The invention relates to a device for spinal column manipulation.

Physiotherapists and osteopaths use mobilization or manipulation techniques for treating back and neck complaints. Mobilization and manipulation are manual techniques used to affect a joint. In mobilization of a joint, the joint is moved continuously within a normal range of motion thereof in order to treat the joint. In manipulation of a joint however, short and sharp or rapid movements are used to move a joint within a normal range of motion thereof.

Research has shown that manipulation techniques are particularly effective for treating a spinal column of a patient. Manipulation of the spinal column is however a physically taxing technique for the treating therapist. Every situation is furthermore very different for each patient and therapist. There is for instance a trend of increasing body weight among patients and ageing among therapists in the field of physiotherapy. The increased body weight of patients is disadvantageous because it makes manipulation more difficult and physically more demanding for the therapist. The issue of ageing, also referred to as greying, refers to a growing proportion of older therapists. Older therapists are generally less physically strong compared to younger therapists, whereby it is difficult or impossible for them to perform these lumbar manipulation techniques. Manipulation of the spinal column is therefore not performed, or not performed correctly.

DE29914969U1 provides a device with an oblique surface which is movable between an upper and lower position. The patient to be treated holds onto a bar so that his or her lower body hangs off the surface. DE29914969U1 has several drawbacks, including the fixing, wherein the patient holds on to the bar him or herself and which creates tension in the body. This makes the treatment highly sub-optimal. This may for instance result in injuries to the back, neck and shoulder girdle of the patient because the muscles are strained and shoulder joints dislocated, or in a dangerous situation wherein the patient slides off the surface. The body of the patient is moreover stretched and not manipulated.

It is an object of the invention to provide a device which performs lumbar manipulation in a safer and more correct manner, wherein a therapist need exert minimal physical effort.

For this purpose the invention provides a device for spinal column manipulation comprising a first treatment surface which is configured to lie at an oblique angle relative to a horizontal plane. The first treatment surface is configured to hold a patient. The treatment surface is provided with a protrusion for supporting a region of the spinal column of the patient to be treated. The treatment surface is movable between an upper position and a lower position via a dropping mechanism. The dropping mechanism comprises a stop which prevents the treatment surface from coming to lie below the lower position. In the context of the application the device can be applied to treat the whole spinal column, in the text below the device will be elucidated in the context of a treatment of the lumbar region of the patient for the sake of clarity. It will however be apparent to the skilled person that the device can also be used to treat the thoracic spinal column. In other words, the first treatment surface holds the patient at an oblique angle. The patient is supported by the protrusion at the position of his or her spinal column region to be treated, for instance the lumbar region. The treatment surface can be moved together with the patient from the upper position to the lower position, wherein a stop prevents the treatment surface from coming to lie below the lower position. In other words, the treatment surface collides with the stop when moving from the upper to lower position. The collision stops a movement from the upper position to the lower position at the lower position. The collision generates a short and substantially upward directed impulse which is transmitted via the protrusion to the lumbar region of the patient. The magnitude of the impulse depends on the weight of the patient and a speed of the movement of the treatment surface. The impulse imparts via the protrusion an effect on the tissue of the spinal column region to be treated and unblocks or, in other words, normalizes so-called static, dynamic or reversible dispositions, also referred to as blockages, in the spinal column. The effect, and more particularly the force, imparted by the impulse on the region to be treated can be resolved into several smaller force vectors. The oblique angle causes the actual force exerted on the lumbar region to be smaller, making the treatment safer. The force exerted on the lumbar region pushes the joints apart, whereby the dispositions, also referred to as joint blocks or blockages, are removed. The mobility of the joints increases here, and a normal function of the joints can once again be performed. This is also referred to as normalizing of joints. It will be apparent on the basis of the above that the amount of physical exertion on the part of the therapist during the movement of the treatment surface is minimal or almost nonexistent. This allows the therapist to repeatedly perform the manipulating treatment by means of the device correctly and safely without coming under physical strain. The device further also allows a therapist of any demographic to perform the treatment independently of his or her physical characteristics since the amount of physical work on the part of the therapist during the treatment is minimal or almost non-existent.

The dropping mechanism preferably comprises a fixing element for fixing the first treatment surface at the upper position. The fixing element allows the patient to be positioned against the first treatment surface in the upper position. Because the patient is held against the first treatment surface in the upper position, the patient need not be lifted manually. As a result, the physical strain on the therapist is reduced further.

