CA2165064A1 - Nerve stimulating device and asociated support device - Google Patents
Nerve stimulating device and asociated support deviceInfo
- Publication number
- CA2165064A1 CA2165064A1 CA002165064A CA2165064A CA2165064A1 CA 2165064 A1 CA2165064 A1 CA 2165064A1 CA 002165064 A CA002165064 A CA 002165064A CA 2165064 A CA2165064 A CA 2165064A CA 2165064 A1 CA2165064 A1 CA 2165064A1
- Authority
- CA
- Canada
- Prior art keywords
- frequency
- stimulation
- key
- carrier
- waveform
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/36014—External stimulators, e.g. with patch electrodes
- A61N1/36021—External stimulators, e.g. with patch electrodes for treatment of pain
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/0404—Electrodes for external use
- A61N1/0408—Use-related aspects
- A61N1/0452—Specially adapted for transcutaneous muscle stimulation [TMS]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/0404—Electrodes for external use
- A61N1/0408—Use-related aspects
- A61N1/0456—Specially adapted for transcutaneous electrical nerve stimulation [TENS]
Abstract
An electrical nerve and electrical muscle stimulation device (14) used in association with a support (12). The stimulation device is adaptable to be selectively engageable with a plurality of different body braces such that output connectorsassociated with the stimulation device electrically contact keyed connectors associated with a mounting carrier (16) secured to the particular support. The support includes at least two electrode pads (44, 46) which are selectively positionable at different locations on the support. The connection between the output connectors of the stimulation device and the keyed connectors applies a stimulation signal to the electrode pads (44, 46) the size of which determines the carrier frequency or the stimulation signal which is impedance matched to the electrode size.
Description
NERV13: Sllr.lUL~TlNG DEV~OE AND Assoc~Al~;D SUPPORT Dh~llOE
BACKGROUND OF THE INVENTION
1. Cross-Reference To Related Application This patent application is related to United States Patent Application Serial Number 07/804,455 ffled December 10, 1991, by Doctor Paul T. Kolen for a Local Application Micro Processor Based Nerve and Muscle Stimulator which is inco~porated herein by this ~fere,.ce.
BACKGROUND OF THE INVENTION
1. Cross-Reference To Related Application This patent application is related to United States Patent Application Serial Number 07/804,455 ffled December 10, 1991, by Doctor Paul T. Kolen for a Local Application Micro Processor Based Nerve and Muscle Stimulator which is inco~porated herein by this ~fere,.ce.
2. Field Of The Invention This invention relates generally to Transcutaneous Electrical Nerve Stimulation (TENS) and Electrical Muscle Stimulation (EMS) devices that provides a stimulating waveform that is imped~nce matched and, more particularly, to a TENS or EMS device in combination with a Support Device such as an orthopedic brace, wrap or Su~ l, the combination providing an integrated means of supplying a nerve or muscle stimulation waveform and wherein the TENS or EMS device is keyed to the particular Support Device used and is impedance matched to the electrodes being used.
3. Discussion Of The Related Art TENS and EMS devices that apply stimulation signals to a particular area of the human body in order to ~U~plCss pain or stimulate a muscle are known in the art. It has been well documented that applying a pulsed waveform, having an adjustable 2 0 intensity, pulse duration and pulse width, to an afnicted area of tissue to stimulate nerve fibers is effective to suppress pain originating from the immediate area. TENS devices have been used for the symptomatic relief and management of chronic, post-surgical, WO 94/28966 ~ PCT/US94/06026 and post-traumatic acute psin. EMS de~ices use more powerful waveforms to cause a muscle contraction. These induced muscle contractions are useful in physical therapy for muscle reeducation, retardation of atrophy and increasing a range of motion. For convenience, both TENS and EMS devices will be colle~ el~ ~efe.,~d to herein as Stimulation De~ices. Where it is ~-ecessPIy to differentia~e bel~.cel. the two, the specific device will be mentioned.
In the conventional Stimulation Devices, a pulse generating circuit will generate a pulse waveform having the desirable parameters. A pair of electrodes positioned st a person's skin will apply a bipolar waveform to the skin of the patient. During lo the positive half of the waveform energy is transferred in one direction to the tissue l,el~.~cn the electrodes and during the negative portion of the waveform energy is transferred in the other direction to the tissue bel~.cen the electrodes. The tissue bel~.~cn the electrodes will act as an electrical load consisting of the skin, muscle and nerve fibers in this area. By varying the frequency, amplitude, pulse width and wavefonn shape of the stimulation signal a therapist can control the effect that the stimulation signal will have on the nen~e between the electrodes. A TENS unit uses a stimulation signal that is strong enough to cause ner-~e stimulation but which is not strong enough to cause a muscle contraction. EMS, on the other hand, uses a stronger signal and causes the muscle to slowly contract and then rele~e.
2 o Stimulation units are typically plug-in desk top units that are used by doctors and physical therapist at a treatment center or are battery operated and can be used on an out-patent basis. The patient is trained by the doctor or therapist in the procedure of using the TENS unit that is tailored to that individual's need. If the patient wishes to move around during treatment, then the patient must pick up the Stimulation Device Wo 94/28966 21~ 5 0 6 4 PCT/US94/06026 and carry the unit or have the device clipped on while the patient is in motion.
Otherwise, ~he patient must remain stationary during the treatment.
SUMMARY OF THE INVENTION
S This invention discloses a Stimulation Device (TENS or EMS) used in association with a Support Device. The Stimulation Device is adaptable to be selectiveb engageable with a plurality of different Support Devices (orthopedic brace or vrrap or other garment capable of supporting a Stimulation Device) such that output connectors associated with the Stimulation Device electrically contact keyed cnnnect(!rs associated v.~ith a mounting carrier integrated with the particular Support Device. The Support Device includes at least two electrode pads which are selectively positionable at dif~erent locations on the Device. The connection bel-.~e.. the output connectors of the Stimulation Device and the keyed connectors of the Support De- ice transfers the stimulation signal to the electrode pads held in position by the Support Device. The keyed connectors of the mo~mting 15 carrier pro~ide a three-bit binary code that can be used by the Stimulation Device to determine what bpe of Support Device the Stimulation Device is being connected to and, for instance, the size of the electrodes connected to the Support Device so that the Stim~ ti~n Device can adjust the carrier 1~4L.cncy of the stimulation signal so that there is an impedonce match between the output waveform of the Stimulation Device 20 and the load (the load co ,.i,~rding to the im~ec~ ce of the two electrodes when attached to the patient).
Additional objects, advantages, and features of the present invention will become spparent from the follov~ing description snd the sppended rl~im~, tsken in conjunction with the sccomr~nying dl&~.;ngs.
wo 94,28966 2 ~ ~ 5 ~ ~ 4 PCT/IUS94/06026 BRIEF DESCRIPI'ION OF THE DRAWINGS
Fig. 1 is a side view Or a person wearing a Support Device that is a knee brace incorporating a Stimulation Device according to a preferred embodiment ot the present invention;
Fig. 2 is an enlarged side view Or the knee braoe and the ~csoci~ted Stimulation Device of Fig. l;
Fig. 3 is an inside front view of the brace Or Fig. 1 showing the electrode place...e..t;
Figs. 4A and 4B are front and back views of the Stimulation Device unit of Fig.
10 1;
Figs. S through 8 are pulsed output signals from a TENS unit showing difrerent frequency and amplitude variations of the signal;
Figs. 9, 9A, and 9B are schematic diagrams of the circuitry of a TENS unit; and Fig. 10 is a software flow diagram for a TENS unit.
DETAILED DESCRIPI'ION OF T~E PREF ERRED EMBODIMENTS
The following description of the ~J,efe.l~d embodiment concerning a TENS unit and its n-ssori~ted brace is merely exemplary in nature and is in no way intended to limit the invention, its application or uses. A Support Device is specifically defined as an 2 0 orthopedic brace or wrap or other garment capable of supporting a Stimulation Device while said Support Device is se~urcd to a person. A Stimulation Device is defined as a portable TENS or EMS device.
Turning to Fig. 1, a person 10 is shown wearing a Support Device which in this case is a knee brace 12 generally comprised of a specinlb shaped neoprene wrap.
Neoprene braces of this type are well known in thc art. Securely PtP~ to an outer surface of the brace 12, according to a ~refer.~d embodiment of the pKsent invention, 5 is a TENS unit 14 for providing stimulation signals to select~ portions of the persons skin beneath the brace 12. The stimulation signals are applied to electrodes (see Fig.
