WO2014080434A1

WO2014080434A1 - An apparatus for the treatment of osteopathic lesions of the pelvis

Info

Publication number: WO2014080434A1
Application number: PCT/IT2013/000326
Authority: WO
Inventors: Chama ABDULKARIM
Original assignee: Abdulkarim Chama
Priority date: 2012-11-21
Filing date: 2013-11-21
Publication date: 2014-05-30
Also published as: ITRM20120585A1

Abstract

An apparatus for the treatment of osteopathic lesions of the pelvis comprises, in combination: a height-adjustable vibrating and rocking surface (1), on which the patient is rested; a main load-bearing structure (2); mobile means (5, 6, 6', 10) for laterally compressing the patient's pelvis during treatment (without blocking it) via purposely provided resting elements (7, 8). Said load-bearing structure (2) is equipped with means for adjusting, the height of the resting surface (1) for the patient, as well as with movement means for imposing on the vibrating and rocking surface (1) a vibrational motion and movement of craniocaudal inclination with preferably arrhythmic motion, where said vibrational motion is designed to reduce muscle retraction linked to the lesions of the pelvis.

Description

AN APPARATUS FOR THE TREATMENT OF OSTEOPATHIC LESIONS OF THE

PELVIS

*****

The present invention substantially relates to an apparatus devised for treating osteopathic lesions of the pelvis .

FIELD OF THE INVENTION

The working and social requirements of present-day life frequently involve mean that the individual is subjected to stresses or has to assume incorrect postural attitudes, which could create osteopathic lesions to the pelvis and consequently to the vertebrae L5/S1, which are strictly linked to one another. There exists a precise mechanical aetiology at the origin of the painful symptoms at a lumbar level due to primary iliac or sacral lesions. Also in the world of sport, practised both at an amateur level and at a professional level, there may at times result sacral/iliac/pubic osteopathic lesions or articular subdislocations .

It is known that the mathematical lines of the human body, as J. Wernham and T.E. Hall noted in "Mechanics of the spine", are only six:

1. Line No. 1 central line of gravity of the body;

2. Line No. 2 anterior line of the body;

3. Line No . 3 pubic transverse line;

4. Line No. 4 anteroposterior line;

5. Lines Nos. 5 and 6: posteroanterior lines of the body; and

6. Lines Nos. 4, 5, and 6 determine two isosceles triangles: a top one and a bottom one.

In physiology, fascial sprain produces a release of prostaglandins, acting via a dual bio-feedback on the pineal gland. If the primary lesion is from above or from beneath, it can be put down to the perturbation of different mathematical lines of the human body. The typical example that is encountered most frequently is provided by the area D3 D4 D5. When this region suffers, the osteopath must not forget that:

• it represents a centre of gravity that corresponds to L3;

• the central line of gravity of the body passes through L3;

• the three, anteroposterior and posteroanterior, mathematical lines of the human body cross at the level of D4;

• D4, which is an important vasculonervous intersection, represents the apex of the isosceles triangles, the bottom one and the top one;

• the line 3, where the central line of gravity of the body passes, forms part of its contiguous anatomical context; and

• engaging at the level ^" of the anterior face of D4 there is a band of occipito-temporal origin.

On the basis of the above knowledge, it has been possible to understand the glandular effects of osteopathic treatment. Any articular osteopathic lesion that lasts more than 24 h may generate a glandular functional disorder. According to the studies of Denise Brookes, osteopathic lesions that persist beyond 24 h determine release of prostaglandins that persist as long as the lesion is in progress. This release of prostaglandins ceases instantaneously as soon as the lesion is suppressed. The diffusion of prostaglandins produces an over- functioning of the adrenal glands, causing a cranial- cortical-adrenal hypertrophic state.

In the current state of the art, there does not exist machinery that can solve these types of articular lesions of the pelvis. With reference to the studies of Denise Brookes, the apparatus according to the present invention enables reduction of the time of normalization of the lesions, without causing any glandular damage, and also enables correction of the ascending scoliotic postures that result from osteopathic lesions of the pelvis, preventing any type of human error.

Frequently, osteopathic lesions are not single, but are associated to other lesions.