The fixing element preferably has a first state and a second state, wherein in the first state the fixing element fixes the first treatment surface at the upper position and wherein in the second state the fixing element releases the first treatment surface. The co-action of the fixing element with the first treatment surface on the one hand allows the first treatment surface to be held and on the other allows the first treatment surface to be released. Releasing of the first treatment surface initiates the treatment in simple manner.

The device preferably comprises a switching element for switching between the first state and the second state. The switching element simplifies the use of the device.

The dropping mechanism preferably comprises a guide for guiding the treatment surface between the upper and lower position in primarily a translation movement. A translation movement of the treatment surface between the upper and lower position is a displacement of the treatment surface wherein the treatment surface moves over a distance and in a predetermined direction as a whole. In other words, the freedom of movement of the treatment surface during the movement between the upper and lower position is thus limited here. On the one hand, the patient is not subject to undesired impulses between the upper and lower position because the direction of movement does not change. On the other hand, an optimal impulse is generated at the position of the stop, whereby the device normalizes the disposition of the spinal column region to be treated in improved manner.

The stop preferably comprises a damper for damping an end of the movement at the lower position. An advantage hereof is based on the insight that too great an impulse may cause injury and pain to the patient. Providing a damper reduces the magnitude of the force exerted on the region of the patient to be treated. The treatment and the use of the device are thus safer.

The dropping mechanism preferably comprises a drop height control means for displacing at least one of the fixing element and the stop in order to control a distance between the upper and lower position. Controlling the distance between the upper and lower position makes a magnitude of the impulse controllable. This is because the magnitude of the impulse is directly proportionally dependent on the weight of the patient and the speed at which the treatment surface collides with the stop. The speed at which the treatment surface collides with the stop depends on the distance travelled.

The dropping mechanism is preferably provided to set the upper position relative to the lower position to a maximum of 15 cm, more preferably a maximum of 12 cm, most preferably a maximum of 10 cm, for instance 5 cm.

The device preferably comprises a shaft, wherein the first treatment surface is mounted tiltably on the dropping mechanism via the shaft, such that the oblique angle is controllable. This allows further control of the effect of the protrusion on the lumbar region.

The device preferably further comprises a second treatment surface which is arranged on a rear side of the first treatment surface, wherein the device has a first state wherein the first treatment surface lies at the oblique angle and has a second state wherein the second treatment surface extends in a lying orientation. The device can therefore be used not just for a spinal column treatment as described above. The device can furthermore also be used for recumbent or seated manipulation and mobilization treatments in the second state. Because the device has the first state and the second state, the device can be utilized in a wider context.

The device preferably comprises an angle limiting element for each of the first and second state, and the first and second treatment surface are preferably tiltable relative to the shaft in order to bring the device into the first or the second state. The angle limiting element limits the tilting movement of the first and second treatment surface. This allows the device to be brought into the different states in simple manner, particularly by tilting the first and the second treatment surface.

The device preferably further comprises a third treatment surface which is arranged at least partially above the dropping mechanism and is provided to extend in line with the second treatment surface in the second state. This allows a patient to be supported in the second state in his or her entirety. Comfort and ergonomics of the patient on the device in the second state therefore improve.

The oblique angle is preferably smaller than 90°, preferably smaller than 75°, most preferably smaller than 60° and/or wherein the oblique angle is greater than 0°, more preferably greater than 20°, most preferably greater than 30°.

The device preferably comprises a support which is configured to support the dropping mechanism at a height. The height can more preferably be set. By supporting the dropping mechanism at a height which can be set a patient can be positioned on the first treatment surface more easily because the patient is able to support themselves while being positioned. The therapist need not lift the patient here in order to position said patient against the first treatment surface. The physical strain on the therapist therefore decreases.

The support preferably extends from the dropping mechanism in a direction away from the patient in order to realize a free space under the dropping mechanism. Because a free space is realized under the dropping mechanism, the risk of a patient knocking into anything while the first treatment surface moves to the lower position decreases. This avoids injury during the treatment and makes the device safer in use.

The support preferably comprises a height control device for controlling the height. This allows the height of the device to be controlled depending on the patient. This improves the ergonomics for the patient and the therapist. The therapist need not perform any taxing lifting movements with the patient in order to position them on the first treatment surface. The patient need not lift themselves onto the first treatment surface either since the height control device can control the height of the device in accordance with said patient in simple manner.

