Arm Support for Medical Imaging and Therapy

Abstract

A bracket assembly for an arm support includes a first panel, a second panel pivotally coupled to the first panel, a support channel configured to receive at least a portion of the arm support, and a clamping channel at least partially defined between the first and second panels. The bracket assembly is movable between a first position in which the first panel is movable relative to the second panel about the pivot and a second position in which the first panel is fixed relative to the second panel.

Description

[Technical Field]

[0001] This application claims priority to and the benefit of U.S. Provisional Patent Application No. 63 / 418,128, filed October 21, 2022, which is incorporated herein by reference in its entirety for all purposes.

[0002] The technology provided herein relates to radiation imaging and therapy, and in particular, but not exclusively, to arm supports configured to support a patient's arm positioned in a vertical position during medical imaging and / or medical procedures, and related methods, kits, and systems. [Background technology]

[0003] Radiation sources have many applications in medicine, including medical imaging and radiation therapy. Radiation sources are typically configured to move relative to a stationary patient, for example, to expose specific portions or regions of the patient to radiation generated by the source. Furthermore, while radiation therapy and related diagnostic and planning imaging are traditionally performed with patients in a prone or supine horizontal position, some patients benefit from treatment in nontraditional positions, such as a vertical position. Some patient supports used to position and support patients include arm supports for positioning, supporting, and / or immobilizing the patient's arms during diagnosis, imaging, and / or treatment. For example, arm supports can generally help support the patient's body or position the patient's arms in a position that minimizes beam attenuation by the arms, minimizes radiation exposure to body regions not being imaged or treated, or maximizes the quality of imaging and treatment of body regions being imaged or treated. However, limitations of patient supports for supporting patients in a vertical position have hindered the adoption and use of beneficial vertical radiation therapy methods. For example, vertical positioning systems have demonstrated reduced positional repeatability compared to horizontal patient positioning. See, e.g., Rahim et al. (2020) Frontiers in Oncology 10, article 213, incorporated herein by reference. In particular, some arm supports for imaging and / or treating patients in a vertical position are complex (see, e.g., patent application WO 2018120604) and therefore require additional time for setting up the patient support, positioning the patient, and removing the patient from the patient support, all of which combine to extend the total imaging or treatment time and thus reduce overall patient procedure volume and treatment. Thus, there is a need for an improved patient arm support. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] International Publication No. 2018 / 120604 [Non-patent literature]

[0005] [Non-Patent Document 1] Rahim et al. (2020) Frontiers in Oncology 10, article 213 Summary of the Invention

[0006] The technology provided herein relates to radiation imaging and treatment, and particularly, but not exclusively, to an arm support configured to support a patient's arm positioned in a vertical position during medical imaging and / or medical procedures, as well as related methods, kits, and systems. Several techniques for supporting a patient in a vertical, stable position are described in U.S. Patent Application Publication No. 20200268327 and U.S. Patent Application No. 63 / 237,513, each of which is incorporated herein by reference. In some embodiments, the technology described herein supplements and / or modifies patient positioning devices and / or patient supports, such as those described in U.S. Patent Application Publication No. 20200268327 or U.S. Patent Application No. 63 / 237,513, each of which is incorporated herein by reference. In some embodiments, the patient positioning system stabilizes and supports a patient in a vertical (e.g., standing, sitting, kneeling, perched) position. Imaging and / or treating a patient in a vertical position provides the advantage of increased patient comfort. Furthermore, diagnosing and / or treating patients in a vertical position offers advantages over diagnosing and / or treating patients in a traditional horizontal position for many indications (e.g., lung cancer, breast cancer). While imaging and / or treating patients in a vertical position offers diagnostic and therapeutic advantages, medical imaging and treatment require improved patient positioning systems to stabilize and support the patient in a proper vertical position for delivering therapeutic radiation doses to target areas and for planning treatment using medical imaging. The technology provided herein relates to improved arm supports for patient positioning systems that support a patient in a vertical position.

[0007] In one aspect, the present disclosure provides a bracket assembly for an arm support, the bracket assembly including: a first panel; a second panel pivotally coupled to the first panel; a support channel configured to receive at least a portion of the arm support; and a clamping channel at least partially defined between the first and second panels. The bracket assembly is movable between a first position in which the first panel is movable relative to the second panel about the pivot and a second position in which the first panel is fixed relative to the second panel.