Advantageously, the invention responds to the need of the individual patient, without causing any professional or dynamic damage due to inadequate corrective osteopathic manoeuvres and/or to non-adequate diagnoses.

It is to be emphasized that some British or American authors, who presented a more theoretical than practical approach, have in the past described bilateral anterior or posterior iliac lesions because they were not conversant with bilateral anterior or posterior sacral lesions, which could be mistaken for bilateral iliac lesions and hence cause confusion.

The apparatus according to the invention is devised also for all those patients who have a handicap or present multiple traumas above or below the pelvis, who are unable to perform corrective manoeuvres.

SUPPLEMENTARY ANALYSIS

What is a lesion? A "lesion" is an exaggeration of the articular physiological structure. It is a modification of an organ or a tissue with alteration of its continuity, its normality, its structure, or its function, due to physical causes (traumatic agents) , chemical causes (intoxication) , or biological causes (micro-organisms) .

Listed briefly in what follows are some of the techniques that in the past, and up to the present, have been adopted for treating anterior iliac lesion, and it will be shown how this lesion may be treated and healed using the apparatus described herein.

The purpose of a therapeutic manoeuvre is to restore the mobility lost by the lesioned structure. The techniques used by the therapist may vary considerably:

1. Direct structural corrective techniques;

2. echniques that use respiration of the subject;

3. Techniques that use muscular energy; and

4. Techniques that use primary respiratory mobility.

None of these techniques in the past has been found superior to any other; hence, the choice between them depends only upon the therapist and/or upon the patient (sex, age, musculature, apprehension) .

The conditions for success of these techniques are:

1. Perfect positioning of the patient;

2. Locking of the upper and lower levers for localizing the work on the articular interline that has suffered injury;

3. Positioning of the osteopath and point of contact of his or her hands;

4. Tensioning; and

5. Thrust (high speed, rapidity, low amplitude = very short: this is a kind of osteopathic technique that does not concern the present application) .

Among these techniques, only the direct structural ones will be taken into consideration.

Before starting normalization, it is necessary to know how to carry out locking. The purpose is to provide two locks: a top one and a bottom one on each side of the articulation to be normalized.

ANTERIOR ILIAC LESION

□ To correct an anterior lesion, it is necessary to make a posterior rotation with exhalation.

Π To correct a posterior lesion, it is necessary to make an anterior rotation with inhalation.

In what follows, a type of correction is described that, thanks to the present invention, can be carried out without the intervention of the therapist:

The patient is lying in the so-called "boomerang" position, i.e., with his pelvis on one side of the bed and his feet and trunk on the opposite side. This position sets the lateral muscles of the thigh and trunk in tension on the side of the convexity and relaxed on the side of the concavity: in this first correction, the lesion will be on the side of the concavity, i.e., on the side of muscular relaxation. The patient puts his hands behind the back of his neck, with his elbows slightly approaching one another.

The therapist is standing at the height of the patient's pelvis, on the side opposite to the lesion, with a slight rotation of the patient's trunk so that the patient is rested on the shoulder on his side opposite to the lesion in order to create a pivot. Then the therapist lays the cephalic hand on the shoulder of the patient on the side of the lesion, resting the corresponding elbow of the patient. The caudal hand is resting on the anterior-superior iliac spine (ASIS) on the side of the lesion.

This position makes it possible to exert a torsion on the trunk of the patient, via the point of rest provided by the patient's elbow; the shoulder resting on the bed serves as pivot, such as the upper arm of the lever. This rotation, which involves all the vertebrae one after another, imprisons the lumbo-sacral hinge. The boomerang position must not be altered. When the pelvic rotation manages to draw along the ASIS - which is perceived easily with the caudal hand - the sacrum is locked and fixed with respect to the rachis.

For the correction times, the therapist moves with his body upwards and downwards, without abandoning locking of the sacrum. With the caudal hand, he exerts a corrective pressure on the ASIS from beneath upwards to correct an anterior lesion by means of a posterior rotation, but when the patient is exhaling.