The protrusion is preferably adapted to substantially follow the periphery of the lumbar region of the patient. The protrusion further preferably comprises a first protrusion portion and a second protrusion portion, which first protrusion portion has a peripheral surface which describes an arc which extends from an edge of the treatment surface to the second protrusion portion which has a flat peripheral surface having an oblique angle with the treatment surface and extending from the first protrusion portion to the treatment surface. In this way the protrusion has on one side an arcuate peripheral surface and on the other a flat oblique surface, which support the patient at the position of the lumbar lordosis. When the first treatment surface hits the stop, the stop exerts an impulse on the first treatment surface. This impulse imparts an effect on the tissue via the protrusion. The shape of the protrusion has the result that the impulse is distributed over the lumbar lordosis along a plurality of divergent force vectors. The advantage of this preferred embodiment is that the protrusion acts advantageously on the lumbar region of the patient. The divergent force vectors push apart the lumbar lordosis of the patient, whereby the disposition, also referred to as joint blockages, are removed. The mobility of the joints increases here, and a normal function of the joints can once again be performed. Because the protrusion follows the lumbar lordosis of the patient, the protrusion is also safer in use.

The first treatment surface preferably comprises a securing means for holding the patient against the first treatment surface.

The invention will now be further described on the basis of an exemplary embodiment shown in the drawing.

In the drawing: figure 1 shows schematically a view of a device for spinal column manipulation according to an embodiment; figure 2 shows schematically a dropping mechanism according to an embodiment; figure 3 shows a side view of a device for spinal column manipulation in a first and a second state; figure 4 shows a perspective view of the device according to figure 3 in the second state; figure 5 shows a perspective view of the device for spinal column manipulation in the second state according to an embodiment; figure 6A shows schematically a perspective view of a first treatment surface with a securing means according to an embodiment; figure 6B shows schematically a perspective view of a first treatment surface with a securing means according to an embodiment; figure 7 shows a side view of a cross-section of a protrusion according to a preferred embodiment.

The following detailed description relates to determined specific embodiments. The teaching hereof can however be applied in different ways. The same or similar elements are designated in the drawing with the same reference numeral.

The present invention will be described with reference to specific embodiments. The invention is however not limited thereto, but solely by the claims. As used here, the singular forms “a” and “the” comprise both the singular and plural references, unless clearly indicated otherwise by the context.

The terms “comprising”, “comprises” and “composed of’ as used here are synonymous with “including”. The terms “comprising”, “comprises” and “composed of’ when referring to stated components, elements or method steps also comprise embodiments which “consist of’ the components, elements or method steps.

The terms first, second, third and so on are further used in the description and in the claims to distinguish between similar elements and not necessarily to describe a sequential or chronological order, unless this is specified. It will be apparent that the thus used terms are mutually interchangeable under appropriate circumstances and that the embodiments of the invention described here can operate in an order other than described or illustrated here.

Reference in this specification to “one embodiment”, “an embodiment”, “some aspects”, “an aspect” or “one aspect” means that a determined feature, structure or characteristic described with reference to the embodiment or aspect is included in at least one embodiment of the present invention. The manifestations of the sentences “in one embodiment”, “in an embodiment”, “some aspects”, “an aspect” or “one aspect” in different places in this specification thus do not necessarily all refer to the same embodiment or aspects. As will be apparent to a skilled person in this field, the specific features, structures or characteristics can further be combined in any suitable manner in one or more embodiments or aspects. Although some embodiments or aspects described here comprise some but no other features which are included in other embodiments or aspects, combinations of features of different embodiments or aspects are further intended to fall within the context of the invention and to form different embodiments or aspects, as would be apparent to the skilled person. In the appended claims all features of the claimed embodiments or aspects can for instance be used in any combination.

In the context of the application the device can be applied to treat the whole spinal column, but will be elucidated in the text below using a treatment of the lumbar region of the patient for the sake of clarity. The device is preferably configured for dorsal and/or lumbar manipulation.

In the context of this application mobilizing of a joint is defined as moving the joint continuously within a normal range of motion.

In the context of this application manipulation of a joint is defined as moving the joint within the normal range of motion using short and sharp or rapid movements.

Figure 1 shows schematically a preferred embodiment of a device 10 for spinal column manipulation.

