# US 11,992,448 B2 · Computer-supported intraneural facilitation for vascular changes > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 11,992,448 B2 - Document ID: US11992448B2 - Status: Granted - Kind: B2 - Application number: 15/733,752 - Filed: 2019-04-23 - Published: 2021-05-13 - Granted: 2024-05-28 - Earliest claimed: 2018-04-23 - Assignees: Loma Linda University - Applicants: Loma Linda University - Inventors: Mark Bussell - Web page: https://patentgrep.com/patent/US11992448B2 ## CPC - A61H 1/0222: {Traction tables (A61H1/0229 take precedence)} - A61B 8/06: Measuring blood flow - A61B 8/463: {characterised by displaying multiple images or images and diagnostic data on one display} - A61B 8/488: {involving Doppler signals} - A61H 1/0266: {Foot} - A61H 1/0285: {Hand} - A61H 1/0288: {Fingers} - A61H 2201/1207: with electric or magnetic drive - A61H 2201/1253: driven by a human being, e.g. hand driven - A61H 2201/1635: Hand or arm, e.g. handle - A61H 2201/164: Feet or leg, e.g. pedal - A61H 2201/5007: computer controlled - A61H 2201/5058: Sensors or detectors - A61H 2203/0456: Supine - A61H 2230/255: used as a control parameter for the apparatus - 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 (electrotherapy, magnetotherapy, radiation therapy or ultrasound therapy A61N) - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract The disclosure is related to a system and method for operating a traction device to detect blood flow patterns in a subject for managing neuropathy related conditions through intraneural facilitation (INF). According to an embodiment, the INF system and method rely on the traction device for positioning the subject in one or more positions, and a processing device for processing intervening signals obtained by a probe positioned on the subject. The signals received from the probe may be used to determine a two dimensional (2D) plane blood flow pattern. Detected changes in the measured blood flow may be used to determine if further traction device positions are required to ensure that the intervening signals demonstrate normal blood flow patterns with improvements to the neuropathy condition. The 2D flow pattern may calculate at least one of Volume Flow (VF) and Pulsatility Index (PI) for each set of signals received. ## Claims ### Claim 1 A method of operating a traction device to detect blood flow patterns for intraneural facilitation (INF), the method comprising: providing the traction device to control traction, by one or more processors, so as to position a subject in one or more positions when positioned on one or more areas of the subject; receiving first signals, by the one or more processors, from a probe when the probe is positioned at a first area of the subject and when the traction device is positioned in a first position; processing the received first signals, via the one or more processors, to determine a first two-dimensional (2D) flow pattern measuring blood flow when being supplied from a first artery to a second artery supplying the blood flow to one or more nerves of the subject; moving the traction device to a second position, via the one or more processors, based at least in part on the determined first 2D flow pattern, thereby to control the blood flow for a first predetermined period of time; receiving second signals, by the one or more processors, from the probe when the probe is positioned at one or more second areas of the subject and when the traction device is positioned in the second position; processing the received second signals, via the one or more processors, to determine a second 2D flow pattern measuring the blood flow from the first artery to the second artery; and comparing the first 2D flow pattern and the second 2D flow pattern, via the one or more processors, to determine a first change in the blood flow through the second artery, thereby to provide vascular changes in the subject via INF. ### Claim 2 (depends on 1) The method according to claim 1, wherein the determined first change in the blood flow comprises a decrease in the blood flow through the second artery, the method further comprising: moving the traction device to a third position, via the one or more processors, based at least in part on the comparing, thereby to control the blood flow for a second predetermined period of time; receiving third signals, by the one or more processors, from the probe when the probe is positioned at the one or more second areas of the subject and when the traction device is positioned in the third position; processing the received third signals, via the one or more processors, to determine a third 2D flow pattern measuring the blood flow from the first artery to the second artery; and comparing the second 2D flow pattern and the third 2D flow pattern, via the one or more processors, to determine a second change in the blood flow through the second artery. ### Claim 3 (depends on 2) The method according to claim 2, wherein the determined second change in the blood flow comprises an increase in the blood flow through the second artery, the method further comprising: moving the traction device to a fourth position, via the one or more processors, based at least in part on the comparing, thereby to alter the blood flow; receiving fourth signals, by the one or more processors, from the probe when the probe is positioned at the one or more second areas of the subject and when the traction device is positioned in the fourth position; processing the received fourth signals, via the one or more processors, to determine a fourth 2D flow pattern measuring the blood flow from the first artery to the second artery; and comparing the first 2D flow pattern and the fourth 2D flow pattern, via the one or more processors, to confirm the increase in blood flow through the second artery. ### Claim 4 (depends on 1) The method according to claim 1, wherein first area of the subject comprises an ulnar artery next to an ulnar nerve. ### Claim 5 (depends on 1) The method according to claim 1, wherein the first area of the subject comprises a foot joint. ### Claim 6 (depends on 1) The method according to claim 1, wherein the one or more second areas comprise one or more distal skin areas that are innervated by an ulnar nerve of the subject. ### Claim 7 (depends on 1) The method according to claim 1, wherein the processing of the first signals and the second signals comprises communicating the first signals and the second signals to an ultrasound machine, and wherein the ultrasound machine is configured to process aspects from the first signals and the second signals so as to calculate at least Volume Flow (VF) and Pulsatility Index (PI) for each of the first signals and the second signals. ### Claim 8 (depends on 7) The method according to claim 7, wherein the ultrasound machine is a Doppler ultrasound machine for converting Doppler measurements from the first area and from the one or more second areas into the first 2D flow pattern and into the second 2D flow pattern, the converting comprising: (a) determining discriminant features of the Doppler measurements, (b) plotting