3) positioned over an amicted area in order to i~,ppleSS pain as a result of any number of different sources of iruuries or ~ur~er;~ - The dif~erent sources of pain and iniury for which TENS is applicable is well understood in the art and the usefulness Or EMS
lO devices during physical therapy for muscle reeducation, retardation of atrophy and for increasing the range of motion are also well understood in the art. Other types of orthopedic braces and wraps for the knee, or other parts of the body, could also be used in association with a Stimulation Devices such as the TENS unit 14 that is shown.
Other types of orthopedic braces include, but are not limited to, back braces, shoulder 15 braces, elbow braces as well as sleeves made from various materials such as neoprene and lycra. The TENS unit 14 is shown in this view to illustrate that normal daily activity can be ~.ro~ ed while the TENS unit 14 is in use.
Fig. 2 shows an enlarged side view of the knee brace 12 and the associated TENS
unit 14. In this figure, the ll~:NS unit 14 is shown partially secured to a support carrier 2 o 16. The carrier 16 is a molded plastic structure se.. ,red to the neoprene brace 12 in any effective manner. In this example, the carrier 16 is se~ured to the brace 12 by means of extra neoprene material 18 sewn onto the brace 12 and placed over extended edges (not shown) of the carrier 16 such that the carrier 16 is securely ~tt~ to the brace 12. The TENS unit 14 comprises a molded plastic housing 20 for enclosing the different WO 94/28966 ~ PCT/US94/06026 electrical components associated with the unit 14 and shown in schematic rorrn in Figures 9, 9A, and 9B. The housing 20 includes molded grooves (not shown) along both sides of the housing 20. The grooves are sli~hle onto tabs 22 eYten~lin~ towards each other from sidewalls on the carrier 16. In this manner, the TENS unit 14 is readily S connected and s~ ~d to the brace 12 in a locking engagement. The TENS unit 14 can be secul~ to the brace 12 in any number of other ways, and can be secured to an inner surface of the brace 12 out of view without departing from the spirit and scope Or the invention.
A series of spring-loaded keyed electrical connectors 24 are molded to the carrier 10 16 at one end, as shown. In a preferred embodim~rt, there are seven individual pin connectors associated with the keyed connectors 24. First and second pins are for electrical contact to the electrodes for a first cl ~r~nel of the TENS unit 14; the third and fourth pins are for electrical contact to the el~ l,odes of a second channel in the TENS
unit 14, and the fifth, sixth and seventh pins are the keyed portion of the connector 24 15 and are used to generate a binary 3-bit code that can tell the TENS unit 14 what type of Support Device the TENS unit is being inserted into and, for instance, the type or size of elc.1,~de that is being used in conjunction with that Support Device. Onoe the Support De~ice type and the electrodes size are known by the TENS unit 14 then the TENS unit 14, can adjust its carrier frequency so that there vvill be an impedance match 20 I~l~.~ell the output and the load. This will be ~ cuss~ in greater detail below. The keyed connectors 24 are electrically connected to the output connectors 92 (see Fig.4B) ~csocis~ted with the TENS unit 14 when the unit 14 is completely inserted ~nd locked into the carrier 16. The pins of the keyed conl~ectors 24 used for the cl~:lrodes are electrically connected to wires (see Fig. 3) which are then eleclr.~-lly connecte~l to the Wo 94/28966 2 :16 5 O ~ 4 PCT/USg4/06026 electrodes. As is apparent, the laminate material 18 extends down the brace 12 to support the wires between the brace 12 and the material 18. The operation of the keyed connectors 24 and the ~SSOCiflted electrodes will be dircussed in greater detail below.
Fig. 3 shows an inside view of the brace 12 as if it were cut lengthwise down its 5 back and ope c~ to reveal an inner surface 30 of the brace 12. In this view, the carrier 16 and the material 18 would be on an opposite surface from the surface 30. A first wire 32 and a second v~ire 34 are shovrn extending from the carrier 16 along the laminate material 18. The v,~ires 32 and 34 protrude from the surface 30 through holes 36 and 38, ~s~cli~el~O Each of the wires 32 and 34 include an end pin connector 40 and 42, 10 ,~spc.li~elyO The pin connectors 40 and 42 are electrically connected to electrode pads 44 and 46, respectively, by sliding the pin connectors 40 and 42 into a~ ;ate connectors associated with the pads 44 and 46. The conr^~t~rs 40 and 42 connect to the back of the electrode pads 44 and 46 ag,qinct the surface 30. The electrode pads 44 and 46 r~ se- t a first channel for applying one stimulation signal to the skin of the user, 15 but it will be understood that in a preferred embodiment there are two other elccll.des pads (not slhown) which establish a second ch~nr~l The electrode pads 44 and 46 consist Or silicone conducti~e rubber electrodes co.e.~d by a water wicking material 48 and ~0,1ei.~ , on a side of the pads 44 and 46 adjacent the user's skin. Additionally, the pads 44 and 46 include a loop material 20 (not shown) on a side towards the surface 30 which can be a pile surface. The water wicking material m~irtnir~ a layer of water bel~.~cn the skin and the elec~rode pads 44 and 46 in order to establish a conductive layer in this region. The electrode pads 44 and 46 are removably secu~ed to the surface 30 by means of the loop material. In this manner, the ele~:lrode pads 44 and 46 can be placed at virtually any desirable location Wo 94/28966 ~ 1 6 ~ O ~ 4 PCT/US94/06026 on the inner surface 30 of the brace 12 within the length Or the wires 32 snd 34. The electrode pads 44 and 46 can be of any desirable size or shape, with respect to the size and type of the Support Device being used and the desired treatment.
Figs. 4A and 4B show a front ~iew and a back view o~ the TENS unit 14, 5 ~c~ ively. The TENS unit 14 is separated into a top portion 60 and a bottom portion 62. The top portion 60 ~ ic911y has a deeper dimension than the bottom portion 62 in order to accommodate a battery pack (not shown) in a battery co~npartment 64. In one ~mhotlin~ent, the battery pack is two replacesble AA size slk~lirJe batteries or two nickel-cadmium rechargeable batteries that fit into the compartment 64 in order to provide 10approYim~tely 2.4 to 3.0 volts. The TENS unit 14 could also incorporate throw-away batteries such that the battery compartment 64 could be elimi-~ted. In this alternate embodiment, the TENS unit 14 could be reduced in size to accommodate the battery size. In the embodiment as shown, the TENS unit 14 is approximately 9.68 cm long, 5.88 cm wide and 2.08 cm deep, and weighs about 3.2 oz.
15The bottom portion 62 accommodates the electrical circuitry. A front face 66 of the bottom portion 62 ^rc- n ~ tes a number of contr~l keys. Onoe the TENS unit 14 is inserted into the carrier 16, the unit 14 is operational. A slidable power switch 68 is pro~ided, and when moved to an ON position, an energy output signal will be delivered to the electrode pads 44 and 46. A default output wa~eform will have a carrier 20 frequency that consists of a high frequency, typically on the order of 2.5 to 3 K~z, that is a bipolar, syml.~etrical one period signal having a zero net DC component. The carrier frequency is modulated into a low therapeutic frequency, typically on the order of a 2 to 100 ~Iz pulse train. Such an output signal is shown in Fig. ~. The carrier frequency is the burst of relatively high frequency, one period wave measured between 1-- ling edge 71 and trailing edge 73. The therapeutic n~ y is the low frequeng w~lveform n~ l red between l-- ling edge 71 of l~ g edge 75. It i5 the carrier frequency that establishes the impedance matching between the output signal and the load. The time l~h.~en the low frequeng pulses, .~presents the time that is allowed for S the stimulated nerves to be reset for subsequent firing. The frequency Or the 2,500 to 3,000 Hz carrier signal is too fast for the nerve to reset bet~ ~en the indi~idual pulses Or the two pulse burst. TheN r~ e, the nerve reacts to the bipolar burst of carrier rrequency as if it were in effect one pulse. Because the waveform is alternating current, there is no net direct current component. Therefore, there are no net polar effects to cause long-10 term positive-..c~j&li~ ion concentrations in the tissue.