The device 10 for lumbar manipulation comprises a first treatment surface 100 and a dropping mechanism 200. The first treatment surface 100 is configured to lie at an oblique angle relative to a horizontal plane. The oblique angle a, also referred to as acute angle, is an angle between the first treatment surface 100 and a fictional horizontal plane (not shown), wherein the first treatment surface 100 forms a first leg of the oblique angle and the horizontal plane forms a second leg. The oblique angle a is thus formed by the first treatment surface 100 and the horizontal plane, and is greater than 0°, preferably greater than 10°, more preferably greater than 30°, most preferably greater than 45°, and is smaller than 90°, preferably smaller than 80°, more preferably smaller than 70°, most preferably smaller than 60°. The first treatment surface 100 is configured to hold a patient P. As described above, the first treatment surface 100 is configured to lie at an oblique angle. In this position the first treatment surface 100 is directed upward and can support the patient at least partially. The patient P is held with his or her back side against the first treatment surface 100. The patient is particularly held at the oblique angle a. For an improved ergonomic comfort of the patient a part of or the whole first treatment surface can be upholstered with a cushion. As will be further elucidated in figures 6A and 6B, the patient can be held against the first treatment surface in different ways.

The first treatment surface 100 is provided with a protrusion 110. The protrusion 110 is provided to support a region L of the spinal column of the patient P to be treated. In the illustrated embodiment the lumbar region L, also referred to as lower back or lumbar spine, is being supported. The lumbar region is the lower part of the back of the patient P and lies at the position of the lumbar spine of the patient. The lumbar spine L consists of five lumbar vertebrae (L1-L5, as counted from the top of the patient). The lumbar vertebrae are loaded with the majority of the patient’ s body weight. This can be a cause of health problems which cause symptoms in patients, such as lower back pain. Further causes of health problems are for instance incorrect body movements, bad posture, excessive strain and so on. These common complaints are caused by a blockage or a so-called disposition of the lumbar vertebrae. A disposition of a vertebra, or more generally, is an incorrect position of that joint. There are different types of disposition, such as static, dynamic or reversible dispositions. In the case of static dispositions a joint has reduced mobility, in the case of dynamic dispositions the mutually coupled joints do not move correctly relative to each other, and in the case of reversible dispositions there are blockages in the joint that can be removed without surgical treatment. Figure 1 illustrates particularly that the lumbar region is supported, although it will be apparent that further regions can also be supported. More specifically, the region at the position of the thoracic spine, also referred to as chest vertebrae, can also be supported for treatment thereof.

The patient P is held against the first treatment surface 100 such that the lumbar region L is supported at least partially by the protrusion 110. Protrusion 110 is provided, as seen in a vertical plane, at the position of a lower side of the first treatment surface 100. The first treatment surface 100 then extends from protrusion 110 in an upward direction along the oblique angle a in order to support an upper body of the patient. Almost the whole upper body of the patient is in this way supported by the first treatment surface 100 and the protrusion 110. In accordance with his or her experience and the patient to be treated, the therapist can position the patient such that only a part of or the whole lumbar region is being supported.

Characteristics of the protrusion will be discussed in detail below with reference to figure 7.

The first treatment surface 100 is movable via the dropping mechanism 200 between an upper position A and a lower position B. The first treatment surface 100 is illustrated in the upper position A in figure 1 using full lines. The second position B of first treatment surface 100 lies below the upper position A. First treatment surface 100 is illustrated in the second position B in figure 1 using broken lines. First treatment surface 100 is movable between the upper and lower position. This means that the first treatment surface 100 can move from the upper position A to the lower position B, and vice versa. A movement of first treatment surface 100 from upper position A to lower position B is a downward directed movement and is defined as a dropping movement. The dropping movement is preferably performed gravitationally. In other words, the force of gravity influences the movement of the first treatment surface 100 from the upper to the lower position. As a result, the dropping movement is performed without the influence of additional actuators such as a motor. The dropping movement in purely gravitational manner allows the device to be produced in simple and inexpensive manner. A movement of first treatment surface 100 from the lower position B to the upper position A is an upward directed movement and is defined as a lifting movement. The lifting movement allows the first treatment surface 100 to be placed in the upper position once again in order to initialize the treatment again or to position a different patient. The lifting movement can be performed manually, for instance when no patient is being held on the first treatment surface 100. The therapist thus need only lift the weight of first treatment surface 100. The lifting movement can also be realized by an actuator (not shown). The actuator lifts the first treatment surface 100, with or without patient, from the lower position B to the upper position A in order to initialize the treatment again or to return the first treatment surface to the upper position A. The actuator can be driven electrically or hydraulically in order to further reduce the physical strain on the therapist.