SUPPLEMENTARY ANALYSIS AND LIST OF PATHOLOGICAL CONDITIONS THAT CAN BE TREATED USING THE PRESENT INVENTION. Lesions of the pelvis:

A) iliac lesions;

B) sacral lesions; and

C) pubic subdislocations .

A) Iliac lesions:

Currently six categories are considered:

1) right anterior iliac lesion;

2) left anterior iliac lesion;

3) left posterior iliac lesion;

4) right posterior iliac lesion; 5) iliac lesion due to primary right torsion; and

6) iliac lesion due to primary left torsion.

B) Sacral lesions:

It is not a sacral lesion that uses a sacral axis. The sacral lesions are eleven and may involve the following:

- superior transverse axis;

- mean transverse axis; and

- oblique axes.

1 - Sacral lesion in respiratory flexion.

2 - Sacral lesion in respiratory extension.

N.B. These first lesions cannot be treated directly using the apparatus according to the present invention, but they can be treated indirectly because the lesions are descending since the sacral lesion in respiratory flexion on the superior transverse axis of Sutherland is secondary to a primary sphenobasilar lesion in flexion. This is a descending cranio-sacral mechanical sequence. The sacral lesion in respiratory extension on the superior transverse axis of Sutherland is primary and causes a secondary sphenobasilar lesion in extension. This is an ascending sacro-sphenobasilar mechanical sequence.

3 - Bilateral anterior sacral lesion;

4 - Bilateral posterior sacral lesion;

5 - Depressed sacrum;

6 - Unilateral anterior sacral lesion;

7 - Unilateral posterior sacral lesion;

8 - Left sacral torsion on left oblique axis;

9 - Right sacral torsion on right oblique axis;

10 - Left sacral torsion on right oblique axis; and

11 - Right sacral torsion on left oblique axis.

C) Pubic subdislocations : - anterior pubic subdislocation;

- anterior-superior pubic subdislocation;

- anterior-inferior pubic subdislocation;

- posterior pubic subdislocation;

- posterior-superior pubic subdislocation;

- posterior-inferior pubic subdislocation;

- superior pubic subdislocation;

- inferior pubic subdislocation; and

- lumbar lesions of L5

SUMMARY OF THE INVENTION:

The invention and its functions will now be described in a preferred embodiment with reference to the drawings.

List of drawings

Figure 1A is a lateral view and a top view that represent schematically a patient resting on an apparatus according to the invention;

Figure IB is a 3D view illustrating schematically the main parts and the accessories that make up the apparatus according to the invention;

Figure 2, which is similar to the previous one, shows the surface on which the patient is stretched out, which is inclined following upon rocking in the direction of the cranial part;

Figure 3 shows a different positioning of the accessories that have the function of applying on the patient the compressions necessary for the treatment;

Figure 4, which is similar to the previous one, shows a different type of soft paddings for contact with the patient, for example having a smooth surface;

Figure 5, which is similar to the previous ones but without some accessories, shows the possibility of shifting vertically the surface on which the patient is lying, to raise it/lower it according to the specific need;

Figure 6 shows a simplified variant of the invention for domestic use;

Figure 7, which is similar to the previous one, shows the above variant with some accessories for supporting the patient that are installed thereon;

Figure 8 shows some views of a cushion specifically indicated for correct positioning of the lower limbs of the patient;

Figures 9A, 9B, and 9C regard the system of sliding coupling of the lateral supports for the patient;

Figures 10A, 10B, and IOC show some constructional details of the inclinable lateral supports, with paddings having a smooth surface;

- Figures 11A, 11B and 11C, which are similar to the previous ones, show the inclinable lateral supports having paddings with non-smooth surfaces;

Figures 12A to 12E show different types of paddings, characterized by different surfaces of contact according to the needs of the treatment to be carried out on the patient;

Figures 13A and 13B show a particular hollow and concave cushion with a single curvature, which can be applied to the lateral supports; and

Figures 14A and 14B show a further hollow and concave cushion with double curvature, which can be applied to the lateral supports.