The size of the cle~trodes 44 and 46 determine the effecti~e capacitance that exists when electrodes are coupled to the patient's skin. Put simply, an electrode acts as one plate Or a first capacitor and the skin acts as a dielectric. The other electrode acts as the plate of a second capacitor which is effe~ co-r~ected in series with the first 15 capacitor. When the si_e of the electrode is increased, it increases the effective surface area of the capacitor plates which, in turn, increases capacitance. As will be dirc~lssed below, when this capacitance changes, optimqlly, the carrier fi~ eng should change so that there is an impedance match l~t~ ~e., the output of the TENS unit and the patient thereby mq~imi7ing the efficient power transfer from the TENS unit to the patient. As 20 will become apparent from the dicc~csicn below, for a particular elc trode si_e, the carrier frequeng will remain the same. It is the therapeutic rr~41 c.-cy and intensity which will be altered by the control keys to give different stimulation results. Ihe waveform parameters of the ther~peutic waveform are controlled by the control keys lo ~te 1 on the front face 66 of the unit 14, as shown in Figure 4A. A positive intensity WO 94/28966 21~ 5 0 ~ 4 PCT/US94106026 control key 72 and a negative intensity control key 74 increase and decrease the amplitude Or the waveform for the rlrst chsnnel. Therefore, in order to increase or decrease the amplitude of the therapeutic waveform, the user need only press the key 72 or the key 74. Likewise, for the second channel, the user need only press an increase 5 intensity key 76 or a decrease intensity key 78. In order to increase the therapeutic frequency, the user plesses an increase rate key 80 or a decrease rate key 82. In a pf~fer.ed e~bodiment, the fre~uency varies from 2 pps to 100 pps in suYteen steps. One set of frequency keys 80 and 82 control both ch~rrelc.
The control keys also include a number of preset program keys. These preset 10 program keys include an intensity surge key 84, a frequency surge key 86, a intensity/frequeng surge key 88, and a surge rate key 90. As shown in Fig. 6, by pressing the intensity surge key 84, the therapeutic waveform will ha~e an increasing and decreasing amplitude. As is apparent from this figure, the amplitude of the therapeutic waveform gradually increases to a maximum value, and then gradually decreases to a 15 minimum value. The therapeutic waveform will cycle in this fashion for a particular therapeutic effect.
When the frequency surge output key 86 is pressed, the therapeutic waveform will have a decreasing and increasing rr~Le.-cy as shown in Fig. 7. In this figure, the therapeutic waveform continuously gcles from a minimum frequency to a maximum 20 frequency for another therspeutic effect.
By pressing the intensib/fi~4uer.c~ surge rate key 88, the frequency and intensity of the therapeutic ~re~ U~Cy vary at the same time. Specifically, as shown in Fig. 8, as the fre~l~.el.cy decreases, the amplitude increases, and as the fi~luency increases, the amplitude decreases for yet another therapeutic effect.
The surge rate key 90 controls how fast each type Or ~arying wa~eform discussed above cycles. Specifically, the surge rate key 90 controls the surge rate for the intensity surge, the frequency surge, and the intensity/frequency surge. When the user ~.~sses the surge rate key 90, esch of these rates will jump to either a slow, medium, or fast surge 5 rate. After reaching the fast surge rate, the next time the surge rate key 90 is pr ssed, the surge rate will jump to the slow rate. When the TENS unit 14 is switched off, the waveform parameters are sa~ed to a non- ~olatile memory.
As ~liscusse~l above, the carrier 16 is equipped with se~en spring loaded keyed output connectors 24. Four of these connectors are connected to the wire leads and then 10 to the conductive electrode pads. The relnDiri-g thm connectors are for pad logic.
These seven ro ~r~ l D;s 24 (Fig. 2) align with and connect to se-~en output pins 92 (Fig.
4B) on a back surface 94 of the TENS unit 14. This binary code on the three pad logic connectors will tell the mi~lo~ccssor the size of the electrodes so that the microprocessor can cause the frequency generator to generate the a~prop.;ate carrier 15 frequency that will impedance match output signal to the electrodes on the skin. In the ~Yompl~ abo~e, there are three output connectors which determine the carrier frequency of the output signal. Therefore, there are four different combinations that can re~ . se--t the electrode size. Of course, more or less connectors could be used in the same fashion which would allow esch Support Device to be keyed in a f~chio-~ such that when a 20 StimrlDt;on Device is inserted into the carrier 16, the Device will know any desirable characteristics of the Support De~ice including the type of brace, the clc~lrode size, and, for ir~tD ~ce~ a particular therapy that is desired. In this ~r~ner, a Stimulation De~ice can be ~tt~he~l to a plurality of different Support Devices having different sized electrodes, and be automatically adjusted for the proper carrier 1~ cy for impe~l~r~
WO 94/28966 216 ~ ~ ~ k PCT/US94/06026 matching. The thm pad logic connectors also ~r~fG.... a safety t. r~ion. Ir the TENS
unit 14 is remo~ed from the carrier 16 then the TENS unit 14 detects that there is no connection to the three pod logic conr~ lD~S and TENS unit 14 turns itself ot~
Turning to Figs. 9, 9A and 9B, a schematic diagram of the TENS circuitry is 5 shown. Figures 9, 9A and 9B connect together in the following manner to show a complete circuit diagram for the TENS unit 14. The lines 100 in Figure 9 connect to the lines 100 in Figure 9A, the line 102 in Figure 9 connects to the line 102 in Figure 9A and the lines 104 in Figure 9 connect to the lines 104 in Figure 9A.
In Figure 9, the control pads in block 106 correspond to the control psds shown in Figure 4A. The pads 92 in Figure 9 also ci)r~es~ond to the pads 92 shown in Figure 4B and ~c~ re~ts the co~r~ectio~ interface bet~..c~ the TENS unit 14 and the Support Device or, in this case, knee brace 12. The micro-controller 108 is an INTEL 80C51 and is connected as shown in Figure 9. Memory 110 is E2 PROM and is used as a non-volatile memory to store the program to set operating parameters and the default 15 pa~ tc~s. The resistor network 112 acts as a digital to analog co ~.. Ier that ~ccives the digital outputs from lines PBO through PB7, via buss 114 and con~erts that digital signal to the analog output on line 102. The range of the analog output on line 102 is O through S volts. This analog output sen~es as the intensity control for the output ~ ~.vefo.~s. The waveform generator 116 in Figure 9A is a dual four channel analog 2 0 multiplexor that is made by Motorola. The input on line 102 controls the amplitude of the ~ .rO .I. and control lines 100, which come from the microcontroller 108 in Figure 9 control the frequency out of the wsveform generator 116. In Figure 9A, the output for channel 1 is on lines 118 and 120 and the output waveform for channel 2 is on lines 122 and 124. Lines 118 and 120 are re~l,ecli~ely connected to the output drive transistors wo 94,28966 ~ L 6 51~ 6 ~ PCTIUS94/06026 126 and 128. Transistors 126 and 128 are N-channel enhancement mode mosrets made by Siliconix. Typically, the signal on line 118 will go fmm _ero to its p.-sel~t~
intensib leYel as determined by the signal on line 102, and it will stay high ror a period Or time and Ibe shut off. Almost at the same time, the signal on line 120 will go high s causing the tr~rCictor 128 to turn on and pull the signal applied to the primary of transformer 134 in the opposite direction. When the waYeform on line 120 goes to _ero, tr~ f;--Dr 128 turns off and causes the output voltage to fall to _ero. Transformer 134 is a 1 to 29 step up, push pull transformer which produces an output waveform across lines 138 and 140 substantially as shown in Figure 5. Channel 2 operates in an identical lo fashion as Channel 1. If the amplitude of the waveform on Channel 1 is different from that on Channel 2, then before Channel 2 is turned on, the microcontroller 108 will send a dirre~t digital signal to the digital-to-analog conYerter 112 causing the analog voltage on line 102 to change to the præsel~ l2d value prior to the time a signal is put on line 122 thereby init~ 7ing the output waveform for Ch~nrel 2. The microcontroller 108 in 15 Figure 9 mulli~l^Y~s between Channel 1 and Channel 2 to provide waveforms with the same r~ cies in Channels 1 and 2. ~owever, the amplitudes of the waveforms in Channels 1 and 2 can be independently varied. The Channel 1 and 2 ~ t~ Is on lines 104 are co ~nected to the Channel 1 and 2 output lines in Figure 9 which are connected to output connectors 92 in Figure 9. Pads 1, 2 and 3 in block 92 on connector J1 are 20 the pad logic keys that can be used to receive a three-bit binary code that can tell the mic,o~ ocessor which bpe of ele.l~e is connected to the Support Device and for instance, what bpe of Support Device is being used. The microcontroller 108 can thereafter make adjustments in carrier frequency and treatment mode for instance, to WO 94/28966 2 L 6 5 O 6 ~ PCTtUS94/06026 provide an output carrier f. e~-,eng which is impedance mstched to the load, . eprese~ted by the two electrodes col~nected to the patient.