The dropping mechanism 200 comprises a stop 210. The stop 210 prevents the first treatment surface from coming to lie below the lower position B. In other words, the stop 210 stops the first treatment surface 100 at the lower position B. The stopping of the first treatment surface can also be seen as a collision between the stop and the first treatment surface. The collision generates a short and substantially upward directed force which is transmitted via the protrusion 110 to the lumbar region L of the patient. In other words, the stop 210 exerts an impulse on the first treatment surface 100 when first treatment surface 100 hits stop 210. The magnitude of the impulse is directly dependent on the weight of the patient and a speed of the movement of the treatment surface. The impulse imparts an effect on the tissue of the lumbar region L via protrusion 100 and unblocks or, in other words, normalizes the static, dynamic or reversible dispositions in the lumbar spinal column. The effect, and more particularly the force, imparted by the impulse on the lumbar region L can be resolved into several force vectors. The magnitude of the force vectors depends on the oblique angle a. Compared to the force generated by the collision, the force vectors are smaller due to the oblique angle a. The oblique angle a therefore causes the actual force exerted on the lumbar region to be smaller, making the treatment safer. The force exerted on the lumbar region L pushes the joints apart, whereby the dispositions, also referred to as joint blockages, are removed. The mobility of the joints increases here, and a normal function of the joints can once again be performed. It will be apparent on the basis of the above that the amount of physical exertion on the part of the therapist during the movement of first treatment surface 100 is minimal or almost nonexistent. This allows the therapist to repeatedly perform the manipulating treatment by means of device 10 correctly and safely without coming under physical strain. The device 10 further also allows a therapist of any demographic to perform the treatment independently of his or her physical characteristics, since the amount of physical work on the part of the therapist during the treatment is minimal or almost non-existent.

Figure 2 shows a schematic view of the device 10 for spinal column manipulation illustrated in figure 1 with a dropping mechanism 200 according to a further preferred embodiment.

In the illustrated preferred embodiment the dropping mechanism 200 comprises a fixing element 220 at the upper position A. The fixing element 220 is configured to fix the first treatment surface 100 at the upper position A. The patient can be positioned safely and under their own power on first treatment surface 100, which is being held at the upper position A. The therapist need therefore not lift the patient, making the treatment less physically straining for the therapist.

Fixing element 220 preferably has a first state wherein the first treatment surface 100 is held and a second state wherein the first treatment surface 100 is released. In this way one single element is used to fix the treatment surface on one hand and release it on the other. In a preferred embodiment fixing element 220 comprises an electromagnet 221 which fixes the first treatment surface in magnetic manner. The electromagnet 221 can be mounted on dropping mechanism 200 at the upper position. A magnetically engageable element such as an anchor plate 222 is preferably connected to the first treatment surface such that, when first treatment surface 100 is placed in the upper position A, the anchor plate 222 is positioned against or in the close vicinity of the electromagnet. Energizing of the electromagnet 221 prevents movement of anchor plate 222 and the first treatment surface 100 connected thereto by an electromagnetic locking of the electromagnet 221 and the anchor plate 222. An energized electromagnet is an example of a fixing element 220 in the first state. By interrupting the energizing of the magnet the electromagnetic locking is interrupted and anchor plate 221 and the first treatment surface 100 connected thereto are released. An example of the use of an electromagnet as fixing element 220 is that the locking is based on electromagnetic forces. Electromagnet 221 is not or hardly exposed to friction, whereby wear due to friction is avoided and the lifespan of such an electromagnetic fixing element is high. It will be apparent that on the one hand the electromagnet 221 can also be mounted on first treatment surface 100, and the corresponding anchor plate 222 on the dropping mechanism 200 on the other hand. According to a preferred embodiment, the electromagnet fixes the first treatment surface 100 in rest. This is understood to mean that the electromagnet locks the first treatment surface in the upper position A without an external signal. Electromagnet 220 releases the first treatment surface 100 when a release signal is generated. Such a preferred embodiment is also referred to as passively safe. This means that, without external instructions, the device 10 keeps fixing the first treatment surface in the upper position A.

The skilled person will appreciate that a number of fixing elements are possible, the dropping mechanism can thus be provided with for instance a sliding bolt (not shown). The sliding bolt comprises a bolt which in the first state extends into a closing loop arranged on the first treatment surface. In the second state the bolt is pulled back such that it is no longer in the closing loop and thus releases the first treatment surface.

According to a further preferred embodiment, device 10 comprises a switching element 240 for switching between the first and the second state of the fixing element 220. The switching element 240 can for instance be an electric switching element which when switched sends a release signal to the electromagnet 221 in order to end energizing. Switching element 240 can also be a handle for for instance manually sliding said bolt.