[0008] In some embodiments, the bracket assembly further comprises a fastener for selectively positioning the bracket assembly in the second configuration.

[0009] In some embodiments, the first panel comprises a first protrusion and a second protrusion, and the support channel is at least partially defined by the first protrusion and the second protrusion.

[0010] In some embodiments, the first protrusion has a first surface configured to engage the arm support, and the second protrusion has a second surface configured to engage the arm support, the first surface being spaced apart from and facing towards the second surface.

[0011] In some embodiments, the bracket assembly further comprises a detent formed on the first surface of the first protrusion.

[0012] In some embodiments, the first panel comprises a first side extending between the first protrusion and the second protrusion and a second side extending between the first protrusion and the second protrusion, the first side being spaced apart from and parallel to the second side.

[0013] In some embodiments, the support channel is at least partially defined between the first side, the second side, the first protrusion, and the second protrusion.

[0014] In some embodiments, the bracket assembly further comprises a detent disposed within the support channel.

[0015] In some embodiments, in the first configuration, the first panel is pivoted further away from the second panel than in the second configuration.

[0016] In some embodiments, the support channel establishes a support axis, the pivot establishes a pivot axis, and the support axis is perpendicular to the pivot axis.

[0017] In some embodiments, the clamping channel is at least partially defined by a planar surface of the first panel and an arcuate surface of the second panel, the planar surface being disposed facing the arcuate surface.

[0018] In some embodiments, the bracket assembly further comprises a detent formed in the clamp channel.

[0019] In some embodiments, the detent is at least partially formed by the first panel and the second panel when the bracket assembly is in the second configuration.

[0020] In one aspect, the present disclosure provides an arm support assembly including a first bracket assembly, a second bracket assembly, and an arm support. The arm support includes a rod having a first linear portion, a second linear portion, and a connecting portion located between the first linear portion and the second linear portion. The first linear portion is at least partially received in the first bracket assembly, and the second linear portion is at least partially received in the second bracket assembly.

[0021] In some embodiments, the arm support comprises a tray coupled to a rod.

[0022] In some embodiments, the tray is coupled to a connector.

[0023] In some embodiments, the tray is a first tray and the arm support comprises a second tray coupled to the linkage, the first tray being spaced apart from the second tray.

[0024] In some embodiments, the handle grip extends between the first tray and the second tray.

[0025] In some embodiments, the handle grip is movable relative to the first tray and the second tray.

[0026] In some embodiments, the spacing between the arm support and the first bracket assembly is adjustable.

[0027] In some embodiments, the spacing is between the first bracket assembly and the linkage.

[0028] In some embodiments, the first bracket assembly and the rod form a first detent arrangement and the second bracket assembly and the rod form a second detent arrangement.

[0029] In some embodiments, the first detent arrangement comprises a protrusion on the first bracket assembly and an opening on the rod.

[0030] In some embodiments, the connector is arcuate.

[0031] In some embodiments, the arm support is movable relative to the first and second bracket assemblies between an in-use position and a retracted position.

[0032] In one aspect, the present disclosure provides an adjustable support assembly configured to support a patient, the adjustable support assembly including a backrest, a first bracket assembly adjustably coupled to the backrest, a second bracket assembly adjustably coupled to the backrest, and an arm support adjustably coupled to the first bracket assembly and the second bracket assembly, wherein a first adjustable dimension relative to the patient is defined between the first bracket assembly and the backrest, and a second adjustable dimension relative to the patient is defined between the arm support and the backrest.

[0033] In some embodiments, the first adjustable dimension and the second adjustable dimension are the only adjustable dimensions for positioning the arm support relative to the patient.

[0034] In some embodiments, the arm support comprises a rod having a first portion and a second portion, the first portion being at least partially received within the first bracket assembly and the second portion being at least partially received within the second bracket assembly.

[0035] In some embodiments, the first bracket assembly is coupled to a first edge of the backrest and the second bracket assembly is coupled to a second edge of the backrest, the second edge being opposite the first edge.

[0036] In some embodiments, the backrest is vertical.