Figure 9B is a scl~m~tic diagram of a step-up voltage regulator 142 which in this instance is a Maxim 631 that steps up the voltage from 2M alkaline batteries, in series 5 pro~ -ing 3 volts, to 5 volts. The output voltage Or S volts on line 150 is connected to all the various components in the circuit requiring S volts. The resistor network formed by reC; tD;s 144 and 146 to suppb a voltage reference on line 152 which is connected to the low battely lead on the step up regulator 142. When a fallen battery voltage causes the reference voltage on line 152 to go below 1.76 ~olts then a signal on line 148 tells the 10 mic~pl-ocessor 108 in Figure 9 that the battery voltage is too low and that the r i ~.oco..troller 108 should begin to shut down in an or~e.l~ fashion. This prevents the microcontroller 108 from generating randorn signals when the batterg voltage is too low for the microcontroller 108 to function properly.
Figure 10 is a sof~ware tlow diagram for the overall operation of a TENS
15 Stimulation Device. In block 1~4 the unit is activated by turning the power switch to the on position. In block 156 the unit turns off the waveforrn output to the patie~t. In block 158 the unit sets the default waveforms. The default waveforrns are used if the unit has never been turned on or if previously sa~ed waveforms do not fall within a predetermined range. The IJur~ose of the default waveforms is to insure that the user 20 will not receive a strong signal immediately upon activation of the unit.
In block 160 the unit deterrnines if waveforms have been saved. "Saved"
waveforms are the waveforms that the patient was using when the unit was last turned off. If the waveforms have been saved then the unit proceeds to block 162 which r~tl e.~ s the waveforrns and to block 164 which sets the output waveform parameters.
Wo 94/28966 PCT/US94/06026 ~ ~5~
The unit then proceeds to block 168 which deterrnines if any of the setup keys have been depressed. If not, then the unit proceeds to block 174 and creates and implements the sa~ed waveform.
If it is determined in block 160 that no waveforms have been saved or if "sa~ed"
5 wa~eforms are not within a predetermined range, then the unit proceeds dilEctly to block 168 with the default waveforms. If no buttons ha~e been pressed then the default waveforms are initi~li7Pd in block 174. If some Or the input pads have been dep~ess~d then the unilt proceeds to block 170 which changes the output wa~eform accordingly.
The output waveforms is sa~ed in block 172 and then the unit proceeds to block 174 to 10 initiali_e the new output wa~eform.
The foregoing ~lisc~ssion ~ rloses and describes merely exemplary embodiments of the present invention. One skilled in the art will readily recognize from such discussion, and from the alr~-np~nying drawings and cl~imC~ that ~arious changes, modiacations and variations can be made therein without departing from the spirit and 15 scope of the ~nvention as d'~fil-ed in the following cl~im~,
In the conventional Stimulation Devices, a pulse generating circuit will generate a pulse waveform having the desirable parameters. A pair of electrodes positioned st a person's skin will apply a bipolar waveform to the skin of the patient. During lo the positive half of the waveform energy is transferred in one direction to the tissue l,el~.~cn the electrodes and during the negative portion of the waveform energy is transferred in the other direction to the tissue bel~.cen the electrodes. The tissue bel~.~cn the electrodes will act as an electrical load consisting of the skin, muscle and nerve fibers in this area. By varying the frequency, amplitude, pulse width and wavefonn shape of the stimulation signal a therapist can control the effect that the stimulation signal will have on the nen~e between the electrodes. A TENS unit uses a stimulation signal that is strong enough to cause ner-~e stimulation but which is not strong enough to cause a muscle contraction. EMS, on the other hand, uses a stronger signal and causes the muscle to slowly contract and then rele~e.
2 o Stimulation units are typically plug-in desk top units that are used by doctors and physical therapist at a treatment center or are battery operated and can be used on an out-patent basis. The patient is trained by the doctor or therapist in the procedure of using the TENS unit that is tailored to that individual's need. If the patient wishes to move around during treatment, then the patient must pick up the Stimulation Device Wo 94/28966 21~ 5 0 6 4 PCT/US94/06026 and carry the unit or have the device clipped on while the patient is in motion.
Otherwise, ~he patient must remain stationary during the treatment.
SUMMARY OF THE INVENTION
S This invention discloses a Stimulation Device (TENS or EMS) used in association with a Support Device. The Stimulation Device is adaptable to be selectiveb engageable with a plurality of different Support Devices (orthopedic brace or vrrap or other garment capable of supporting a Stimulation Device) such that output connectors associated with the Stimulation Device electrically contact keyed cnnnect(!rs associated v.~ith a mounting carrier integrated with the particular Support Device. The Support Device includes at least two electrode pads which are selectively positionable at dif~erent locations on the Device. The connection bel-.~e.. the output connectors of the Stimulation Device and the keyed connectors of the Support De- ice transfers the stimulation signal to the electrode pads held in position by the Support Device. The keyed connectors of the mo~mting 15 carrier pro~ide a three-bit binary code that can be used by the Stimulation Device to determine what bpe of Support Device the Stimulation Device is being connected to and, for instance, the size of the electrodes connected to the Support Device so that the Stim~ ti~n Device can adjust the carrier 1~4L.cncy of the stimulation signal so that there is an impedonce match between the output waveform of the Stimulation Device 20 and the load (the load co ,.i,~rding to the im~ec~ ce of the two electrodes when attached to the patient).
Additional objects, advantages, and features of the present invention will become spparent from the follov~ing description snd the sppended rl~im~, tsken in conjunction with the sccomr~nying dl&~.;ngs.
wo 94,28966 2 ~ ~ 5 ~ ~ 4 PCT/IUS94/06026 BRIEF DESCRIPI'ION OF THE DRAWINGS
Fig. 1 is a side view Or a person wearing a Support Device that is a knee brace incorporating a Stimulation Device according to a preferred embodiment ot the present invention;
Fig. 2 is an enlarged side view Or the knee braoe and the ~csoci~ted Stimulation Device of Fig. l;
Fig. 3 is an inside front view of the brace Or Fig. 1 showing the electrode place...e..t;
Figs. 4A and 4B are front and back views of the Stimulation Device unit of Fig.
10 1;
Figs. S through 8 are pulsed output signals from a TENS unit showing difrerent frequency and amplitude variations of the signal;
Figs. 9, 9A, and 9B are schematic diagrams of the circuitry of a TENS unit; and Fig. 10 is a software flow diagram for a TENS unit.
DETAILED DESCRIPI'ION OF T~E PREF ERRED EMBODIMENTS
The following description of the ~J,efe.l~d embodiment concerning a TENS unit and its n-ssori~ted brace is merely exemplary in nature and is in no way intended to limit the invention, its application or uses. A Support Device is specifically defined as an 2 0 orthopedic brace or wrap or other garment capable of supporting a Stimulation Device while said Support Device is se~urcd to a person. A Stimulation Device is defined as a portable TENS or EMS device.
Turning to Fig. 1, a person 10 is shown wearing a Support Device which in this case is a knee brace 12 generally comprised of a specinlb shaped neoprene wrap.
Neoprene braces of this type are well known in thc art. Securely PtP~ to an outer surface of the brace 12, according to a ~refer.~d embodiment of the pKsent invention, 5 is a TENS unit 14 for providing stimulation signals to select~ portions of the persons skin beneath the brace 12. The stimulation signals are applied to electrodes (see Fig.
3) positioned over an amicted area in order to i~,ppleSS pain as a result of any number of different sources of iruuries or ~ur~er;~ - The dif~erent sources of pain and iniury for which TENS is applicable is well understood in the art and the usefulness Or EMS
lO devices during physical therapy for muscle reeducation, retardation of atrophy and for increasing the range of motion are also well understood in the art. Other types of orthopedic braces and wraps for the knee, or other parts of the body, could also be used in association with a Stimulation Devices such as the TENS unit 14 that is shown.