Dropping mechanism 200 preferably comprises a guide 230 for guiding treatment surface 100 between the upper and lower position in primarily a translation movement. The guide 230 limits the freedom of movement of the first treatment surface 100 such that the treatment surface moves along the same distance and in a downward direction as a whole. On one hand, the patient is not subjected to undesired impulses between the upper and lower position because the direction of movement does not change. On the other hand, an optimal impulse is generated at the position of the stop, whereby the device 10 normalizes the disposition of the lumbar region in improved manner. The guide 230 can be embodied in two parts. The guide can for instance comprise a first part and a second part. The first part, such as a guide wheel, is for instance coupled to the first treatment surface. The second part, for instance a guide slot, forms a part of the dropping mechanism 200. According to the example, the guide wheel is mounted on the first treatment surface 100 on one side and arranged in the guide slot on the other. First treatment surface 100 is movable via the guide. The guide limits the degrees of freedom of the first treatment surface 100. Stop 210 preferably comprises a damper 250. The damper 250 damps an end of the movement at the lower position B. Providing a damper 250 reduces the magnitude of the force exerted on the lumbar region of the patient. This therefore makes the treatment and the use of the device safer. The damper 250 can be manufactured from an elastically deformable material, for instance rubber. Damper 250 can also comprise a brake element. The brake element is configured to control the speed at which the first treatment surface is stopped. This allows the impulse given to the patient to be further optimized depending on the patient’s health status. The brake element can for instance be a biased spring. The bias of the spring is further preferably controllable.

The dropping mechanism 200 further preferably comprises a drop height control means 260. The drop height control means is configured to displace fixing element 220 in order to control a distance between the upper position A and the lower position B. The drop height control means 260 can alternatively be configured to displace the stop. The distance A-B between the upper and lower position is also controlled here. Controlling the distance between the upper and lower position makes a magnitude of the impulse controllable. This is because the magnitude of the impulse is directly proportional to the weight of the patient and the speed at which the treatment surface 100 hits the stop 250. The dropping mechanism is preferably provided to set the upper position A relative to the lower position B to a maximum of 15 cm, more preferably a maximum of 12 cm, most preferably a maximum of 10 cm.

Figure 3 illustrates a side view of a preferred embodiment of the device 10 for spinal column manipulation.

In the illustrated figure the first treatment surface 100 is mounted tiltably on the dropping mechanism via a shaft 120. This allows the oblique angle a relative to the horizontal plane to be controlled. The oblique angle is preferably smaller than 90°, preferably smaller than 75°, most preferably smaller than 60°. The oblique angle is optionally or additionally greater than 0°, more preferably greater than 20°, most preferably greater than 30°.

The first treatment surface 100 is preferably mounted on the shaft 120 at the position of protrusion 110 via a peripheral edge of the first treatment surface 100. First treatment surface 100 thus extends from and away from the shaft 120. This allows the first treatment surface 100 to tilt around the shaft as a whole.

The illustrated preferred embodiment shows that the device 10 can be in a first state C and a second state D. In the first state C the first treatment surface 100 lies at the oblique angle a. In the first state C device 10 can be used for spinal column manipulation, as described at length above.

In the figure device 10 is further provided with a second treatment surface 300 which is arranged on a rear side of the first treatment surface 100. In the second state D the second treatment surface 300 extends in a lying orientation. In the second state D device 10 can be used for recumbent treatments. Such a preferred embodiment, wherein device 10 has a first state and a second state, makes it possible to utilize the device in a wider context. The second treatment surface can moreover also drop, as was described in the context of the oblique treatment surface. This is advantageous because the dropping movement also realizes a physically advantageous effect in recumbent treatments, in addition to the actions of the specialist.

According to the illustrated embodiment, device 10 can be brought into one of the first or the second state by tilting the first and the second treatment surface relative to shaft 120. For a simplified use of the device an angle limiting element can be provided for each of the first state C and the second state D. This can also be one and the same angle limiting element which prevents a tilting movement of the first and second treatment surface beyond the first state and second state. The tilting of the first and the second treatment surface is limited by the angle limiting element in the correct position in which the first or second state is reached. The angle limiting element limits for instance the tilting movement of the first treatment surface so that the oblique angle a relative to the horizontal plane is 45°. A further angle limiting element is for instance provided to limit the tilting movement of the second treatment surface so that the second treatment surface 300 forms a straight angle with the horizontal plane. The second treatment surface 300 thus extends in a lying orientation. The angle limiting element allows the device to be brought into the first or second state in simple and rapid manner.

The illustrated preferred embodiment of the device 10 in figure 3 further comprises a support 20. The support 20 is configured to support the dropping mechanism 200 at a height. Support 20 can comprise a base 21 which is configured to be placed on the ground. Support 20 can alternatively be mounted on a wall (not shown).