[0037] In one aspect, the present disclosure provides a method of adjusting a patient support to accommodate a patient, the method including adjusting a first height of a first bracket assembly relative to a backrest, adjusting a second height of a second bracket assembly relative to the backrest, inserting an arm support at least partially into the first bracket assembly and at least partially into the second bracket assembly, and adjusting a spacing of the arm support relative to the backrest.

[0038] In some embodiments, the adjustment of the spacing of the arm support relative to the backrest is perpendicular to the adjustment of the first height of the first bracket assembly relative to the backrest.

[0039] In some embodiments, the method further includes moving the arm support between an in-use position and a stowed position.

[0040] Some portions of this specification describe embodiments of the present technology in terms of algorithms and symbolic representations of operations on information. These algorithmic descriptions and representations are commonly used by those skilled in the data processing arts to effectively convey the substance of their work to others skilled in the art. These operations, while described functionally, computationally, or logically, are understood to be implemented by computer programs or equivalent electrical circuits, microcode, or the like. Further, it has proven convenient at times to refer to arrangements of these operations as modules, without loss of generality. The described operations and their associated modules may be embodied in software, firmware, hardware, or any combination thereof.

[0041] Certain steps, operations, or processes described herein may be performed or embodied in one or more hardware or software modules, alone or in combination with other devices. In some embodiments, software modules are implemented in a computer program product comprising a computer-readable medium containing computer program code that can be executed by a computer processor to perform any or all of the steps, operations, or processes described.

[0042] In some embodiments, the system comprises a computer and / or data storage that is virtually provided (e.g., as a cloud computing resource). In particular embodiments, the present technology involves the use of cloud computing to provide a virtual computer system that comprises the components and / or performs the computer functions described herein. Thus, in some embodiments, cloud computing provides the infrastructure, applications, and software described herein over a network and / or the Internet. In some embodiments, computing resources (e.g., data analysis, calculations, data storage, application programs, file storage, etc.) are provided remotely over a network (e.g., the Internet and / or a cellular network).

[0043] Embodiments of the present technology may also relate to an apparatus for performing the operations herein. This apparatus may be specially constructed for the required purposes and / or may comprise a general-purpose computing device selectively activated or reconfigured by a computer program stored in the computer. Such a computer program may be stored on a non-transitory, tangible, computer-readable storage medium or any type of medium suitable for storing electronic instructions that can be coupled to a computer system bus. Furthermore, any computing system referred to herein may include a single processor or may be an architecture that utilizes a multiple processor design to increase computing power.

[0044] Further embodiments will be apparent to those skilled in the art based on the teachings contained herein.

[0045] The patent or application contains at least one drawing executed in color. Copies of this patent or patent application publication with color drawing(s) will be provided by the Office upon request and payment of the necessary fee.

[0046] These and other features, aspects, and advantages of the present technology will become better understood with regard to the following drawings. [Brief explanation of the drawings]

[0047] [Figure 1A] 1 shows a patient positioning system that supports a patient in an elevated seated position, for example, for treatment in the pelvis or lower abdomen. [Figure 1B] 1 shows a patient positioning system supporting a patient in a seated position, for example for treatment in the chest or upper abdomen. [Figure 1C] 1 shows a patient positioning system for supporting a patient, for example for treatment in the head or neck region. [Figure 2] FIG. 1 is a perspective view of a vertical backrest with arm support assembly. [Figure 3] FIG. 3 is a perspective view of FIG. 2 with a portion of the arm support assembly removed. [Figure 4] FIG. 1 is a perspective view of an arm support with a rod and a tray. [Figure 5] FIG. 10 is a partial perspective view of the bracket assembly in an open position. [Figure 6] FIG. 6 is a partial perspective view of the bracket assembly of FIG. 5 in a closed configuration. [Figure 7] FIG. 1 is a perspective cross-sectional view of an arm support assembly. [Figure 8] FIG. 10 is a side view of the arm support assembly showing two adjustable dimensions of the arm support relative to the backrest. [Figure 9] FIG. 10 is a perspective view of the front panel of the bracket assembly. [Figure 10] FIG. 10 is a partial perspective view of the front panel of FIG. 9. [Figure 11] FIG. 10 is another perspective view of the front panel of FIG. 9. [Figure 12] FIG. 10 is a perspective view of the rear panel of the bracket assembly. [Figure 13] FIG. 12 is a perspective view of the arm support assembly in a stowed position, allowing the patient free access to the vertical backrest. [Figure 14] FIG. 14 is a perspective view of the arm support assembly of FIG. 13 in an in-use position, with a patient supporting their arm on the arm support assembly, for example, during fixed beam therapy. [Figure 15] FIG. 1 is a perspective view of a vertical backrest with an arm support assembly including vertical handle grips. [Figure 16] FIG. 16 is a perspective view of the arm support assembly of FIG. 15 in an in-use position, with a patient supporting their arm on the arm support assembly, for example, during fixed beam therapy. DETAILED DESCRIPTION OF THE INVENTION

