Patient support device

Abstract

A modular patient support device includes links that provide advanced kinematics for moving portions of the patient support device. A patient support device includes a cantilevered lift system supporting an upper frame, the cantilevered lift system including a link configured to lift the upper frame in a substantially vertical direction, a telescoping cylinder engaged with the link, telescopic extension and contraction of the cylinder moving the link, and a lift assist assembly configured to lift the upper frame in a substantially vertical direction when the cantilevered lift system is lowered. The lift assist assembly loads to exert a force on the link to reduce the load on the telescoping cylinder. The lifting system includes a manual or powered actuation system.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This application claims priority under 35 U.S.C. §119(e) to U.S. Provisional Application No. 63 / 252,853, filed on October 6, 2021, the disclosure of which is expressly incorporated herein by reference. Background Art

[0003] The present disclosure relates to a modular patient support device that can adapt to different disease levels to provide support for patients at specific disease levels. More specifically, the present disclosure relates to a patient support device having an articulated structure that can be adapted to provide manual and powered modes.

[0004] In modern medical facilities, patients are often kept in the emergency department or observation ward for long periods of time while tests are performed and the patient is under observation. Due to cost constraints, patients are not administratively allowed to be admitted until it is determined that the patient's level of condition qualifies for reimbursement of treatment as an inpatient. Therefore, patients may spend extended periods of time in atypical ward spaces. From this location, patients may be transported to other parts of the facility for diagnostic tests.

[0005] In some cases, the patient may be in significant discomfort, lack mobility, or otherwise incapacitated. Therefore, it may be necessary to move the patient to another area in the facility without transferring the patient to another patient support device or transport equipment. An appropriate patient support device, such as a bed or stretcher, may be provided based on the patient's level of acuity to provide a suitable environment for the patient. However, early in the admission process or during long-term observation, the functionality of both a bed and a stretcher may be required.

[0006] Being able to select the appropriate patient support device for the patient's expected length of stay when the patient presents reduces the likelihood that the patient will soil multiple patient support devices. After the patient is removed from the patient support device, the patient support device must be cleaned before being used on another patient. Thus, it is helpful for the patient to be properly positioned. However, adapting different patient support devices to different acuities may present a challenge to the caregiver because the operation of each device must be understood.

[0007] Therefore, there is a need for a patient support device structure that has common elements for basic operation, but is modular so that features can be included while maintaining the basic operation with which the caregiver is familiar. Summary of the invention

[0008] The present disclosure comprises one or more of the features recited in the appended claims and / or the following features, which alone or in any combination may constitute patentable subject matter.

[0009] According to a first aspect of the present disclosure, a patient support device includes an upper frame, a cantilever lift system, and a drive assembly. The cantilever lift system supports the upper frame and includes a connecting rod, which is configured to raise the upper frame in a substantially vertical direction. The cantilever lift system includes a telescopic cylinder that is engaged with the connecting rod, and the telescopic extension and retraction of the cylinder causes the connecting rod to move. The cantilever lift system includes a lift assist assembly that applies a force on the connecting rod to reduce the load on the telescopic cylinder when the cantilever lift system is lowered. The drive assembly is operable to extend and retract the telescopic cylinder. The drive assembly includes a manual module and a power module, the manual module being configured to allow a user to provide manual input to the drive assembly to extend the telescopic cylinder, and the power module being removably connected to the manual module to allow the power module to be added to the drive assembly to allow powered extension of the telescopic cylinder.

[0010] In some embodiments, the lift assist assembly acts in parallel to the telescoping cylinders.

[0011] In some embodiments, the lift assist assembly includes a compression spring.

[0012] In some embodiments, the lift assist assembly includes a gas spring.

[0013] In some embodiments, the lift assist assembly includes a torsion spring.

[0014] In some embodiments, the telescoping cylinder is a hydraulic cylinder.

[0015] In some embodiments, the manual input is a foot pedal.

[0016] In some embodiments, the power module includes a motor and a pump driven by the motor.

[0017] In some embodiments, the patient support device further comprises a user interface, wherein operation of the power module is controlled by the user interface.

[0018] In some embodiments, the linkage comprises a parallelogram linkage.

[0019] In some embodiments, when the cantilever lift system is in its lowest position, the free end of the cantilever lift system is lower than the fixed end.

