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WO2002098333A1 - Appareil et procede permettant d'eviter une thrombose veineuse profonde - Google Patents

Appareil et procede permettant d'eviter une thrombose veineuse profonde Download PDF

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Publication number
WO2002098333A1
WO2002098333A1 PCT/IB2002/001852 IB0201852W WO02098333A1 WO 2002098333 A1 WO2002098333 A1 WO 2002098333A1 IB 0201852 W IB0201852 W IB 0201852W WO 02098333 A1 WO02098333 A1 WO 02098333A1
Authority
WO
WIPO (PCT)
Prior art keywords
calf
person
foot
elastic member
backing element
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.)
Ceased
Application number
PCT/IB2002/001852
Other languages
English (en)
Inventor
Johan David Van Wyk
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of WO2002098333A1 publication Critical patent/WO2002098333A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices ; Anti-rape devices
    • A61F5/01—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces
    • A61F5/0102—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
    • A61F5/0104—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations without articulation
    • A61F5/0111—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations without articulation for the feet or ankles
    • A61F5/0113—Drop-foot appliances
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B23/00—Exercising apparatus specially adapted for particular parts of the body
    • A63B23/035—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously
    • A63B23/04—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for lower limbs
    • A63B23/08—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for lower limbs for ankle joints
    • A63B23/085—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously for lower limbs for ankle joints by rotational movement of the joint in a plane substantially parallel to the body-symmetrical-plane
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2209/00—Devices for avoiding blood stagnation, e.g. Deep Vein Thrombosis [DVT] devices