Other types of orthopedic braces include, but are not limited to, back braces, shoulder 15 braces, elbow braces as well as sleeves made from various materials such as neoprene and lycra. The TENS unit 14 is shown in this view to illustrate that normal daily activity can be ~.ro~ ed while the TENS unit 14 is in use.
Fig. 2 shows an enlarged side view of the knee brace 12 and the associated TENS
unit 14. In this figure, the ll~:NS unit 14 is shown partially secured to a support carrier 2 o 16. The carrier 16 is a molded plastic structure se.. ,red to the neoprene brace 12 in any effective manner. In this example, the carrier 16 is se~ured to the brace 12 by means of extra neoprene material 18 sewn onto the brace 12 and placed over extended edges (not shown) of the carrier 16 such that the carrier 16 is securely ~tt~ to the brace 12. The TENS unit 14 comprises a molded plastic housing 20 for enclosing the different WO 94/28966 ~ PCT/US94/06026 electrical components associated with the unit 14 and shown in schematic rorrn in Figures 9, 9A, and 9B. The housing 20 includes molded grooves (not shown) along both sides of the housing 20. The grooves are sli~hle onto tabs 22 eYten~lin~ towards each other from sidewalls on the carrier 16. In this manner, the TENS unit 14 is readily S connected and s~ ~d to the brace 12 in a locking engagement. The TENS unit 14 can be secul~ to the brace 12 in any number of other ways, and can be secured to an inner surface of the brace 12 out of view without departing from the spirit and scope Or the invention.
A series of spring-loaded keyed electrical connectors 24 are molded to the carrier 10 16 at one end, as shown. In a preferred embodim~rt, there are seven individual pin connectors associated with the keyed connectors 24. First and second pins are for electrical contact to the electrodes for a first cl ~r~nel of the TENS unit 14; the third and fourth pins are for electrical contact to the el~ l,odes of a second channel in the TENS
unit 14, and the fifth, sixth and seventh pins are the keyed portion of the connector 24 15 and are used to generate a binary 3-bit code that can tell the TENS unit 14 what type of Support Device the TENS unit is being inserted into and, for instance, the type or size of elc.1,~de that is being used in conjunction with that Support Device. Onoe the Support De~ice type and the electrodes size are known by the TENS unit 14 then the TENS unit 14, can adjust its carrier frequency so that there vvill be an impedance match 20 I~l~.~ell the output and the load. This will be ~ cuss~ in greater detail below. The keyed connectors 24 are electrically connected to the output connectors 92 (see Fig.4B) ~csocis~ted with the TENS unit 14 when the unit 14 is completely inserted ~nd locked into the carrier 16. The pins of the keyed conl~ectors 24 used for the cl~:lrodes are electrically connected to wires (see Fig. 3) which are then eleclr.~-lly connecte~l to the Wo 94/28966 2 :16 5 O ~ 4 PCT/USg4/06026 electrodes. As is apparent, the laminate material 18 extends down the brace 12 to support the wires between the brace 12 and the material 18. The operation of the keyed connectors 24 and the ~SSOCiflted electrodes will be dircussed in greater detail below.
Fig. 3 shows an inside view of the brace 12 as if it were cut lengthwise down its 5 back and ope c~ to reveal an inner surface 30 of the brace 12. In this view, the carrier 16 and the material 18 would be on an opposite surface from the surface 30. A first wire 32 and a second v~ire 34 are shovrn extending from the carrier 16 along the laminate material 18. The v,~ires 32 and 34 protrude from the surface 30 through holes 36 and 38, ~s~cli~el~O Each of the wires 32 and 34 include an end pin connector 40 and 42, 10 ,~spc.li~elyO The pin connectors 40 and 42 are electrically connected to electrode pads 44 and 46, respectively, by sliding the pin connectors 40 and 42 into a~ ;ate connectors associated with the pads 44 and 46. The conr^~t~rs 40 and 42 connect to the back of the electrode pads 44 and 46 ag,qinct the surface 30. The electrode pads 44 and 46 r~ se- t a first channel for applying one stimulation signal to the skin of the user, 15 but it will be understood that in a preferred embodiment there are two other elccll.des pads (not slhown) which establish a second ch~nr~l The electrode pads 44 and 46 consist Or silicone conducti~e rubber electrodes co.e.~d by a water wicking material 48 and ~0,1ei.~ , on a side of the pads 44 and 46 adjacent the user's skin. Additionally, the pads 44 and 46 include a loop material 20 (not shown) on a side towards the surface 30 which can be a pile surface. The water wicking material m~irtnir~ a layer of water bel~.~cn the skin and the elec~rode pads 44 and 46 in order to establish a conductive layer in this region. The electrode pads 44 and 46 are removably secu~ed to the surface 30 by means of the loop material. In this manner, the ele~:lrode pads 44 and 46 can be placed at virtually any desirable location Wo 94/28966 ~ 1 6 ~ O ~ 4 PCT/US94/06026 on the inner surface 30 of the brace 12 within the length Or the wires 32 snd 34. The electrode pads 44 and 46 can be of any desirable size or shape, with respect to the size and type of the Support Device being used and the desired treatment.
Figs. 4A and 4B show a front ~iew and a back view o~ the TENS unit 14, 5 ~c~ ively. The TENS unit 14 is separated into a top portion 60 and a bottom portion 62. The top portion 60 ~ ic911y has a deeper dimension than the bottom portion 62 in order to accommodate a battery pack (not shown) in a battery co~npartment 64. In one ~mhotlin~ent, the battery pack is two replacesble AA size slk~lirJe batteries or two nickel-cadmium rechargeable batteries that fit into the compartment 64 in order to provide 10approYim~tely 2.4 to 3.0 volts. The TENS unit 14 could also incorporate throw-away batteries such that the battery compartment 64 could be elimi-~ted. In this alternate embodiment, the TENS unit 14 could be reduced in size to accommodate the battery size. In the embodiment as shown, the TENS unit 14 is approximately 9.68 cm long, 5.88 cm wide and 2.08 cm deep, and weighs about 3.2 oz.
15The bottom portion 62 accommodates the electrical circuitry. A front face 66 of the bottom portion 62 ^rc- n ~ tes a number of contr~l keys. Onoe the TENS unit 14 is inserted into the carrier 16, the unit 14 is operational. A slidable power switch 68 is pro~ided, and when moved to an ON position, an energy output signal will be delivered to the electrode pads 44 and 46. A default output wa~eform will have a carrier 20 frequency that consists of a high frequency, typically on the order of 2.5 to 3 K~z, that is a bipolar, syml.~etrical one period signal having a zero net DC component. The carrier frequency is modulated into a low therapeutic frequency, typically on the order of a 2 to 100 ~Iz pulse train. Such an output signal is shown in Fig. ~. The carrier frequency is the burst of relatively high frequency, one period wave measured between 1-- ling edge 71 and trailing edge 73. The therapeutic n~ y is the low frequeng w~lveform n~ l red between l-- ling edge 71 of l~ g edge 75. It i5 the carrier frequency that establishes the impedance matching between the output signal and the load. The time l~h.~en the low frequeng pulses, .~presents the time that is allowed for S the stimulated nerves to be reset for subsequent firing. The frequency Or the 2,500 to 3,000 Hz carrier signal is too fast for the nerve to reset bet~ ~en the indi~idual pulses Or the two pulse burst. TheN r~ e, the nerve reacts to the bipolar burst of carrier rrequency as if it were in effect one pulse. Because the waveform is alternating current, there is no net direct current component. Therefore, there are no net polar effects to cause long-10 term positive-..c~j&li~ ion concentrations in the tissue.