With reference to the figures referred to above, the apparatus according to the present invention preferably comprises :

1. vibrating and rocking surface, on which the patient is stretched out, which is height-adjustable with respect to the lateral rests so as to compress the patient' s pelvis (without blocking it) ;

2. main load-bearing structure of the apparatus, with adjustable lengthening according to the needs of the patient;

3 - 4. fixed horizontal transverse guides;

5. mobile horizontal longitudinal guides;

6. horizontally sliding lateral supports;

6'. supporting arms for the supports 6;

7. vertical lateral rests;

8. inclinable lateral rests;

9. elements of contact with the patient on the surface of the padding R;

10. simplified lateral supporting arms;

11. vertical lateral supporting elements for constraining said lateral rests 7, 8 on the simplified arms 10;

S. sliding coupling means;

M. knobs for manual adjustment of positioning;

C. accessory cushion for the lower limbs of the patient; C2. accessory cushion for compressing the pelvis laterally; C3. accessory cushion for compressing the great trochanter; and

R. soft padding for contact with the patient.

It should be noted that the central surface 1, on which the patient's pelvis is rested, has a vibratory motion and a movement of craniocaudal inclination (rocking) about the transverse axis X, with arrhythmic motion when the device is equipped with an electric motor.

The above movement of inclination about the axis X may be obtained both manually and electrically. The above resting surface for the patient is formed by the surface 1 with the padding R that is in contact with the patient's pelvis and must be made of soft material (e.g., rubber or the like) and have various shapes (Figures 12A- 12E) .

According to a peculiar characteristic of the invention, the machinery is equipped with a vibrating system that reduces the muscle retraction linked to the lesions of the pelvis, for example, retraction of the rectus muscle of the quadriceps, or the like.

Figures 9A, 9B, and 9C are schematic illustrations of the insertion of the sliding elements. This is a type of structure made of metal materials and constitutes the sliding coupling for inserting the vertical lateral rests 7 on the lateral sliding supports 6 and for positioning them correctly with respect to the patient.

With reference to Figures 9A onwards, it should be noted that the lateral rests 7-8 that are mounted on the sliding coupling S are made up of two preferably plane rests arranged on top of one another, for example with one or more springs that cause rotation of the top rest 8 with respect to the bottom rest 7 thanks to a purposely provided articulated joint. This movement can be operated manually or electrically.

Basically, the two plane elements 7 and 8 are joined together thanks to an articulated joint equipped with springs for inclination of the rest 8 with respect to the rest 7. According to the present invention, within both of the lateral rests 7 and 8 there are springs and a vibrating motor. These springs, thanks to their compressibility and to their compliance, cause the two rests to be substantially ductile for the patient's body. The vibrating motor is preferably set within the rests 7 and 8, but in some cases can be applied to the supports 6 or 11 of the lateral rests 7, 8, as well as to the surface 1 on which the patient is lying .

The body of the rests 7 and 8 must be made of rigid metal material or some other sufficiently resistant material .

The surface of the plane rests 7 and 8, i.e., their padding R, can be changed according to the therapeutic need, and it is possible to apply a vibrating motor set between the soft padding and the supporting structure 6.

It should be noted that, in the areas of contact between the apparatus and the patient, there may be provided safety sensors for warning that a certain pressure value has been exceeded. Figure 11 shows a different version of the surface padding R of the rests 7 and 8 according to the therapeutic need, which is made of rubbery material or latex and is comfortable.

Purely by way of example, Figures 12A to 12E show some of the possible shapes of the surfaces of the padding R that come into direct contact with the patient's body.

Another form that can be applied to the rests 7 (Figures 13A-13B) envisages a cushion C2 with a hollow structure that may be made of rubbery material. Since this cushion is hollow, during lateral compression thereof it remains elastic, thus creating a spring effect.

Also of significant interest is a particular cushion C3 for padding the lateral rests 7 (Figures 14A, 14B) , which is purposely provided for compression of the great trochanter. The central surface part C3 ' of this cushion is concave for housing the great trochanter and is made of rubbery material or of other suitable material.

Advantageously, the cushion C3 is mounted on the vertical lateral rest 7, which can be shifted if it is necessary to cause passive movement of the lower limbs of the patient.

These purposely provided cushions modelled for compression of the great trochanter, with the passive movement of the lower limbs of the patient, improve the conditions of subjects who suffer from coxo-femoral arthrosis .