Definitions

  • THIS invention relates to a method and apparatus for avoiding deep vein thrombosis.
  • Deep vein thrombosis refers to the formation of a thrombus (blood clot) within a deep vein, commonly in the thigh or calf of a person.
  • the blood clot can either partially or completely block the flow of blood in the vein.
  • DVT often begins in the calf or thigh because blood moves relatively slowly in these areas, particularly if exercise is limited. As a clot develops in size, it can shed pieces of the clot. These pieces of the clot are referred to as emboli.
  • emboli float through the system and can cause serious and sometimes fatal complications in the major arteries of the heart and the lung. One of the most serious cases is a pulmonary embolism where blood flow to the lung is blocked.
  • DVT can be brought on by long periods of immobility, for example during aeroplane flights when a person is constrained to sit in cramped conditions for long periods of time.
  • United States patent no. 4,624,244 discloses a device for aiding veinous flow of blood from the foot and leg of a patient.
  • This device is extremely complicated and makes use of a number of bladders which are sequentially inflated with compressed air. When the bladders are inflated, they bulge inwardly to provide pressure against deep vein thrombosis in the leg.
  • the bladders are inflated by a compressor.
  • the main problem with this device is that it requires a complicated operating system and is difficult to transport because it requires a compressor. It is highly unlikely that such a device could conveniently be used " while travelling, especially in cramped conditions on an aircraft.
  • United States patent no. 4,841 ,956 discloses an apparatus for increasing blood flow in the leg by pressurizing muscles using gas from a pressurized source of gas. Again, this apparatus is complicated and bulky as it requires special solenoid valves and a device for providing a pressurized source of gas.
  • United States patent no. 6,002,965 discloses a device comprising a cuff which is arranged to be wrapped around the calf muscles of a user's leg.
  • the cuff includes electrodes which, when activated, cause muscle and nerve stimulation and contraction of the calf muscle.
  • the contraction of the calf muscle causing increase of blood flow and decreases the possibility of developing deep vein thrombosis.
  • this apparatus does not take up much space is non-intrusive, it does require electronic circuitry and batteries which have to be replaced.
  • the electric stimulas which causes muscle contraction is also uncomfortable.
  • this invention relates to a method of avoiding circulatory ailments, particularly the onset of deep vein thrombosis in a person, by exercising the calf muscles of a person when the person is constrained to remain immobile for long periods of time in cramped conditions, for example during an aeroplane flight, while bed ridden in hospital, or while sitting behind a desk at work.
  • an apparatus for avoiding circulatory ailments in a person including a calf attachment means which is arranged to attach to and surround the calf of the person, at least one elastic member having a first end which is connected to the calf attachment means and a second end which is connectable to the foot of the person, preferably in the arch, ball or toe region of the persons foot, by way of foot connector means.
  • the apparatus includes a backing element to which the elastic member is attached, and the backing element in turn is attached to the calf attachment means.
  • the backing element is also connected to the foot connector means.
  • the foot connector means may be an article of footwear which is designed to be worn by the person, or it may be a device which is attachable to an article of footwear.
  • the foot connector means includes a raised heel.
  • the backing element may include a series of spaced apart notches onto which the elastic member is attached, for altering the position of the elastic member on the backing element.
  • the position of the attachment of the elastic member on the foot connector means is also changeable.
  • the calf attachment means may be a calf strap which is arranged to attach to and surround the calf of a user.
  • the calf attachment means includes a calf support for supporting and massaging a region of a user's calf, when in use.
  • the calf support may be generally half cylindrical in shape, preferably half cone in shape, with a perimeter which is curved outwardly, away from a longitudinal axis passing through the calf support.
  • the position of the calf support on the backing element is adjustable.
  • a method for avoiding circulatory disorders in a person including attaching an apparatus as described above to the leg of a person.
  • the person extending and relaxing his or her foot at the ankle.
  • Figure 1 is a pictorial view of a calf exercise apparatus according to a first embodiment of the invention
  • Figure 2 is a side view of the calf exercise apparatus of Figure 1 on a person in a relaxed position;
  • Figure 3 is a side view of the calf exercise apparatus of Figure 1 in an extended position
  • Figure 4 is a side view of a calf exercise device according to a second simplified embodiment of the invention, on a person
  • Figure 5 is a pictorial view of a calf exercise apparatus according to a third embodiment of the invention.
  • the calf exercise apparatus 10 includes a calf attachment means in the form of a calf strap 12 which is arranged to attach to, and surround, the calf of the leg of a user.
  • An elastic member 14 is connected to the calf strap 12 via an elongate backing element 16 and is attached to the foot of a user, by way of a foot connector means, in this case a shoe 18.
  • the shoe 18 has a sole 20 including a raised heel 22, an arch region 24, a ball region 26 and a toe region 28, which correspond to the regions of a user's foot.
  • a rigid support element 30 is attached to the heel 22 of the shoe 18 and is connected, by way of a hinge 32 to the backing element 16.
  • the backing element 16 is made from a flexible plastics material and bears a series of opposed notches 34.
  • the calf strap 12 is flexible and has strips of VelcroTM tape 38 and 40 on either end thereof, for fastening the calf strap 12 to the leg of a user.
  • the sole 20 of the shoe 18 bears a series of opposed lugs 42, on either side thereof.
  • the lugs 42 are provided on the arch, ball and toe regions 24, 26 and 28 on the sole 20 and provide connector means for connecting the elastic member 14 to the foot of a user.
  • the elastic member 14 is an elastic band which is supported on one of the pairs of notches 34 in the backing element 16 and on one of the pairs of lugs 42 on the sole 20 of the shoe 18, thereby connecting the calf strap 12 to the sole of the shoe 20. It will be seen that the position of the elastic member 14 on the backing element 16 can be adjusted by using different pairs of notches 34, and the position of the elastic member 14 on the sole 20 of the shoe 18 can be adjusted by using different pairs of lugs 42.