[0048] It should be understood that the drawings are not necessarily drawn to scale, and that objects within the drawings are not necessarily drawn to scale relative to each other. The drawings are representations intended to bring clarity and understanding to various embodiments of the devices, systems, and methods disclosed herein. Wherever possible, the same reference numbers will be used throughout the drawings to refer to the same or like parts. Furthermore, it should be understood that the drawings are not intended to limit the scope of the present teachings in any way.

[0049] The technology provided herein relates to radiation imaging and therapy, and in particular, but not exclusively, to arm supports configured to support a patient's arm positioned in a vertical position during medical imaging and / or medical procedures, and related methods, kits, and systems.

[0050] In this detailed description of various embodiments, for purposes of explanation, numerous specific details are set forth in order to provide a thorough understanding of the disclosed embodiments. However, those skilled in the art will understand that the various embodiments may be practiced without or with these specific details. In other instances, structures and devices are shown in block diagram form. Furthermore, those skilled in the art will readily understand that the specific order in which the methods are presented and performed is exemplary and that it is contemplated that the order can be changed and still remain within the spirit and scope of the various embodiments disclosed herein.

[0051] All literature and similar materials cited in this application, including but not limited to patents, patent applications, papers, books, treatises, and Internet web pages, are expressly incorporated by reference in their entirety for any purpose. Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by those skilled in the art to which the various embodiments described herein belong. If the definition of a term in an incorporated reference appears to differ from the definition provided in the present teachings, the definition provided in the present teachings shall prevail. The section headings used herein are for organizational purposes only and should not be construed as limiting the subject matter described in any way.

[0052] definition To facilitate understanding of the present technology, several terms and phrases are defined below. Additional definitions are set forth throughout the detailed description.

[0053] Throughout the specification and claims, the following terms shall take the meanings expressly associated therewith unless the context clearly dictates otherwise. As used herein, the phrase "in one embodiment" does not necessarily refer to the same embodiment, although it may. Additionally, as used herein, the phrase "in another embodiment" does not necessarily refer to different embodiments, although it may. Thus, as described below, various embodiments of the invention can be readily combined without departing from the scope or spirit of the invention.

[0054] Additionally, as used herein, the term "or" is an inclusive "or" operator and is equivalent to the term "and / or" unless the context clearly dictates otherwise. The term "based on" is not exclusive and allows for additional unlisted elements to be based on unless the context clearly dictates otherwise. Additionally, throughout this specification, the meanings of "a," "an," and "the" include plural referents. The meaning of "in" includes "in" and "on."

[0055] As used herein, the terms "about," "approximately," "sufficiently," and "significantly" are interpreted by those skilled in the art and vary to some extent depending on the context in which they are used. If there are uses of these terms that are not clear to those skilled in the art given the context in which they are used, "about" and "approximately" mean plus or minus 10% or less of the particular term, and "sufficiently" and "significantly" mean plus or minus more than 10% of the particular term.

[0056] As used herein, the disclosure of a range includes the disclosure of all values ​​within the entire range and further divided ranges, including the endpoints and subranges given in the range. As used herein, the disclosure of a numerical range includes the endpoints and each number therebetween with the same precision. For example, in the range of 6 to 9, the numbers 7 and 8 are contemplated in addition to 6 and 9, and in the range of 6.0 to 7.0, the numbers 6.0, 6.1, 6.2, 6.3, 6.4, 6.5, 6.6, 6.7, 6.8, 6.9, and 7.0 are expressly contemplated.