Support 20 preferably extends from dropping mechanism 200 in a direction away from the patient. This allows a free space to be realized under dropping mechanism 200. It will therefore be impossible or difficult for the patient to bump into device 10 during movement between the upper and lower position. This is because undesired bumping can cause injuries or compression of the vertebrae, as will be further elucidated below.

In the illustrated exemplary embodiment the support 20 comprises a height control device 22 for controlling the height h. By controlling the height h the device can be used for patients of all sizes in the first state C. The height h can thus be controlled such that a patient who is for instance 1.95 m tall is securable to the first treatment surface 100 in simple manner and without significant physical exertion. If the patient is smaller, for instance 1.56 m tall, the height can be controlled such that such a small patient can also be positioned on the first treatment surface in simple manner. The height h is for instance controllable such that the protrusion 110 is already positioned at the height of the lumbar lordosis without the patient having to climb up onto the device therefor. The patient can then easily position themselves on first treatment surface 100 and subsequently be held against the first treatment surface. When he or she is already being held against the first treatment surface, the patient can also be positioned higher or lower using the height control device 22. This is because the lower limbs may hit the ground during a dropping movement, causing the intervertebral discs to be compressed and injuries to be inflicted. Using the height control device 22 the patient can be lifted higher so that the risk of the patient hitting the ground with his or her lower limbs during the dropping movement of first treatment surface 100 is minimal or nonexistent.

The height control device 22 also makes device 10 more ergonomic in use for the therapist. The height h can also be controlled in the second state D of device 10. The height can thus be controlled subject to the therapist’s height. Because the height h can be controlled in accordance with the therapist, the therapist can always perform treatments with correct posture. The therapist is thus subjected to less physical strain compared to for instance treatment tables with a height h which is not controllable.

Figure 4 shows a perspective view of the device 10 according to figure 3 in the first state. Figure 4 illustrates particularly that a patient is held against the first treatment surface at a distance from the ground.

The height control device 22 in figure 4 comprises a linear drive 22, 23 such as a spindle with a sliding nut or ball circulating spindle. A movement along the spindle of the sliding nut or ball circulating spindle enables the height to be precisely controlled. The movement along the spindle moreover prevents the dropping mechanism from dropping down unexpectedly. This makes the device safer in use.

Figure 4 further also illustrates that a space under dropping mechanism 200 is free. The patient P can therefore not knock into parts of the device between the dropping mechanism and the ground, or into the ground itself. In the illustrated embodiment the space is created by mounting the height control device 22 on a first outer end of the base 21. Height control device 22 then extends from base 21 in an upward direction above base 21. In this way the device 10 also achieves a static equilibrium.

Figure 5 shows a perspective view of the device according to figure 3 or 4 in the second state.

Figure 5 shows particularly that a third treatment surface 301, 302, 303 can be provided. The third treatment surface 301, 302, 303 is arranged at least partially above the dropping mechanism and in the second state extends in line with the second treatment surface 200. The third and the second treatment surface together form a larger treatment surface which allows the patient to be supported in his or her entirety. In the illustrated preferred embodiment the third treatment surface comprises a plurality of treatment surface segments 301, 302, 303. The plurality of treatment surface segments are preferably adjustable relative to each other. This allows further personalization to the patient to be treated of device 10 in the second state. An opening for the face can thus for instance be provided in the treatment surface segment 302. The face opening is configured to receive the face of a patient so that the patient can be treated on his or her stomach, without this realizing a rotation of the vertebrae of the neck or back.

Figures 6A and 6B show schematic perspective views of a patient being held against the first treatment surface. For this purpose a securing means 40 serves to hold the patient against the first treatment surface.

In figure 6A the securing means 40 is provided at an upper outer end 101 of the first treatment surface 100. The patient holds on to securing means 40 at the position of his or her shoulders so that the patient is held against first treatment surface 100 from above. At least the back vertebrae of the patient are in this way held against the first treatment surface almost without being loaded.

In figure 6B the securing means 40 can be mounted at the position of a peripheral side edge 102 of the first treatment surface. By placing securing means 40 at the position of the peripheral side edge 102 the height of the securing means is controllable and the patient is always held against first treatment surface 100 from above. First securing means 40 can for instance be mounted on the peripheral side edge 102 close to the upper outer end 101 in the case of physically large patients.