  • the calf exercise apparatus 10 is attached to the leg 46 of a user, for example when the user is sitting down on a chair 48.
  • the calf exercise apparatus 10 is attached to the user's leg 46 by putting the shoe 18 on the user's foot and attaching the calf strap 12 to the calf 50 of the user's leg 46 so that the calf strap 12 surrounds the calf 50.
  • the user exercises muscles in the calf 50 by extending his/her foot at the ankle.
  • the user extends his/her foot by contracting the muscles in the calf 50.
  • the raised heel 22 is important as it provides a fulcrum on which the heel of the user is pivoted.
  • the elastic member 14 stretches and resiliently resists movement of the foot, thus providing a resistance to movement for exercising the calf muscles.
  • his/her foot returns to the position shown in Figure 2 and the user exercises muscles in the calf 50 by again extending, and then relaxing his/her foot.
  • the exercising of the calf muscles causes a pump action of blood in the leg.
  • the downward movement of the toe region 28 of the shoe 18 causes the backing element 16 to push upwardly against the calf 50, thereby massaging the calf 50.
  • the calf exercise apparatus 10 not only exercises the muscles in the calf 50, but also massages the muscles of the calf 50.
  • the tension of the elastic member 14, and thus the level of exercise of the calf 50, can be altered by moving the position of the elastic member 14 on the notches 34 on the backing element 16, and on the lugs 42 on the sole 20 of the shoe 18.
  • the muscles in a persons calf 50 store a large amount of blood.
  • contraction of these calf muscles causes blood to flow through the leg 46, particularly through the long and short saphenous veins.
  • This flow of blood through the veins helps to prevent formation of blood clots in the veins of the leg 46.
  • the gastrocnemius and soleus muscles cause so much flow of blood that they have been referred to as the "peripheral heart”.
  • the movement of the backing element 16 massages the muscles of the calf 50 which helps to prevent the formation of blood clots in veins in this region.
  • the increase of blood flow through the veins of the calf 50, and the massaging of the calf 50 thus assists in stopping the formation of blood clots in the veins of the calf and in veins in the rest of the leg.
  • the calf exercise apparatus 10 may be used by persons who are forced to remain immobile and/or sitting for long periods of time in confined spaces, for example when sitting on a aeroplane flight, when sitting on a chair at work, or when lying in a hospital bed.
  • the calf exercise apparatus 59 includes a calf attachment means in the form of a strap 52 which is arranged to attach to and surround the calf 50 of a user.
  • the apparatus 59 also includes foot connector means in the form of a toe cap 54 which is arranged to fit over the toes 56 of the foot of a user and an elastic member in the form of an elastic band 58 which is attached to the strap 52 and to the toe cap 54. The user can then exercise the muscles in his/her calf 50 by extending and releasing his/her foot.
  • the strap 52 which is attached to the user's calf 50, also provides some degree of massaging to the calf 50, and works in a similar way to the calf exercise apparatus 10 shown in Figure 1.
  • a third embodiment of the invention is shown in Figure 5, which shows a calf exercise apparatus 60 wherein the calf attachment means includes a calf support 62 which is generally half cylindrical in shape, preferably half cone in shape, to correspond with the shape of a calf region of a user.
  • the calf support 62 is flared outwards along its perimeter 64, away from the longitudinal axis A-A passing through the calf support 62, so that the perimeter 64 does not contact, and apply pressure to, the skin of the user, causing discomfort.
  • the calf support 62 is attached to a rod 68 that fits slidably within a backing element 70, enabling the position of the calf support 62 to be adjustable on the backing element 70, and thus allowing the position of the calf support 62 to be adjustable on the calf of a user, and allowing the device to be used by users with different size legs.
  • the rod 68 to which the calf support 62 is attached includes a number of apertures 72 that align with an aperture 74 provided in the backing element 70.
  • the aperture 74 in the backing element 70 is aligned with the most proximal aperture in the rod 68 and a pin 76 is inserted therethrough, thereby securing the calf support 62 in the preferred position.
  • the backing element 70 includes an elongate aperture 78, along which a second pin 80, which is secured at one end to the rod 68, travels.
  • the calf exercise apparatus 60 of this third embodiment includes an elastic member 82 that is connected to the elongate backing element 70.
  • the backing element 70 similarly bears a series of opposed notches 84, and is hingedly attached to a rigid support element 86 on a foot connector 88.
  • the foot connector 88 includes a shoe support element 90 for receiving the shoe of a user.
  • the shoe support element 90 includes tabs 92 that extend around the perimeter of the sole of a shoe, to secure the shoe in the support element 90.
  • the support element 90 further includes a raised heel 93, an aperture 94 through which the heel of a shoe (i.e. the heel of a woman's high-heel shoe) can extend.
  • a strip 96 for limiting the movement of a shoe heel (which does not extend through the aperture 94).
  • two strips of elastic material 96 that have two strips of VelcroTM tape 98 on either end thereof, for binding over the top of a shoe and preventing the shoe from lifting from the support element 90.
  • the shoe support element 90 is attached to the shoe of a user using the strips of elastic material 96.
  • the user then adjusts the position of the calf support 62 on the backing element 70, to position the calf support 62 on his or her calf, and then secures the support in place on the calf, by securing the strips of elastic material 66 around the user's leg.
  • the user uses the exercise device in the same manner as the device described in the first embodiment of the invention above.
  • the main advantage of this exercise apparatus of the third embodiment of the invention is that the calf support 62 surrounds the calf muscle of a user and provides better massaging of the muscle, thereby further stimulating blood flow within the calf muscle.
  • the calf support 62 moves upwardly against the calf muscles and the cone shape of the calf support 62 forces veinous blood upwardly and simultaneously compresses the vein, resulting in a massaging effect.
  • the foot is relaxed and the calf support 62 moves downwardly, there would be no veinous obstruction and the blood again allowed to move.
  • the calf exercise apparatus' according to the first, second and third embodiments of the invention described above are useful for avoiding deep vein thrombosis when a user is forced to remain immobile for long periods of time. They are also compact and thus easy to transport and to attach to the leg in confined spaces. Another advantage is that the apparatus does not make a sound and will allow the user to use it without disturbing others.