[0020] According to a second aspect of the present disclosure, a patient support device includes: an upper frame; a thigh plate section, which is pivotally connected to the upper frame at a first pivot; a foot plate section, which is pivotally connected to the thigh section at a second pivot, the foot section having a free end; and an actuator, which is operable to simultaneously move the thigh plate section and the foot plate section, wherein movement of the actuator causes the second pivot to vertically raise and lower the free end of the foot plate section.

[0021] In some embodiments, the actuator is pivotally coupled to the upper frame.

[0022] In some embodiments, an actuator drives a foot link coupled to the foot plate segment and a thigh link coupled to the thigh plate segment.

[0023] In some embodiments, the foot link and the thigh link are interconnected by a swing link, and the actuator acts on the swing link.

[0024] In some embodiments, the pendulum is kinematically constrained such that the pendulum pivots about an imaginary axis.

[0025] In some embodiments, the thigh link is pivotally coupled to the thigh plate segment and the foot link is pivotally coupled to the foot plate segment.

[0026] In some embodiments, the foot link is pivotally coupled to the swing link and the thigh link is pivotally coupled to the swing link.

[0027] In some embodiments, the actuator is pivotally coupled to the rocker arm.

[0028] In some embodiments, contraction of the actuator raises the second pivot and lowers the free end of the foot plate segment.

[0029] Additional features, alone or in combination with any other features, such as those listed above and / or those listed in the claims, may comprise patentable subject matter and will be apparent to those skilled in the art upon consideration of the following detailed description of the various embodiments, which illustrate the best currently known modes of implementing the embodiments. BRIEF DESCRIPTION OF THE DRAWINGS

[0030] The detailed description makes particular reference to the accompanying drawings, in which:

[0031] Figure 1 is a perspective view of a first embodiment of a patient support device according to the present disclosure;

[0032] Figure 2 is a perspective view of a second embodiment of a patient support device according to the present disclosure;

[0033] Figure 3 is a perspective view of a third embodiment of a patient support device according to the present disclosure;

[0034] Figure 4 yes Figure 3 A perspective view of an embodiment of , with parts removed;

[0035] Figure 5 is a right side view of the third embodiment of the patient support device with the plate segment moved to a raised position;

[0036] Figure 6 is similar to Figure 5 , with the flat plate section in the lowered position;

[0037] Figure 7 yes Figure 3-Figure 6 A kinematic view of a portion of an embodiment of the present invention showing the relationship of the various parts of the head plate in a lowered position;

[0038] Figure 8 is similar to Figure 7 A kinematic view of the head panel showing the relationship of the various parts of the head panel in the raised position;

[0039] Fig. 9 yes Figure 3-Figure 6 A kinematic view of a portion of an embodiment of the invention showing the relationship of portions of the foot plate segment and the thigh plate segment in a lowered position;

[0040] Fig.10 is similar to Fig. 9 A kinematic view of the foot plate segment and the thigh plate segment in a raised position showing the relationship of the various parts;

[0041] Fig.11 yes Figure 3-Figure 6 A kinematic view of a portion of an embodiment of the invention showing the relationship of the parts of the lifting system in a lowered position;

[0042] Fig.12 is similar to Fig.11 A kinematic view showing the relationship of the parts of the lifting system in a raised position;

[0043] Fig.13 is an end view of the left side rail of the third embodiment shown in a lowered position;

[0044] Fig.14 Shot from different angles Fig.13 a view of the left railing of

[0045] Fig.15 is a perspective view of portions of a third embodiment showing a hydraulic system operable via foot pedal input and motorized operation of a hydraulic pump. DETAILED DESCRIPTION

[0046] According to this disclosure, Figure 1The patient support device 10 shown in FIG. 1 can be configured to provide care to patients with varying medical conditions while also providing improved mobility when moving patients between areas of a care facility, such as a hospital. The patient support device 10 includes a base 12 supported on four casters 14 that are lockable to prevent the patient support device 10 from moving across the floor, but are oversized to provide smooth movement across the floor when released. The base 12 supports a lift assembly 16 that provides cantilever support for an upper frame 18 and vertically moves the upper frame 18 when the lift assembly 16 is activated.