The size of the cle~trodes 44 and 46 determine the effecti~e capacitance that exists when electrodes are coupled to the patient's skin. Put simply, an electrode acts as one plate Or a first capacitor and the skin acts as a dielectric. The other electrode acts as the plate of a second capacitor which is effe~ co-r~ected in series with the first 15 capacitor. When the si_e of the electrode is increased, it increases the effective surface area of the capacitor plates which, in turn, increases capacitance. As will be dirc~lssed below, when this capacitance changes, optimqlly, the carrier fi~ eng should change so that there is an impedance match l~t~ ~e., the output of the TENS unit and the patient thereby mq~imi7ing the efficient power transfer from the TENS unit to the patient. As 20 will become apparent from the dicc~csicn below, for a particular elc trode si_e, the carrier frequeng will remain the same. It is the therapeutic rr~41 c.-cy and intensity which will be altered by the control keys to give different stimulation results. Ihe waveform parameters of the ther~peutic waveform are controlled by the control keys lo ~te 1 on the front face 66 of the unit 14, as shown in Figure 4A. A positive intensity WO 94/28966 21~ 5 0 ~ 4 PCT/US94106026 control key 72 and a negative intensity control key 74 increase and decrease the amplitude Or the waveform for the rlrst chsnnel. Therefore, in order to increase or decrease the amplitude of the therapeutic waveform, the user need only press the key 72 or the key 74. Likewise, for the second channel, the user need only press an increase 5 intensity key 76 or a decrease intensity key 78. In order to increase the therapeutic frequency, the user plesses an increase rate key 80 or a decrease rate key 82. In a pf~fer.ed e~bodiment, the fre~uency varies from 2 pps to 100 pps in suYteen steps. One set of frequency keys 80 and 82 control both ch~rrelc.
The control keys also include a number of preset program keys. These preset 10 program keys include an intensity surge key 84, a frequency surge key 86, a intensity/frequeng surge key 88, and a surge rate key 90. As shown in Fig. 6, by pressing the intensity surge key 84, the therapeutic waveform will ha~e an increasing and decreasing amplitude. As is apparent from this figure, the amplitude of the therapeutic waveform gradually increases to a maximum value, and then gradually decreases to a 15 minimum value. The therapeutic waveform will cycle in this fashion for a particular therapeutic effect.
When the frequency surge output key 86 is pressed, the therapeutic waveform will have a decreasing and increasing rr~Le.-cy as shown in Fig. 7. In this figure, the therapeutic waveform continuously gcles from a minimum frequency to a maximum 20 frequency for another therspeutic effect.
By pressing the intensib/fi~4uer.c~ surge rate key 88, the frequency and intensity of the therapeutic ~re~ U~Cy vary at the same time. Specifically, as shown in Fig. 8, as the fre~l~.el.cy decreases, the amplitude increases, and as the fi~luency increases, the amplitude decreases for yet another therapeutic effect.
The surge rate key 90 controls how fast each type Or ~arying wa~eform discussed above cycles. Specifically, the surge rate key 90 controls the surge rate for the intensity surge, the frequency surge, and the intensity/frequency surge. When the user ~.~sses the surge rate key 90, esch of these rates will jump to either a slow, medium, or fast surge 5 rate. After reaching the fast surge rate, the next time the surge rate key 90 is pr ssed, the surge rate will jump to the slow rate. When the TENS unit 14 is switched off, the waveform parameters are sa~ed to a non- ~olatile memory.
As ~liscusse~l above, the carrier 16 is equipped with se~en spring loaded keyed output connectors 24. Four of these connectors are connected to the wire leads and then 10 to the conductive electrode pads. The relnDiri-g thm connectors are for pad logic.
These seven ro ~r~ l D;s 24 (Fig. 2) align with and connect to se-~en output pins 92 (Fig.
4B) on a back surface 94 of the TENS unit 14. This binary code on the three pad logic connectors will tell the mi~lo~ccssor the size of the electrodes so that the microprocessor can cause the frequency generator to generate the a~prop.;ate carrier 15 frequency that will impedance match output signal to the electrodes on the skin. In the ~Yompl~ abo~e, there are three output connectors which determine the carrier frequency of the output signal. Therefore, there are four different combinations that can re~ . se--t the electrode size. Of course, more or less connectors could be used in the same fashion which would allow esch Support Device to be keyed in a f~chio-~ such that when a 20 StimrlDt;on Device is inserted into the carrier 16, the Device will know any desirable characteristics of the Support De~ice including the type of brace, the clc~lrode size, and, for ir~tD ~ce~ a particular therapy that is desired. In this ~r~ner, a Stimulation De~ice can be ~tt~he~l to a plurality of different Support Devices having different sized electrodes, and be automatically adjusted for the proper carrier 1~ cy for impe~l~r~
WO 94/28966 216 ~ ~ ~ k PCT/US94/06026 matching. The thm pad logic connectors also ~r~fG.... a safety t. r~ion. Ir the TENS
unit 14 is remo~ed from the carrier 16 then the TENS unit 14 detects that there is no connection to the three pod logic conr~ lD~S and TENS unit 14 turns itself ot~
Turning to Figs. 9, 9A and 9B, a schematic diagram of the TENS circuitry is 5 shown. Figures 9, 9A and 9B connect together in the following manner to show a complete circuit diagram for the TENS unit 14. The lines 100 in Figure 9 connect to the lines 100 in Figure 9A, the line 102 in Figure 9 connects to the line 102 in Figure 9A and the lines 104 in Figure 9 connect to the lines 104 in Figure 9A.
In Figure 9, the control pads in block 106 correspond to the control psds shown in Figure 4A. The pads 92 in Figure 9 also ci)r~es~ond to the pads 92 shown in Figure 4B and ~c~ re~ts the co~r~ectio~ interface bet~..c~ the TENS unit 14 and the Support Device or, in this case, knee brace 12. The micro-controller 108 is an INTEL 80C51 and is connected as shown in Figure 9. Memory 110 is E2 PROM and is used as a non-volatile memory to store the program to set operating parameters and the default 15 pa~ tc~s. The resistor network 112 acts as a digital to analog co ~.. Ier that ~ccives the digital outputs from lines PBO through PB7, via buss 114 and con~erts that digital signal to the analog output on line 102. The range of the analog output on line 102 is O through S volts. This analog output sen~es as the intensity control for the output ~ ~.vefo.~s. The waveform generator 116 in Figure 9A is a dual four channel analog 2 0 multiplexor that is made by Motorola. The input on line 102 controls the amplitude of the ~ .rO .I. and control lines 100, which come from the microcontroller 108 in Figure 9 control the frequency out of the wsveform generator 116. In Figure 9A, the output for channel 1 is on lines 118 and 120 and the output waveform for channel 2 is on lines 122 and 124. Lines 118 and 120 are re~l,ecli~ely connected to the output drive transistors wo 94,28966 ~ L 6 51~ 6 ~ PCTIUS94/06026 126 and 128. Transistors 126 and 128 are N-channel enhancement mode mosrets made by Siliconix. Typically, the signal on line 118 will go fmm _ero to its p.-sel~t~
intensib leYel as determined by the signal on line 102, and it will stay high ror a period Or time and Ibe shut off. Almost at the same time, the signal on line 120 will go high s causing the tr~rCictor 128 to turn on and pull the signal applied to the primary of transformer 134 in the opposite direction. When the waYeform on line 120 goes to _ero, tr~ f;--Dr 128 turns off and causes the output voltage to fall to _ero. Transformer 134 is a 1 to 29 step up, push pull transformer which produces an output waveform across lines 138 and 140 substantially as shown in Figure 5. Channel 2 operates in an identical lo fashion as Channel 1. If the amplitude of the waveform on Channel 1 is different from that on Channel 2, then before Channel 2 is turned on, the microcontroller 108 will send a dirre~t digital signal to the digital-to-analog conYerter 112 causing the analog voltage on line 102 to change to the præsel~ l2d value prior to the time a signal is put on line 122 thereby init~ 7ing the output waveform for Ch~nrel 2. The microcontroller 108 in 15 Figure 9 mulli~l^Y~s between Channel 1 and Channel 2 to provide waveforms with the same r~ cies in Channels 1 and 2. ~owever, the amplitudes of the waveforms in Channels 1 and 2 can be independently varied. The Channel 1 and 2 ~ t~ Is on lines 104 are co ~nected to the Channel 1 and 2 output lines in Figure 9 which are connected to output connectors 92 in Figure 9. Pads 1, 2 and 3 in block 92 on connector J1 are 20 the pad logic keys that can be used to receive a three-bit binary code that can tell the mic,o~ ocessor which bpe of ele.l~e is connected to the Support Device and for instance, what bpe of Support Device is being used. The microcontroller 108 can thereafter make adjustments in carrier frequency and treatment mode for instance, to WO 94/28966 2 L 6 5 O 6 ~ PCTtUS94/06026 provide an output carrier f. e~-,eng which is impedance mstched to the load, . eprese~ted by the two electrodes col~nected to the patient.
