevelandClinicstates:
“Youmaymoveyourarmnormallyanddonothavetorestrictitsmotionduringnormaldailyactivities.”Inkeepingwithsuchdirectives,pacemakerrecipientaretoldthatitisimportanttomovebotharmsforthesakeofbetterhealing,protectionagainstthelossofmusclestrength,maintainingarmagility,andsoon.
Problems
Theproblemwiththesedirectivesregardingwhatpatientsshouldnotandshoulddoisthattoassistpatientsinfollowingthesedirectives,patientsareissuedastandardarmsling,anarmslingdesignedspecificationforbrokenarms,towearuponleavingthehospital.However,sucharmslingsaretotallycounterproductivetothepost-operativecounselthepatientsare.
Infact,thetraditionalsling,becauseofitsdesign,keeppatientsfromdoingwhattheyweretoldtheyshouldbedoing,i.e.,normal(butnonstrenuous)movementsoftheleftarm,andhavelittleornoeffectonrestrictinghowhightheleftarmisraised.Thedesignofatraditionalarmslingdoesnotpreventapatientfromraisinghis/herarmaboveshoulderlevelwhileawakeorasleep.Thus,traditionalarmslingsarewhollyinadequatetopreventorremindpatientsnottoraisetheirleftarmaboveshoulderlevel.Thislackofprotectionfromatraditionalarmsling,hasanddoescausepatientstohavetogobacktothehospitaltohavepulledoutleadsreinsertedintotheheartmuscle.
Solution
Thedeficienciesinatraditionalarmslingareovercomebytheapparatusofthisinvention.Initscrudeform,theapparatus
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