[0047] The upper frame 18 supports the tablet 20. The tablet 20 has multiple segments and has a panel made of a radiolucent material so that a C-arm X-ray device or other similar imaging device can be used with the tablet 20. The tablet 20 has a pivoting head tablet segment 22 that pivots relative to the upper frame 18. The thigh tablet segment 24 is also pivotable relative to the upper frame 18. The foot tablet segment 26 is supported by the upper frame 18 and is pivotable relative to the thigh tablet segment 24. As will be described in more detail below, the foot tablet segment 26 is constructed to move to a dependent position in which the foot end 40 of the foot tablet segment 26 is lowered below the upper frame 18 so that the tablet 20 can be formed into a chair-like arrangement for comfortable and optimal positioning of the patient. Figure 1 In an embodiment of the patient support device 10, articulation of the foot plate segment 26 and the thigh plate segment 24 is accomplished manually. The same is true for the head plate segment 22. Articulation may be assisted by a releasable gas spring that provides some force to assist in the movement of the segments when the segments are manually manipulated.

[0048] To assist in the mobility of the patient support device 10 , a push handle 28 is positioned at the head end 42 of the patient support device 10 . Figure 1 The push handle 28 in the embodiment is fixed to the upper frame 18, and the height of the push handle 28 is adjusted by adjusting the height of the upper frame 18 using the lifting assembly 16. The patient support device 10 also includes an oxygen tank support 30 that supports the oxygen tank 46, such as Figure 3 . The patient support device 10 also includes a right side rail 32 and a left side rail 34. The orientation of the sides and ends of the patient support device 10 is determined by the orientation of the patient supported on the patient support device 10 in a supine position, such that the right side rail 32 is positioned on the right side of the patient and the left side rail 34 is positioned on the left side of the patient. Similarly, reference is made to the foot plate section 26 or foot end 40 in relation to the position of the patient's feet when in a supine position on the patient support device 10. Likewise, the head end 42 is oriented at the end of the patient support device 10 where the patient's head will be in a supine position.

[0049] The lift assembly 16 is operated by a raise pedal 36, which may allow a user to manually activate the raise pedal 36 so that the lift assembly 16 is raised. In some embodiments, the raise pedal 36 may require multiple activations to move the lift assembly 16, but in other embodiments, the lift assembly 16 may be power-actuated by a single activation of the raise pedal 36. A lowering pedal 38 may be actuated to lower the lift assembly 16, thereby lowering the upper frame 18.

[0050] The patient support device 10 includes a brake / steer mechanism supported by the base frame 12. The brake / steer mechanism is of a type known in the art and is capable of switching the operation of the casters 14 between a full lock, a neutral position, and a drive position, wherein the full lock prevents rotation of the wheels of the casters 14 and prevents the casters 14 from rotating about a vertical axis, a neutral position, in which the casters 14 can rotate and swivel freely, and a drive position in which one of the casters 14 is locked to rotate to serve as a tracking wheel to assist in the driving of the patient support device 10. In this embodiment, the caster 14 located at the left foot end of the patient support device 10 is used as a driving caster. In other embodiments, different casters 14 can be set for driving. Activation of the brake / steer mechanism is provided by an actuator 50 located at each caster 14, each actuator 50 having a brake pedal 52 and a steer pedal 54, as is known in the art. This allows a caregiver to actuate the brake / steer mechanism 10 at multiple locations around the periphery of the patient support device.

[0051] It is noteworthy that the patient support device 10 also includes a support cushion assembly or mattress 60, which is supported on the flat plate 20 and can move with the flat plate 20 to conform to the flat plate in various positions. In addition, the patient support device 10 includes a user interface 62, which operates a scale system built into the patient support device 10 as is known in the art.

[0052] Figure 2 Another embodiment of a patient support 110 is shown that is similar to the patient support 10 but lacks some of the additional features present in the patient support 10 and illustrates the ability of the patient support 10 to adapt and reduce features to a basic procedural patient support. For example, the patient support 110 lacks the scale system discussed above. In addition, the patient support 110 does not have the foot plate section 26 or the thigh plate section 24, but the entire lower body of the patient is supported on the flat plate 64 that is not hinged relative to the upper frame 18.