DETAILED DESCRIPTION OF THE INVENTION

The padding R fixed on the vibrating surface 1 is interchangeable so that it is possible to choose between one with a smooth surface and one with a surface having projecting elements 9 of different shapes, designed to come into contact with the patient's pelvis. It may be made of different materials, such as rubber, latex, plastic, etc., so that it can present different characteristics of elasticity and strength according to the specific therapeutic needs. Possibly provided on the paddings R are sensors that are able to transmit, thanks to the aid of a computerized system, the movements and information of various types. The vibrating surface 1, which supports the padding R on which the patient lies in the supine position with the area of the pelvis in the central position, is made of appropriately resistant and rigid material, for example, metal or some other kind of material. This surface 1 is installed on mechanisms actuated mechanically or electrically, which enable movements of craniocaudal rocking, raising, and lowering, as well as vibrational movements .

It should be noted that the movement of raising/lowering of the surface 1 on which the patient's pelvis rests is not with respect to the floor, but is a displacement with respect to the means 7-8 for compressing the patient's pelvis laterally and, if necessary, at the front in order to obtain correct positioning, in height, of the pelvis with respect to the lateral and front compression means .

From the constructional standpoint, the vibrating and rocking surface 1 and its padding R are substantially a single body set on the load-bearing structure 2, which is the main structure of the apparatus itself and must be made of very resistant materials, preferably metal materials, so that it may be sufficiently stable.

The central area of the load-bearing structure 2 is occupied by the most important part of the apparatus according to the invention, which is, precisely, the surface 1 on which the patient's pelvis rests.

Alongside the surface 1, both on the right and on the left, the load-bearing structure 2 is equipped with transverse guides 3 and 4, in which the longitudinal guides 5 slide, these being moved by purposely provided knobs M and/or by other electrically actuated means. Of course, all these constructional elements are made of resistant materials, preferably (but not exclusively) metal.

Installed on the longitudinal guides 5 are lateral supports 6 that are mobile longitudinally with respect to the patient along the aforesaid guides by means of purposely provided knobs M and/or electrical means. Furthermore, these supports 6 are equipped with sliding coupling means S, installed on which are vertical lateral rests 7 and corresponding inclinable lateral rests 8.

When the supports 7 are brought into lateral contact with the body of the patient, they compress the lateral iliac wings with a mechanism equipped with springs and safety sensors and vibration sensors, according to the therapeutic need. Contact of the lateral supports 7 and of the inclinable supports 8 can occur in different positions on the patient's body to enable treatment or normalization of the osteopathic lesions listed previously.

EXAMPLE: LEFT OR RIGHT ANTERIOR ILIAC LESIONS

The inclinable support 8, with its approach obtained with the spring-operated or electrically operated systems, compresses the anterior-superior iliac spine (ASIS) or the surrounding musculature, restoring its functional normality.

Before proceeding to a description of how an anterior- superior iliac lesion can be treated using the apparatus according to the present invention, a brief anatomical analysis of the sacroiliac joint is called for. What happens when a patient presents a lesion of this type? The sacroiliac joint is made up of two synovial cavities: one for the short arm and one for the long arm. They are separated by a perforated fibrous mass that enables communication between the cavities. Under the action of a compression on either one of the synovial cavities the liquid enters the other cavity and creates the lesion (see figure A) . In anterior iliac rotation, the short arm descends and the long arm moves back so that it combines an anterior deviation and a slight recession.

In posterior rotation, the movement is the reverse. It is important to bear in mind that the short arm is not strictly vertical (95°) and the long arm is not strictly horizontal (185°). The upper surfaces (short arm) and the lower surfaces (long arm) do not lie, on the anterior- posterior plane, in one and the same plane. Between the two planes, the posterior plane may be open outwards (out flame) or inwards (in flame) . The sacroiliac joints, physiologically speaking, are arthrodiae, the plane surfaces of which can glide and move along several different axes.

There now follows a description of treatment using the apparatus so far described. When we talk of iliac osteopathic lesion, or any other lesion, we are speaking of a micro-movement. To correct an anterior superior iliac lesion using the apparatus according to the present

invention, it is necessary to perform a posterior rotation.