Figure 9B is a scl~m~tic diagram of a step-up voltage regulator 142 which in this instance is a Maxim 631 that steps up the voltage from 2M alkaline batteries, in series 5 pro~ -ing 3 volts, to 5 volts. The output voltage Or S volts on line 150 is connected to all the various components in the circuit requiring S volts. The resistor network formed by reC; tD;s 144 and 146 to suppb a voltage reference on line 152 which is connected to the low battely lead on the step up regulator 142. When a fallen battery voltage causes the reference voltage on line 152 to go below 1.76 ~olts then a signal on line 148 tells the 10 mic~pl-ocessor 108 in Figure 9 that the battery voltage is too low and that the r i ~.oco..troller 108 should begin to shut down in an or~e.l~ fashion. This prevents the microcontroller 108 from generating randorn signals when the batterg voltage is too low for the microcontroller 108 to function properly.
Figure 10 is a sof~ware tlow diagram for the overall operation of a TENS
15 Stimulation Device. In block 1~4 the unit is activated by turning the power switch to the on position. In block 156 the unit turns off the waveforrn output to the patie~t. In block 158 the unit sets the default waveforms. The default waveforrns are used if the unit has never been turned on or if previously sa~ed waveforms do not fall within a predetermined range. The IJur~ose of the default waveforms is to insure that the user 20 will not receive a strong signal immediately upon activation of the unit.
In block 160 the unit deterrnines if waveforms have been saved. "Saved"
waveforms are the waveforms that the patient was using when the unit was last turned off. If the waveforms have been saved then the unit proceeds to block 162 which r~tl e.~ s the waveforrns and to block 164 which sets the output waveform parameters.
Wo 94/28966 PCT/US94/06026 ~ ~5~
The unit then proceeds to block 168 which deterrnines if any of the setup keys have been depressed. If not, then the unit proceeds to block 174 and creates and implements the sa~ed waveform.
If it is determined in block 160 that no waveforms have been saved or if "sa~ed"
5 wa~eforms are not within a predetermined range, then the unit proceeds dilEctly to block 168 with the default waveforms. If no buttons ha~e been pressed then the default waveforms are initi~li7Pd in block 174. If some Or the input pads have been dep~ess~d then the unilt proceeds to block 170 which changes the output wa~eform accordingly.
The output waveforms is sa~ed in block 172 and then the unit proceeds to block 174 to 10 initiali_e the new output wa~eform.
The foregoing ~lisc~ssion ~ rloses and describes merely exemplary embodiments of the present invention. One skilled in the art will readily recognize from such discussion, and from the alr~-np~nying drawings and cl~imC~ that ~arious changes, modiacations and variations can be made therein without departing from the spirit and 15 scope of the ~nvention as d'~fil-ed in the following cl~im~,
Claims (28)
1. An electrical stimulation system for applying a stimulation signal to living tissue, said system comprising:
stimulation means for applying electrical signals to living tissue, said stimulation means is adapted to be physically and electrically connected to a support means; and support means adapted to be remotely attached to a human user, said support means having a connection means for physically and electrically connecting to said stimulation means.
stimulation means for applying electrical signals to living tissue, said stimulation means is adapted to be physically and electrically connected to a support means; and support means adapted to be remotely attached to a human user, said support means having a connection means for physically and electrically connecting to said stimulation means.
2. A Stimulation system in Claim 1 wherein;
said support means is adapted to support at least two electrode pads, said electrode pads adaptable to be positioned against the skin of a user when the support means is in position on a user, said stimulation means including output connectors that are adapted to be electrically connected to the electrode pads when the stimulation means is connected to the support means.
said support means is adapted to support at least two electrode pads, said electrode pads adaptable to be positioned against the skin of a user when the support means is in position on a user, said stimulation means including output connectors that are adapted to be electrically connected to the electrode pads when the stimulation means is connected to the support means.
3. The electrical stimulation system according to Claim 1, wherein;
said support means includes a rigid carrier for accepting the stimulation means, said carrier including a series of keyed connectors, wherein the output connectors of the stimulation means electrically contact the keyed connectors when the stimulation means is secured to the carrier.
said support means includes a rigid carrier for accepting the stimulation means, said carrier including a series of keyed connectors, wherein the output connectors of the stimulation means electrically contact the keyed connectors when the stimulation means is secured to the carrier.
4. The electrical stimulation system according to Claim 1 wherein;
the support means is a neoprene brace and the carrier is a molded plastic carrier attached to the brace, wherein the stimulation means includes grooves which conform to tabs associated with carrier.
the support means is a neoprene brace and the carrier is a molded plastic carrier attached to the brace, wherein the stimulation means includes grooves which conform to tabs associated with carrier.
5. The electrical stimulation system according to Claim 2 wherein;
the electrode pads are selectively removable from the support means and positionable at alternate locations on the brace.
the electrode pads are selectively removable from the support means and positionable at alternate locations on the brace.
6. The electrical stimulation system according to Claim 5 wherein;
the electrode pads are comprised of silicone conductive rubber electrodes covered by a water wicking material at a surface adjacent the skin and a loop material covering a surface adjacent the brace, wherein the water wicking material holds water so as to provide a layer of conductive water between the skin and the electrode.
the electrode pads are comprised of silicone conductive rubber electrodes covered by a water wicking material at a surface adjacent the skin and a loop material covering a surface adjacent the brace, wherein the water wicking material holds water so as to provide a layer of conductive water between the skin and the electrode.
7. The electrical stimulation system according to Claim 3 wherein;
at least two of the keyed connectors are connected to the electrode pads.
at least two of the keyed connectors are connected to the electrode pads.
8. The electrical stimulation system according to Claim 3 wherein;
the stimulation means includes a microcontroller, said microcontroller selecting a carrier frequency to be impedance matched to the load being stimulated.
the stimulation means includes a microcontroller, said microcontroller selecting a carrier frequency to be impedance matched to the load being stimulated.
9. The electrical stimulation system according to Claim 8 wherein;
a number of the keyed connectors are representative of the size of the electrode pads such that the correction between the output connectors and the keyed connectors enables the microcontroller to determine the size of the electrode pads and adjust the carrier frequency based on the electrode size.
a number of the keyed connectors are representative of the size of the electrode pads such that the correction between the output connectors and the keyed connectors enables the microcontroller to determine the size of the electrode pads and adjust the carrier frequency based on the electrode size.
10. The electrical stimulation system according to Claim 9 wherein;
the number of keyed connectors is seven, wherein two of the keyed connectors are connected to electrode pads of a first channel of the system, two of the remaining keyed connectors are electrically connected to electrode pads for a second channel and the remaining three keyed connectors represent a three-bit code for determining the electrode pad size.
the number of keyed connectors is seven, wherein two of the keyed connectors are connected to electrode pads of a first channel of the system, two of the remaining keyed connectors are electrically connected to electrode pads for a second channel and the remaining three keyed connectors represent a three-bit code for determining the electrode pad size.
11. The electrical stimulation system according to Claim 1 wherein;
the stimulation means includes a first intensity control key and a second intensity control key, wherein the first intensity control key increases the waveform amplitude and the second intensity control key decreases the waveform amplitude.
the stimulation means includes a first intensity control key and a second intensity control key, wherein the first intensity control key increases the waveform amplitude and the second intensity control key decreases the waveform amplitude.
12. The electrical stimulation system according to Claim 1 wherein;
the stimulation means includes a first frequency control key and a second frequency control key, wherein the first frequency control key increases the therapeutic frequency of the waveform and the second frequency control key decreases the therapeutic frequency of the waveform.
the stimulation means includes a first frequency control key and a second frequency control key, wherein the first frequency control key increases the therapeutic frequency of the waveform and the second frequency control key decreases the therapeutic frequency of the waveform.
13. The electrical stimulation system according to Claim 1 wherein;
the stimulation means includes an intensity surge key, an intensity/frequency surge key, a strength duration surge key, and a surge rate key, wherein the intensity surge key increases and decreases the amplitude of the therapeutic frequency of the waveform, the frequency surge program key increases and decreases the therapeutic frequency of the waveform, the intensity/frequency surge key alters the amplitude and frequency of the therapeutic waveform such that as the frequency decreases the amplitude increases and as the frequency increases the amplitude decreases, and wherein the surge rate key controls the frequency of the surge cycle.
the stimulation means includes an intensity surge key, an intensity/frequency surge key, a strength duration surge key, and a surge rate key, wherein the intensity surge key increases and decreases the amplitude of the therapeutic frequency of the waveform, the frequency surge program key increases and decreases the therapeutic frequency of the waveform, the intensity/frequency surge key alters the amplitude and frequency of the therapeutic waveform such that as the frequency decreases the amplitude increases and as the frequency increases the amplitude decreases, and wherein the surge rate key controls the frequency of the surge cycle.