In order to position the patient relative to first treatment surface 100 the securing means 40 can comprise a securing control means 41 (see figure 5). The securing control means 41, illustrated in figure 5, is provided on a rear side of the first treatment surface 100 but can also be provided on the peripheral side edge 102. In the illustrated preferred embodiment the securing control means 41 is elongated and extends in a longitudinal direction of first treatment surface 100. Securing control means 41 extends along the peripheral side edge 102 and comprises a plurality of engaging parts 42 (see figure 5) which are distributed over a longitudinal length of the securing control means 41. The plurality of engaging parts 42 are provided to engage an opening in securing means 40 compatible with the engaging parts. The position and orientation of engaging parts 42 therefore make securing means 40 adjustable and make it possible to set the position of the patient relative to the first treatment surface 100. A patient cannot injure themselves on the engaging parts when the securing control means 41 is mounted on the rear side of first treatment surface 100. The engaging parts furthermore remain relatively easily accessible for setting the position of the patient relative to the first treatment surface.

In figures 6A and 6B securing means 40 comprises a brace adapted to support the patient at the position of his or her forearm. More specifically, two braces are provided on either side of treatment surface 100, wherein each brace supports a corresponding forearm of the patient. The securing means can alternatively or in combination also be configured to fix the patient at the position of the shoulders or the waist. Figure 7 shows a side view of a cross-section of protrusion 110. Figure 7 does not show first treatment surface 100, although it will be apparent that the protrusion 110 preferably extends from first treatment surface 100 in a direction away from first treatment surface 100. Protrusion 110 is preferably configured to connect closely to the back of the patient, more specifically the lumbar region L as shown in figure 1. The protrusion 110 is preferably formed such that it follows the periphery of the lumbar lordosis or, in other words, the hollow in the lower back. For this purpose protrusion 110 is preferably provided with a first protrusion portion 110a and a second protrusion portion 110b. In figure 7 the first protrusion portion 110a and the second protrusion portion 110b are manufactured from one piece of material. It is however not essential for the first protrusion portion 110a and the second protrusion portion 110b to be manufactured integrally, first protrusion portion 110a and second protrusion portion 110b can also be manufactured as individual parts and, correspondingly, be connectable to each other. The first protrusion portion 110a comprises a peripheral surface Illa which describes at least partially an arc, as seen in a cross- sectional direction. The arc is preferably substantially circular, wherein a radius of the arc is at least 15 cm, more preferably at least 20 cm, most preferably 25 cm, for instance 27 cm. In the shown preferred embodiment the arc has an arc length extending at least through an angle of 90° or l fl. The arc length is measured from the edge of protrusion 110 at the position of first treatment surface 100 to the second protrusion portion 110b. In the shown embodiment the first protrusion portion 110a transposes into the second protrusion portion 110b. The second protrusion portion 110b has a flat peripheral surface 111b which has an acute angle with the first treatment surface. This angle is preferably smaller than 60°, more preferably smaller than 50°. The flat peripheral surface 111b preferably has a length of at least 300 mm, for instance 400 mm. In this way protrusion 110 has on one side an arcuate peripheral surface Illa and on the other a flat oblique surface 11 lb, which support the patient at the position of the lumbar lordosis. The advantage of this preferred embodiment is that the protrusion acts in highly advantageous manner on the lumbar region of the patient. When the patient is resting on the protrusion 110, protrusion 110 imparts a mutual effect on the tissue of the patient. This effect is shown using a plurality of arrows Fnl-Fn5, which represent force vectors. As already described above, when first treatment surface 100 hits stop 210, the stop exerts an impulse on the first treatment surface 100. This impulse imparts an effect on the tissue via protrusion 110, and more specifically along the illustrated plurality of force vectors Fnl-Fn5. It will be apparent that the protrusion exerts more than five force vectors on the tissue of the patient. More specifically, figure 7 illustrates that the force vectors are divergent. This is understood to mean that force vectors Fnl-Fn5 have different directions. This has the advantage that the force exerted on the lumbar region pushes the joints apart whereby the disposition, also referred to as joint blockages, is removed. The mobility of the joints increases here, and a normal function of the joints can once again be performed. It is noted here that these forces act substantially on the so-called facet joints, which are removed about 4 cm from the centre of an intervertebral disc. It will be apparent that the forces do not act directly on the intervertebral discs. Because the protrusion 110 is formed in this way, the joint blockages are unblocked safely and effectively.

The skilled person will appreciate on the basis of the above description that the invention can be embodied in different ways and on the basis of different principles. The invention is not limited to the above described embodiments. The above described embodiments and the figures are purely illustrative and serve only to increase understanding of the invention. The invention will not therefore be limited to the embodiments described herein, but is defined in the claims.