For this purpose, the patient must first of all be set in the supine position on the surface 1 of the load-bearing structure 2, which must be set with a cranial inclination and slightly raised so as to set the ASIS and the muscle insertions on the ASIS in tension.

The vibrational motion of the surface 1 and of the lateral rests 7 and 8, together with the inclination of the surface 1 itself and with the shape of the surface padding R, causes the long arm to advance and then the short arm to ascend, thus bringing about muscular relaxation. The anterior thrust of the inclinable lateral rest 8 on the ASIS brings about, posteriorly, a rotation of the iliac bone, and hence the joints return to normal.

In the other types of lesions, the patient must be set once again in the supine position, but the movements of the apparatus are different.

It should be noted that the various components that make up the apparatus according to the invention may be of sizes different from the ones illustrated, according to the therapeutic needs, without this in any way modifying the technical teachings underlying the present invention.

CONTRAINDICATIONS

1 - patients suffering from bone neoplasms;

2 - patients suffering from osteoporosis;

3 - pregnant patients (at least for the first three months of pregnancy) ; and

4 - infants must receive only professional treatment. In a simplified variant of the apparatus according to the invention, which is particularly suited for domestic use, the side arms 10 (Figure 6) , which are preferably made of resistant metal materials or some other material having an appropriate strength, can be moved towards the patient's body by means of an actuation knob M. The free ends of the side arms 10 are shaped so as to be able to support vertical lateral rests 7, as well as possible inclinable lateral rests 8 for the patient's body.

The arched shape of the arms 10 is particularly suited for those patients who present deformations of the adipose tissue or the like.

Shown in Figure 8 is a small cushion C, which should be made of an elastic material, such as for example latex or sponge, which is in turn coated with a resistant material, such as leather or some other material of an anallergic type.

The cushion C is particularly useful for positioning the lower limbs of the patient correctly and for improving and correcting the ascending posture in the patient.

Its particular shape follows the profile of the inside of the sole of the foot (it is approximately 80 cm in length, or may be of various other sizes) , preserving the physiological position of the foot, the heel part measuring from 5 to 8 cm.

Bibliography

- Collection of "College Osteopathique de Provence" BY Michel Coquillant Do.M.R.O. (F) director of CO. P. "Osteopatia del bacino" ["Osteopathy of the pelvis"]; translated by Barbara Ranuzzi, 1989 edition

- Marcel Bienfait, "Basi elementari tecniche della terapia manuale e dell' osteopatia" ["Elemental basics, techniques of manual therapy and osteopathy"]; Italian edition by Professor Massara, 1994 - Marcel Bienfait, "Fisiologia della terapia manuale" ["Physiology of manual therapy"]; Italian edition by Antoine Raymond Gemayel, 1995;

- Kapandji A., "Fisiologia articolare" ["The physiology of the joints"]; Marrapese editore, 1983.

Claims

1. An apparatus for the treatment of osteopathic lesions of the pelvis, characterized in that it comprises, in combination:

- a vibrating surface (1) rocking about an axis X in the craniocaudal direction, which is height-adjustable with respect to mobile lateral uprights so as to compress the patient' s pelvis laterally, the pelvis of the patient who is stretched out on the apparatus being positioned on the vibrating and rocking surface;

a main load-bearing structure (2) where said vibrating and rocking surface (1) is housed; and

- at least two mobile lateral uprights (5, 6, 6', 10) for laterally compressing the pelvis of the patient during treatment - without stabilizing it or blocking it - via purposely provided resting elements (7, 8) in such a way that the vertebral column remains free during treatment;

wherein said load-bearing structure (2) is equipped with means for adjusting the height of the surface (1) on which the patient rests, as well as with movement means for imposing on the vibrating and rocking surface (1) a vibrational motion and movement of craniocaudal inclination with preferably arrhythmic motion, where said vibrational motion is designed to reduce muscle retraction linked to the lesions of the pelvis.