[0053] Figure 3Another embodiment of a patient support device 210 that adds features to the patient support device 10 to include additional features is shown. The patient support device 210 includes side rails 232 and 234 that present a different look and feel that is more suitable for a higher acuity environment. The push handle 228 of the patient support device 210 includes a force sensing load cell that is used to apply force to the powered drive wheel assembly 66 (e.g., Figure 5 The patient support device 210 is preferably provided with input by a motor 68 (best shown). The powered drive wheel assembly 66 is of a type known in the art and includes a configured motor (not shown) and a drive motor 68. When the brake / steer mechanism is placed in the steering configuration, the drive wheel 70 is deployed to engage the floor. The input from the push handles 228, 228 determines the speed at which the motor 68 drives the wheel 70 to assist the caregiver in moving the patient support device 210 across the floor.

[0054] The patient support device 210 also includes a status notification system similar to that disclosed in US20140259410A1, which is incorporated herein by reference to disclose alarm indicators. The patient support device 210 includes a panel 72 that displays various conditions of the patient support device 210 on a vertical surface 74 on the base 12. In addition, the patient support device 210 projects an image 76 on the floor that also indicates the condition of the patient support device 210 or the condition of a sensor on the patient support device 210.

[0055] In addition, the patient support device 210 includes a touch screen user interface 80 mounted on the side rail 234. The interface 80 allows the caregiver to control various aspects of the patient support device 210, including the operation of the lifting assembly 16 to raise and lower the upper frame 18, the movement of the head plate section 22 between the lowered position and the raised position, or the movement of the thigh plate section 24 and the foot plate section 26. The interface 80 can operate other features that are not shown in the patient support device 210 but can be included. These features include integration with an electronic medical record (EMR) system, operation of a weighing system, operation of clinical sensors integrated into the patient support device 210 (e.g., heart rate and respiration monitoring), operation of a patient position monitoring or bed exit system, or other systems generally integrated into a patient support device.

[0056] The side rails 232, 234 of the patient support device 210 can be Figure 3-Figure 5 Raised position shown and Figure 6 Move between the lowered positions shown. Figure 4, the side rail 234 is shown to include an upper body 236 and a lower panel 238. The upper body 236 is supported on a pair of outer brackets 240 and 242. The panel 238 is fixed to a pair of inner brackets 246 and 248 and moves with the outer brackets 240 and 242. Each of the brackets 240, 242, 246, 248 includes a curved lower arm 244 that pivots about a respective pivot axis relative to the upper frame 18. In addition, each bracket 240, 242, 246 and 248 includes a latch pivot joint 250 that is locked in a raised position but can be manually released by raising the upper body 236 to unlatch the respective latch. A latch mechanism 254 mounted on the upper frame 18 engages with the bracket 242 to hold the bracket 242 in a vertical position until the latch mechanism 254 is released. The handle 256 ( Fig.14 The upper body 236 is actuated to allow the bracket 242 to be released relative to the upper frame 18. The side rails 234 can be moved to the lowered position by raising the upper body 236 and releasing the latch mechanism 254, and the lower panel 238 is rotated to be received behind the upper body 236 in the lowered position. The gas spring shock absorbers 258, 258 prevent the side rails 234 from colliding when lowered.

[0057] Reference now Figure 5 , Figure 7 and Figure 8 ,by Figure 7 The lowered position shown in Figure 8 The raised position shown in represents the kinematic function of the movement of the head plate segment 22. The head plate segment 22 is moved by an electric actuator 260, which is fixed to the upper frame 18 at a pivot 262, and the actuator 260 can pivot about the pivot 262, as shown by arrow 263. The actuator 260 is pivotally connected to a crank arm 272 at a pivot 264. The crank arm 272 is fixed to the head plate segment 22, and the two move together. The actuator 260 is pivotable relative to the crank arm 272 at the pivot 264. The compression link 266 is pivotally connected to the upper frame 18 at the pivot 270 and is pivotally connected to the head plate segment 22 at the pivot 268. The compression link 266 is shaped so that the rotation of the compression link 266 as shown by the arrow 274 causes the effective distance between the pivot 268 and the pivot 270 to decrease. In operation, the actuator 260 is extended and acts on the crank arm 272. The compression link 266 reacts to this movement to cause pivoting about the pivot 268, which effectively pivots the crank arm 272 and the head plate segment 22 relative to the actuator 260, thereby raising the head plate segment 22, as shown in FIG. Figure 8As shown. Notably, this causes the head plate segment 22 to move in the direction of arrow 276, which is parallel to the upper frame 18. This movement mimics a sliding motion and often reduces the shear forces on the patient's back during movement. Figure 5 , the linear movement of the head plate segment 22 at the pivot 86 is constrained by the movement of the slide member 82 in the guide tube 84.