[0057] As used herein, the suffix "-free" refers to an embodiment of a technology that excludes the underlying feature of the word to which "-free" is added. That is, the term "X-free" as used herein means "without X," where X is the technology feature excluded in the "X-free" technology. For example, a "calcium-free" composition does not contain calcium, a "mixing-free" method does not include a mixing step, etc. Terms such as "first," "second," and "third" are used herein to describe various steps, elements, compositions, components, regions, layers, and / or sections; however, these steps, elements, compositions, components, regions, layers, and / or sections are not limited by these terms unless otherwise indicated. These terms are used to distinguish one step, element, composition, component, region, layer, and / or section from another step, element, composition, component, region, layer, and / or section. As used herein, terms such as "first," "second," and other numerical terms do not imply an order or sequence unless clearly indicated by context. Thus, a first step, element, composition, component, region, layer, or section discussed herein could be referred to as a second step, element, composition, component, region, layer, or section without departing from the art.

[0058] As used herein, the words "presence" or "absence" (or "present" or "absence") are used in a relative sense to describe the amount or level of a particular entity (e.g., a component, an action, an element). For example, when an entity is said to be "present," it means that the level or amount of this entity is above a predetermined threshold. Conversely, when an entity is said to be "absent," it means that the level or amount of this entity is below a predetermined threshold. The predetermined threshold may be the threshold of detection associated with a particular test used to detect the entity, or any other threshold. If an entity is "detected," it is "present." If an entity is "not detected," it is "absent."

[0059] As used herein, "increase" or "decrease" refers to a detectable (e.g., measured) positive or negative change in the value of a variable relative to a previously measured value, a pre-established value, and / or a standard control value, respectively. An increase is preferably at least a 10%, more preferably a 50%, even more preferably a 2-fold, even more preferably at least a 5-fold, and most preferably at least a 10-fold positive change relative to a previously measured, pre-established, and / or standard control value of the variable. Similarly, a decrease is preferably at least a 10%, more preferably a 50%, even more preferably at least a 80%, and most preferably at least a 90% negative change relative to a previously measured, pre-established, and / or standard control value of the variable. Other terms indicating quantitative changes or differences, such as "more" or "less," are used herein in the same manner as above.

[0060] As used herein, a "system" refers to multiple actual and / or abstract components that work together for a common purpose. In some embodiments, a "system" is an integrated collection of hardware and / or software components. In some embodiments, each component of a system interacts with and / or is related to one or more other components. In some embodiments, a system refers to a combination of components and software for controlling and directing a process. For example, a "system" or a "subsystem" can comprise one or more, or any combination of, mechanical devices, hardware, hardware components, circuits, electrical circuits, logic designs, logic components, software, software modules, components of software or software modules, software procedures, software instructions, software routines, software objects, software functions, software classes, software programs, files containing software, etc., to perform the functions of the system or subsystem. Thus, the methods and apparatus of the embodiments, or certain aspects or portions thereof, may take the form of program code (e.g., instructions) embodied in a tangible medium, such as a floppy diskette, a CD-ROM, a hard drive, a flash memory, or any other machine-readable storage medium, which, when loaded into and executed by a machine, such as a computer, causes the machine to become an apparatus for practicing the embodiments. When executing the program code on a programmable computer, the computing device generally includes a processor, a storage medium readable by the processor (e.g., volatile and non-volatile memory and / or storage elements), at least one input device, and at least one output device. One or more programs may implement or utilize the processes described in connection with the embodiments, for example, through the use of application programming interfaces (APIs), reusable controllers, or the like.Such programs are preferably implemented in a high-level procedural or object-oriented programming language to communicate with a computer system. However, the programs can be implemented in assembly or machine language, if desired. In either case, the language may be a compiled or interpreted language, and combined with hardware implementations.

[0061] As used herein, the term "computed tomography" is abbreviated to "CT" and refers to both tomographic and non-tomographic radiography. For example, the term "CT" refers to numerous forms of CT, including, but not limited to, X-ray CT, positron emission tomography (PET), single-photon emission computed tomography (SPECT), and photon-counting computed tomography. Generally, computed tomography (CT) involves the use of an X-ray source and detector that rotate around the patient, followed by reconstruction of images into different planes. In the CT embodiments described herein (e.g., devices, apparatus, and methods provided for CT), the X-ray source is a stationary source, and the patient rotates relative to the stationary source. The current for X-rays used in CT represents the flow of current from the cathode to the anode and is typically measured in milliamperes (mA).