2. The apparatus according to Claim 1, characterized in that mobile means for gripping and . compressing laterally the pelvis of the patient comprise:

one or more fixed horizontal transverse guides (3, 4); - one or more horizontal longitudinal guides (5) mobile along said transverse guides (3, 4);

- horizontally sliding lateral supports (6) , designed to be moved along said longitudinal guides (5) either directly or else via interposition of purposely provided supporting arms (6¹) for said lateral supports (6);

- vertical lateral resting surfaces (7) for the patient's pelvis, which are installed on the lateral support (6);

- inclinable lateral resting surfaces (8) for the anterior part of the patient's pelvis, which are installed adjacent to said vertical surfaces (7);

- sliding coupling means (S) for vertical sliding of the lateral resting surfaces (7, 8) with respect to the supporting elements (6); and

- knobs (M) for manual adjustment of positioning of the lateral resting surfaces (7, 8) on the patient's pelvis.

3. The apparatus according to Claim 1, characterized in that mobile means for laterally compressing the patient's pelvis comprise:

- arched lateral supporting arms (10), presenting a rotational movement to follow the morphology of the patient;

- lateral supporting elements (11) for supporting the vertical lateral supports (6) on the arched arms (10);

- vertical lateral resting surfaces (7) for the patient's pelvis;

- inclinable lateral resting surfaces (8) for the anterior part of the patient's pelvis;

- sliding coupling means (S) for vertical sliding of the lateral resting surfaces (7, 8) with respect to the supporting elements (11); and - knobs (M) for manual adjustment of positioning of the lateral resting surfaces (7, 8) on the patient's pelvis .

4. The apparatus according to Claim 2 or Claim 3, characterized in that the lateral resting surfaces (7, 8) that are mounted on the sliding coupling (S) are plane, are arranged on top of one another, and are provided with sprung rim pads, with an articulated joint that can be operated manually or electrically.

5. The apparatus according to Claim 4, characterized in that provided within both of the lateral resting surfaces (7 and 8) are springs and a vibrating motor

6. The apparatus according to Claim 5, characterized in that the body of the resting surfaces (7 and 8) is made of rigid metal material or other sufficiently resistant material .

7. The apparatus according to any one of the preceding claims, characterized in that all the surfaces that are to come into contact with the patient's body have a soft and elastic padding (R) that can be changed according to the therapeutic need.

8. The apparatus according to any one of the preceding claims, characterized in that provided on the surfaces of contact between the apparatus and the patient are safety sensors for detecting the degree of the pressure applied, as well as for detecting the position of the patient and his anatomical conformation.

9. The apparatus according to Claim 7, characterized in that prearranged on the surface of the padding (R) are elements (9) of contact with the patient's body having different shapes to vary the degree of penetration into the tissues according to the width of the surface of contact of each element (9) .

10. The apparatus according to Claim 2 or Claim 3, characterized in that it envisages at least one first accessory cushion (C) for the lower limbs of the patient, which can be positioned on the surface on which the patient is lying.

11. The apparatus according to Claim 2 or Claim 3, characterized in that it envisages at least one second accessory supporting cushion (C2) for compressing the pelvis laterally, which can be anchored to the lateral supports (6, 11), wherein said supporting cushion (C2) has a concave surface and may be made of rubbery material, said cushion, given that it is hollow, during lateral compression remaining elastic, thus creating a spring effect.

12. The apparatus according to Claim 2 or Claim 3, characterized in that it envisages at least one third accessory cushion (C3) for compressing the great trochanter, which can be fixed to the lateral uprights (6, 11), has a central part (C3') made of rubbery material with a concave surface for housing, compressing it, the great trochanter, which is a bony protuberance of the femur.

13. The apparatus according to Claim 12, characterized in that the cushion (C3) is rotatably mounted on the vertical lateral resting surface (7) so as not to hamper the flexor-extensor movements of the coxo-femoral joint when it is necessary to cause passive movement of the lower limbs of the patient.

14. The apparatus according to Claim 1, characterized in that said movement means and said means for adjusting the height of the rocking vibrating surface (1) with respect to the means for lateral compression of the patient' s pelvis are operated manually and/or mechanically. and/or electrically and/or hydraulically and/or pneumatically and/or magnetically.