[0058] Reference now Figure 5 , Fig. 9 and Fig.10 , showing the kinematic function of the movement of the thigh plate segment 24 and the foot plate segment 26. The movement of the thigh plate segment 24 and the foot plate segment 26 is caused by the actuator 280, which is pivotally coupled to the upper frame 18 at pivot 282. The actuator 280 is pivotally coupled to an arm 286 fixed to a swing link 288, and the two move together. The swing link 288 is pivotally coupled to the foot link 290 at pivot 292. The foot link 290 is also pivotally coupled to an arm 296 fixed to the foot plate segment 26 at pivot 294. The swing link 288 is also pivotally coupled to the thigh link 298 at pivot 302. The thigh link 300 is pivotally coupled to the thigh plate segment 24 at pivot 306. The thigh plate section 24 pivots relative to the upper frame 18 at pivot 304 , and the foot plate section 26 pivots relative to the thigh plate section 24 at pivot 306 .

[0059] The actuator 280 is extended to position the thigh plate segment 24 and the foot plate segment 26 as shown. Fig. 9 306. The upper frame 18 is shown in a flat configuration. When the actuator 280 is retracted, the rocker link 288 actually rotates about the point 308 due to the kinematic constraints of the system of linkages. The link 298 acts on the thigh plate segment 24, which in turn acts on the foot plate segment 26, thereby raising the pivot 306. However, the rocker link 288 also acts on the foot link 290, causing the foot end 40 of the foot plate segment 26 to be lowered. Effectively, the foot plate segment 26 is placed in a dependent position, wherein the foot end 40 is below the upper frame 18. This facilitates placement of the patient in the patient support device 210 in a chair position.

[0060] Now refer to Fig.11 and Fig.12, the operation of the lift assembly 16 may be understood by reference to the kinematic function of the various links of the lift assembly 16. The lift assembly 16 supports an upper frame at point 310, which is moved vertically by the lift assembly 16, which in turn is driven by a hydraulic cylinder / jack 312. The hydraulic cylinder 312 is pivotally coupled to an arm 314, which is fixed to a link 318, such that extension and retraction of the hydraulic cylinder 312 acts on the link 318. The link 318 is pivotally coupled to the base at a pivot 322. A second link 320 is pivotally coupled to the base 12 at a pivot 324. The links 318, 320 are pivotally coupled to a connector 330 at pivots 326 and 328, respectively. Link 318, link 320, base 12 and connector 330 form a parallelogram structure that controls the movement of point 310, and therefore the upper frame 18, in a generally vertical manner and with minimal sway, thereby limiting horizontal movement. Fig.11 and Fig.12 In the illustrated embodiment, the lifting assembly 16 includes a gas spring 332 disposed parallel to the hydraulic cylinder 312 and pivotally coupled to the arm 314. Fig.11 As shown, when the lifting assembly 16 is lowered and at a mechanical disadvantage, the gas spring 332 provides lifting assistance to the hydraulic cylinder 312. In other embodiments, the gas spring 332 can be omitted and replaced with a compression spring. In other embodiments, a leaf spring can be used to act on the parallelogram structure of the lifting assembly 16 to provide lifting assistance. In other embodiments, a torsion spring or multiple torsion springs can be applied to the pivot 322 and the pivot 324 to provide lifting assistance.

[0061] Now refer to Fig.15 , operation of the hydraulic cylinder 312 is achieved by a foot pedal assembly 350 or a motor 352. The foot pedal assembly 350 is connected to the foot pedal 36, and when the user steps on the foot pedal 36, the assembly rotates about the axis 354, causing the connecting rod 356 to act on the pump arm 358. The pump arm 358 moves hydraulic oil from the oil reservoir into the cylinder body 360 and extends the piston rod 362. In the alternative, the motor 352 drives a hydraulic pump 368, which moves oil through the manifold 366 and into the cylinder body 360 to extend the piston rod 362. The releaser 364 is acted on by a cable assembly that can be activated by the user to release hydraulic oil from the cylinder body 360 to retract the rod 362. When the motor 352 is present, the user can actuate the motor 352 from the user interface 80. Similarly, the electric valve can be activated from the user interface 80 to retract the piston rod 362 and lower the lifting assembly 16.