14. The electrical stimulation system according to Claim 1 wherein;
the stimulation means includes a removable power source for providing power.
the stimulation means includes a removable power source for providing power.
15. An electrical stimulation device adapted to be inserted into a support device connected to a human body, said support device being adapted to include at least two electrode pads, said stimulation device comprising:
securing means allowing the stimulation device to be secured to the support device;
a series of output connectors, said output connector adaptable to be electrically connected to a series of keyed connectors associated with the support device when the stimulation device is secured to the support device, wherein at least two of the connectors are connectable to the at least two electrode pads; and pulse generating means for generating a stimulation signal, wherein the stimulation signal is a waveform including a therapeutic frequency and a carrier frequency.
securing means allowing the stimulation device to be secured to the support device;
a series of output connectors, said output connector adaptable to be electrically connected to a series of keyed connectors associated with the support device when the stimulation device is secured to the support device, wherein at least two of the connectors are connectable to the at least two electrode pads; and pulse generating means for generating a stimulation signal, wherein the stimulation signal is a waveform including a therapeutic frequency and a carrier frequency.
16. The device according to Claim 15, wherein;
the securing means is a first groove on a first side of a housing associated with the Stimulation Device and a second groove on a second side of the housing, wherein the first and second grooves are adaptable to be engaged to tab portions associated with a rigid carrier of the support device.
the securing means is a first groove on a first side of a housing associated with the Stimulation Device and a second groove on a second side of the housing, wherein the first and second grooves are adaptable to be engaged to tab portions associated with a rigid carrier of the support device.
17. The unit according to Claim 15, wherein;
a predetermined number of the output connectors are engageable with a predetermined number of the keyed connectors in the support means wherein the keyed connectors in the brace are representative of the size of the electrode pads such that the pulse generating means generates a stimulation signal having a carrier frequency that is impedance matched to the electrode.
a predetermined number of the output connectors are engageable with a predetermined number of the keyed connectors in the support means wherein the keyed connectors in the brace are representative of the size of the electrode pads such that the pulse generating means generates a stimulation signal having a carrier frequency that is impedance matched to the electrode.
18. The unit according to Claim 15, further comprising;
a first intensity control key and a second intensity control key, wherein the first intensity control key increases the intensity of the waveform amplitude and a second intensity control key decreases the intensity of the waveform amplitude.
a first intensity control key and a second intensity control key, wherein the first intensity control key increases the intensity of the waveform amplitude and a second intensity control key decreases the intensity of the waveform amplitude.
19. The unit according to Claim 15, further comprising;
a first frequency control key and a second frequency control key, wherein the first frequency control key increases the therapeutic frequency of the waveform and the second frequency control key decreases the therapeutic frequency of the waveform.
a first frequency control key and a second frequency control key, wherein the first frequency control key increases the therapeutic frequency of the waveform and the second frequency control key decreases the therapeutic frequency of the waveform.
20. The unit according to Claim 15, further comprising;
an intensity surge key, said intensity surge key operable to increase and decrease the amplitude of the therapeutic frequency of the waveform.
an intensity surge key, said intensity surge key operable to increase and decrease the amplitude of the therapeutic frequency of the waveform.
21. The unit according to Claim 15, further comprising;
a frequency surge key, said frequency surge key operable to increase and decrease the therapeutic frequency of the waveform in a cyclical fashion.
a frequency surge key, said frequency surge key operable to increase and decrease the therapeutic frequency of the waveform in a cyclical fashion.
22. The unit according to Claim 15, further comprising;
a intensity/frequency surge key, said intensity/frequency surge key operable to alter the amplitude and frequency of the therapeutic frequency of the waveform in a cyclical fashion such that as the therapeutic frequency decreases, the amplitude increases and as the therapeutic frequency increases, the amplitude decreases.
a intensity/frequency surge key, said intensity/frequency surge key operable to alter the amplitude and frequency of the therapeutic frequency of the waveform in a cyclical fashion such that as the therapeutic frequency decreases, the amplitude increases and as the therapeutic frequency increases, the amplitude decreases.
23. The unit according to Claim 15, further comprising;
a surge rate key, said surge rate key controls the cycle rate for each type of varying therapeutic waveform.
a surge rate key, said surge rate key controls the cycle rate for each type of varying therapeutic waveform.
24. A support device for connection to a human user, said support device adaptable to accept a stimulation device, said stimulation device generating a pulsed stimulation signal including a therapeutic frequency, said support device comprising:
a carrier for accepting the stimulation device, said carrier including a series of electrical connectors, wherein output connectors associated with a stimulation device electrically contact the electrical connectors when the stimulation device is secured to the carrier; and said carrier is adapted to have at least two electrode pads removably secured to an inside surface of the support device, said electrode pads adaptable to be positioned against the skin of the user when the brace is in position on the body.
a carrier for accepting the stimulation device, said carrier including a series of electrical connectors, wherein output connectors associated with a stimulation device electrically contact the electrical connectors when the stimulation device is secured to the carrier; and said carrier is adapted to have at least two electrode pads removably secured to an inside surface of the support device, said electrode pads adaptable to be positioned against the skin of the user when the brace is in position on the body.
25. The support device according to Claim 24, wherein;
the support device is a neoprene brace and the carrier is a molded plastic carrier attached to the brace.
the support device is a neoprene brace and the carrier is a molded plastic carrier attached to the brace.
26. The brace according to Claim 24, wherein;
the rigid carrier includes a set of tabs adaptable to conform to grooves associated with the stimulation means.
the rigid carrier includes a set of tabs adaptable to conform to grooves associated with the stimulation means.
27. The brace according to Claim 24, wherein;
the electrode pads are selectively removable from the support device and positionable at alternate locations on the support device.
the electrode pads are selectively removable from the support device and positionable at alternate locations on the support device.
28. The support device according to Claim 24, wherein;
the electrode pads are comprised of silicone conductive rubber electrodes covered by a water wicking material at a surface adjacent the skin and a loop material covering a surface adjacent the brace, wherein the water wicking material holds water so as to provide a layer of conductive water between the skin and the electrode.
the electrode pads are comprised of silicone conductive rubber electrodes covered by a water wicking material at a surface adjacent the skin and a loop material covering a surface adjacent the brace, wherein the water wicking material holds water so as to provide a layer of conductive water between the skin and the electrode.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US08/077,349 US5487759A (en) | 1993-06-14 | 1993-06-14 | Nerve stimulating device and associated support device |
| US077,349 | 1993-06-14 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA2165064A1 true CA2165064A1 (en) | 1994-12-22 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002165064A Abandoned CA2165064A1 (en) | 1993-06-14 | 1994-05-27 | Nerve stimulating device and asociated support device |
Country Status (6)
| Country | Link |
|---|---|
| US (1) | US5487759A (en) |
| EP (1) | EP0705117A4 (en) |
| JP (1) | JPH08511445A (en) |
| AU (1) | AU686180B2 (en) |
| CA (1) | CA2165064A1 (en) |
| WO (1) | WO1994028966A1 (en) |
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-
1993
- 1993-06-14 US US08/077,349 patent/US5487759A/en not_active Expired - Lifetime
-
1994
- 1994-05-27 CA CA002165064A patent/CA2165064A1/en not_active Abandoned
- 1994-05-27 AU AU70475/94A patent/AU686180B2/en not_active Ceased
- 1994-05-27 EP EP94919277A patent/EP0705117A4/en not_active Withdrawn
- 1994-05-27 WO PCT/US1994/006026 patent/WO1994028966A1/en not_active Application Discontinuation
- 1994-05-27 JP JP7501873A patent/JPH08511445A/en not_active Ceased
Also Published As
| Publication number | Publication date |
|---|---|
| US5487759A (en) | 1996-01-30 |
| JPH08511445A (en) | 1996-12-03 |
| WO1994028966A1 (en) | 1994-12-22 |
| AU686180B2 (en) | 1998-02-05 |
| EP0705117A4 (en) | 1998-02-25 |
| AU7047594A (en) | 1995-01-03 |
| EP0705117A1 (en) | 1996-04-10 |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| EEER | Examination request | ||
| FZDE | Discontinued |