the discriminant features in two dimensions, and (c) determining that the discriminant features cluster in areas of predetermined flow patterns representing a first flow condition or a second flow condition. ### Claim 9 (depends on 8) The method according to claim 8, wherein the discriminant features of the Doppler measurements include velocity values, and wherein: the first flow condition is represented by first clusters including increasing velocity values above a time axis and a second cluster including receding velocity values below a time axis; and the second flow condition is represented by third clusters including increasing velocity values above the time axis and two or more fourth clusters including receding velocity values below the time axis. ### Claim 10 A system for operating a traction device to detect blood flow patterns for intraneural facilitation (INF), the system comprising: one or more processors; one or more traction devices to control traction, by the one or more processors, so as to position a subject in one or more positions when positioned on one or more areas of the subject; one or more probes connected to the one or more processors to supply signals when applied to one or more areas of the subject; and one or more memory devices in communication with the one or more processors and including instructions that, when executed by the one or more processors, cause the system to: receive first signals from the probe when the probe is positioned at the first area of the subject and when the traction device is positioned in a first position; process the received first signals to provide a first display of a first 2D flow pattern measuring blood flow when being supplied from a first artery to a second artery supplying the blood flow to one or more nerves of the subject; move the traction device to a second position based at least in part on the determined first 2D flow pattern, thereby to control the blood flow for a first predetermined period of time; receive second signals from the probe when the probe is positioned at one or more second areas of the subject and when the traction device is positioned in the second position thereby to control the blood flow for a first predetermined period of time; process the received second signals to provide a second display of a second 2D flow pattern measuring the blood flow from the first artery to the second artery; and compare the first 2D flow pattern and the second 2D flow pattern to determine a first change in the blood flow through the second artery, thereby to provide vascular changes in the subject via INF. ### Claim 11 (depends on 10) The system according to claim 10, wherein the determined first change in the blood flow comprises a decrease in the blood flow through the second artery, the instructions further configured to cause the system to: move the traction device to a third position based at least in part on the comparing, thereby to control the blood flow for a second predetermined period of time; receive third signals from the probe when the probe is positioned at the one or more second areas of the subject and when the traction device is positioned in a third position; process the received third signals to provide a third display of a third 2D flow pattern measuring the blood flow from the first artery to the second artery; and compare the second 2D flow pattern and the third 2D flow pattern to determine a second change in the blood flow through the second artery. ### Claim 12 (depends on 11) The system according to claim 11, wherein the determined second change in the blood flow comprises an increase in the blood flow through the second artery, the instructions further configured to cause the system to: move the traction device to a fourth position based at least in part on the comparing, thereby to alter the blood flow; receive fourth signals from the probe when the probe is positioned at the one or more second areas of the subject and when the traction device is positioned in the fourth position; process the received fourth signals to provide a fourth display of a fourth 2D flow pattern measuring the blood flow from the first artery to the second artery; and compare the first 2D flow pattern and the fourth 2D flow pattern to confirm the increase in blood flow through the second artery. ### Claim 13 (depends on 10) The system according to claim 10, wherein the first area of the subject comprises an ulnar artery next to an ulnar nerve. ### Claim 14 (depends on 10) The system according to claim 10, wherein the first area of the subject comprises a foot joint. ### Claim 15 (depends on 10) The system according to claim 10, wherein the at least one memory includes instructions that, when executed in the at least one processor, further cause the system to: determine the one or more second areas in a distal skin area that is innervated by an ulnar nerve of the subject. ### Claim 16 (depends on 10) The system according to claim 10, the system further comprising an ultrasound machine configured to process the first signals and the second signals so as to calculate at least Volume Flow (VF) and Pulsatility Index (PI) for each of the first signals and the second signals. ### Claim 17 (depends on 16) The system according to claim 16, wherein the ultrasound machine is a Doppler ultrasound machine for converting Doppler measurements from the first area and from the one or more second areas into first 2D flow pattern and into the second 2D flow pattern, the converting by the instructions in the at least one memory that, when executed in the at least one processor, further cause the system to: (a) determine discriminant features of the Doppler measurements, (b) plot the discriminant features in two dimensions, and (c) determine that the discriminant features cluster in areas of predetermined flow patterns representing a first flow condition or a second flow condition. ### Claim 18 (depends on 17) The system according to claim 17, wherein the discriminant features of the Doppler measurements include velocity values, and wherein: the first flow condition is represented by first clusters including increasing velocity values above a time axis and a second cluster including receding velocity values below a time axis; and the second flow condition is represented by third clusters including increasing velocity values above the time axis and two or more fourth clusters including receding velocity values below the time axis. ### Claim 19 (depends on 16) The system according to claim 16, the instructions further configured to cause the system to derive a ratio between a distal control value and a local circulation value based at least in part on the calculated VF and PI for each of the first signals and the second signals. ### Claim 20 (depends on 19) The system according to claim 19, the instructions further configured to cause the system to determine, based on the derived ratio, a percentage by which local neurovascular circulation is impacting one or more targeted nerves as compared to one or more nerves distal the first area at which the probe is positioned.