[0062] It should be understood that the actuators 260 and 280 and the hydraulic cylinder 312 can take various forms within the spirit of the present disclosure. For example, the actuators 260 and 280 can be powered or unpowered. In embodiments, they can be electrically driven screw-driven actuators or hydraulic cylinders. In other embodiments, they can be releasable gas springs. The hydraulic cylinder 312 can be replaced with another retractable structure, such as an electrically driven screw-driven actuator. When a releasable gas spring is used, the gas spring can provide support for the lifting auxiliary support.

[0063] While the present disclosure is directed to particular embodiments, it will be understood by those skilled in the art that various changes in form and details may be made without departing from the subject matter set forth in the following claims.

Claims

1. A patient support device, characterized in that: include: Upper frame, a cantilever lift system supporting the upper frame, the cantilever lift system comprising a connecting rod, a telescopic cylinder and a lift assist assembly, the connecting rod being configured to raise the upper frame in a substantially vertical direction, the telescopic cylinder being engaged with the connecting rod, the telescopic extension and retraction of the cylinder causing the connecting rod to move, the lift assist assembly being loaded to exert a force on the connecting rod to reduce a load on the telescopic cylinder when the cantilever lift system is lowered, A drive assembly operable to extend and retract the telescoping cylinder, the drive assembly comprising a manual module and a power module, the manual module being configured to allow a user to provide manual input to the drive assembly to extend the telescoping cylinder, the power module being removably coupled to the manual module to allow the power module to be added to the drive assembly to allow powered extension of the telescoping cylinder, wherein the telescoping cylinder is a hydraulic cylinder.

2. The patient support device according to claim 1, characterized in that The lift assist assembly acts in parallel to the telescoping cylinder.

3. The patient support device according to claim 2, characterized in that The lift assist assembly includes a compression spring.

4. The patient support device according to claim 2, characterized in that The lift assist assembly includes a gas spring.

5. The patient support device according to claim 2, characterized in that The lift assist assembly includes a torsion spring.

6. The patient support device according to claim 1, characterized in that The manual input is a foot pedal.

7. The patient support device according to claim 1, characterized in that The power module includes a motor and a pump driven by the motor.

8. The patient support device according to claim 1, characterized in that Also included is a user interface, wherein the operation of the power module is controlled by the user interface.

9. The patient support device according to claim 1, characterized in that The connecting rod comprises a parallelogram connecting rod.

10. The patient support device according to claim 1, characterized in that When the cantilever lifting system is in its lowest position, the free end of the cantilever lifting system is lower than the fixed end.

11. A patient support device, characterized in that: include: Upper frame, a thigh plate section pivotably coupled to the upper frame at a first pivot, a foot plate section pivotally coupled to the thigh section at a second pivot, the foot section having a free end, An actuator pivotally connected to the upper frame is extendable and retractable to simultaneously move the thigh plate section and the foot plate section, wherein the actuator drives a foot link connected to the foot plate section and a thigh link connected to the thigh plate section, wherein movement of the actuator causes the second pivot to vertically raise and lower the free end of the foot plate section.

12. The patient support device according to claim 11, characterized in that The foot link and the thigh link are interconnected by a swing link, and the actuator acts on the swing link.

13. The patient support device according to claim 12, characterized in that The pendulum is kinematically constrained such that it pivots about a virtual axis.

14. The patient support device according to claim 11, characterized in that The thigh link is pivotally coupled to the thigh plate segment and the foot link is pivotally coupled to the foot plate segment.

15. The patient support device according to claim 14, characterized in that The foot link and the thigh link are interconnected by a swing link, and the actuator acts on the swing link.

16. The patient support device according to claim 15, characterized in that The pendulum is kinematically constrained such that it pivots about a virtual axis.

17. A patient support device according to claim 16, characterized in that The foot link is pivotally coupled to the swing link and the thigh link is pivotally coupled to the swing link.

18. A patient support device according to claim 17, characterized in that The actuator is pivotally coupled to the rocker link.

19. A patient support device according to claim 18, characterized in that Contraction of the actuator raises the second pivot and lowers the free end of the foot plate segment.

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