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Nursing (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Massaging Devices (AREA)
  • Rehabilitation Tools (AREA)

Abstract

L'invention concerne une méthode et un appareil (60) qui permettent d'éviter des problèmes circulatoires, tels que la thrombose veineuse profonde. Cet appareil (60) comprend un connecteur de pied (88) qui est attaché par des sangles (96) au pied d'une personne et un soutien de mollets rigide (62) qui est attaché par des sangles (66) au mollet d'une personne. Le soutien de mollets (62) est relié à un élément de support (70) qui est à son tour relié au connecteur de pied (88) par un élément élastique (82). Après avoir attaché le dispositif, la personne l'utilise en étirant et en relâchant son pied au niveau de la cheville. L'étirement du pied est provoqué par une contraction musculaire qui stimule la circulation sanguine dans le muscle du mollet. Le soutien de mollets (62) présente l'avantage de masser les muscles du mollet afin d'encourager la circulation sanguine. La stimulation de la circulation sanguine diminue le risque de formation de caillots dans les veines de la jambe et, par conséquent, diminue le risque de thrombose veineuse profonde chez une personne.
PCT/IB2002/001852 2001-06-01 2002-05-28 Appareil et procede permettant d'eviter une thrombose veineuse profonde Ceased WO2002098333A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
ZA2001/4531 2001-06-01
ZA200104531 2001-06-01
ZA2001/10353 2001-12-18
ZA200110353 2001-12-18

Publications (1)

Publication Number Publication Date
WO2002098333A1 true WO2002098333A1 (fr) 2002-12-12

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Country Status (1)

Country Link
WO (1) WO2002098333A1 (fr)

Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2005046803A1 (fr) * 2003-11-14 2005-05-26 Johan David Van Wyk Dispositif pour reduire le risque d'apparition de thrombose veineuse profonde
EP1778139A4 (fr) * 2004-07-29 2008-07-23 United Pacific Ind Pty Ltd Dispositif de limitation de flexion plantaire
CN105943319A (zh) * 2016-05-26 2016-09-21 成都润惠科技有限公司 一种外骨骼自适应下肢助力装置
JP2018534959A (ja) * 2015-10-06 2018-11-29 リュ，ジョンヨプ 乗物装置に着脱可能な下肢加圧用機器
CN111298376A (zh) * 2020-02-19 2020-06-19 吉林大学 一种脑瘫综合康复护理训练辅具
GB2582669A (en) * 2019-04-12 2020-09-30 The Communications Business Ltd Foot rest device
KR20210106667A (ko) * 2020-02-21 2021-08-31 인제대학교 산학협력단 인체의 관절운동 보조기
JP2022126226A (ja) * 2021-02-18 2022-08-30 株式会社カワイチ・テック 下腿押圧器具
GB2614399A (en) * 2021-10-27 2023-07-05 Hatem Tamer An exercise apparatus

Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE548527C (de) * 1930-11-26 1932-10-07 Felix Du Bois Reymond Dr UEbungsgeraet zur Verhuetung bzw. Behebung des Senk-, Platt- und Knickfusses
US2567195A (en) * 1946-03-05 1951-09-11 Emmett C Ellery Orthopedic drop-foot brace
US4566447A (en) * 1978-02-09 1986-01-28 The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration Drop foot corrective device
US4624244A (en) 1984-10-15 1986-11-25 Taheri Syde A Device for aiding cardiocepital venous flow from the foot and leg of a patient
US4817589A (en) * 1987-08-27 1989-04-04 Wertz Larry W Foot support device for improved ambulation
US4841956A (en) 1985-10-15 1989-06-27 Electro-Biology, Inc. Apparatus for inducing venous-return flow from the leg
US5088480A (en) * 1989-09-01 1992-02-18 Wang Tzu C Lower leg orthosis apparatus
DE4038511A1 (de) * 1990-12-03 1992-06-04 Gerd Dr Jungkunz Sport- und trainingsgeraet zum verstaerken der sprungkraft des fusses waehrend der sprungphase
US5860423A (en) * 1996-12-06 1999-01-19 Thompson; Terry Ankle-foot orthosis
US6002965A (en) 1998-06-10 1999-12-14 Katz; Amiram Self applied device and method for prevention of deep vein thrombosis

Patent Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE548527C (de) * 1930-11-26 1932-10-07 Felix Du Bois Reymond Dr UEbungsgeraet zur Verhuetung bzw. Behebung des Senk-, Platt- und Knickfusses
US2567195A (en) * 1946-03-05 1951-09-11 Emmett C Ellery Orthopedic drop-foot brace
US4566447A (en) * 1978-02-09 1986-01-28 The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration Drop foot corrective device
US4624244A (en) 1984-10-15 1986-11-25 Taheri Syde A Device for aiding cardiocepital venous flow from the foot and leg of a patient
US4841956A (en) 1985-10-15 1989-06-27 Electro-Biology, Inc. Apparatus for inducing venous-return flow from the leg
US4817589A (en) * 1987-08-27 1989-04-04 Wertz Larry W Foot support device for improved ambulation
US5088480A (en) * 1989-09-01 1992-02-18 Wang Tzu C Lower leg orthosis apparatus
DE4038511A1 (de) * 1990-12-03 1992-06-04 Gerd Dr Jungkunz Sport- und trainingsgeraet zum verstaerken der sprungkraft des fusses waehrend der sprungphase
US5860423A (en) * 1996-12-06 1999-01-19 Thompson; Terry Ankle-foot orthosis
US6002965A (en) 1998-06-10 1999-12-14 Katz; Amiram Self applied device and method for prevention of deep vein thrombosis

Cited By (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2005046803A1 (fr) * 2003-11-14 2005-05-26 Johan David Van Wyk Dispositif pour reduire le risque d'apparition de thrombose veineuse profonde
EP1778139A4 (fr) * 2004-07-29 2008-07-23 United Pacific Ind Pty Ltd Dispositif de limitation de flexion plantaire
US7806844B2 (en) 2004-07-29 2010-10-05 United Pacific Industries Pty Ltd. Plantar-flexion restraint device
JP2018534959A (ja) * 2015-10-06 2018-11-29 リュ，ジョンヨプ 乗物装置に着脱可能な下肢加圧用機器
CN105943319A (zh) * 2016-05-26 2016-09-21 成都润惠科技有限公司 一种外骨骼自适应下肢助力装置
GB2582669A (en) * 2019-04-12 2020-09-30 The Communications Business Ltd Foot rest device
GB2582669B (en) * 2019-04-12 2021-05-19 The Communications Business Ltd Foot rest device
CN111298376A (zh) * 2020-02-19 2020-06-19 吉林大学 一种脑瘫综合康复护理训练辅具
KR20210106667A (ko) * 2020-02-21 2021-08-31 인제대학교 산학협력단 인체의 관절운동 보조기
KR102359961B1 (ko) * 2020-02-21 2022-02-07 인제대학교 산학협력단 인체의 관절운동 보조기
JP2022126226A (ja) * 2021-02-18 2022-08-30 株式会社カワイチ・テック 下腿押圧器具
JP7595859B2 (ja) 2021-02-18 2024-12-09 株式会社カワイチ・テック 下腿押圧器具
GB2614399A (en) * 2021-10-27 2023-07-05 Hatem Tamer An exercise apparatus

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