[0062] As used herein, the phrase "assembled to [verb]" means that the specified element or assembly has a structure that is shaped, sized, arranged, joined, and / or configured to perform the specified verb. For example, a member "assembled to move" is movably coupled to another element, includes an element that causes the member to move, or is otherwise configured to move in response to another element or assembly. Thus, as used herein, "assembled to [verb]" describes structure, not function. Additionally, as used herein, "assembled to [verb]" means that the specified element or assembly is intended and designed to perform the specified verb.

[0063] As used herein, the term "associated" means that elements are part of the same assembly and / or work together or act in some way relative to / with each other. For example, a car has four tires and four hubcaps. It is understood that all elements are combined as parts of the car, but each hubcap is "associated" with a particular tire.

[0064] As used herein, the term "coupled" refers to two or more components secured together by any suitable means. Thus, in some embodiments, a statement that two or more parts or components are "coupled" means that the parts are joined or operate together directly or indirectly, for example, through one or more intermediate parts or components. As used herein, "directly coupled" means that the two elements are in direct contact with each other. As used herein, "fixedly coupled" or "fixed" means that the two components are coupled so that they move as one while maintaining a constant orientation relative to each other. Thus, when two elements are coupled, all portions of those elements are coupled. However, a reference to a particular portion of a first element being coupled to a second element, e.g., the first end of an axle being coupled to a first wheel, means that the particular portion of the first element is located closer to the second element than the other portions. Furthermore, an object resting solely on another object held in place by gravity is not "coupled" to the lower object unless the upper object is otherwise sufficiently held in place. That is, for example, a book on a table is not bound to it, and a book glued to the table is bound to it.

[0065] As used herein, the phrases "removably coupled" or "temporarily coupled" mean that one component is coupled to another component in an essentially temporary manner. That is, the two components are coupled in a manner that allows for easy joining or separation of the components without damaging the components. Thus, "removably coupled" components are easily separated and recoupled without damaging the components.

[0066] As used herein, the phrase "operably coupled" means that several elements or assemblies are coupled together that are each movable between a first position and a second position or between a first and a second configuration, such that movement of the first element from one position / configuration to another position / configuration similarly moves the second element between positions / configurations. Note that a first element is "operably coupled" to another element, and the opposite is not true.

[0067] As used herein, the phrase "rotatably coupled" refers to two or more components coupled such that at least one of the components is rotatable relative to the other.

[0068] As used herein, the phrase "translatably coupled" refers to two or more components coupled such that at least one of the components is translatable relative to the other.

[0069] As used herein, the phrase "temporarily disposed" means that a first element or assembly is placed on a second element or assembly such that the first element / assembly can be moved without separating or otherwise manipulating the first element. For example, a book that simply rests on a table, i.e., is not glued or fastened to the table, is "temporarily disposed" on the table.

[0070] As used herein, the term "corresponding" indicates that two structural components are similar in size and shape to one another and will fit together with minimal friction. Thus, an opening that "corresponds" to a member is sized slightly larger than the member so that the member can pass through the opening with minimal friction. This definition changes when two components fit together "nicely." In that case, the difference in size of the components is even smaller, increasing the amount of friction. If the elements forming the opening and / or the components inserted into the opening are made of deformable or compressible materials, the opening can even be slightly smaller than the components being inserted into the opening. With respect to surfaces, shapes, and lines, two or more "corresponding" surfaces, shapes, or lines generally have the same size, shape, and contour.

[0071] As used herein, a "path of travel" or "path," when used in reference to a moving element, includes the space that the element travels through when in motion. Thus, any moving element inherently has a "path of travel" or "path."

[0072] As used herein, a statement that two or more parts or components "engage" one another shall mean that the elements exert a force or bias on one another, either directly or through one or more intermediate elements or components. Additionally, as used herein with respect to a movable part, the movable part may "engage" another element during movement from one position to another and / or may "engage" another element once at the described position. Thus, the statements "element A engages element B when element A moves to element A's first position" and "element A engages element B when element A is in element A's first position" are understood to be equivalent statements and mean that element A engages element B while moving to element A's first position and / or that element A engages element B while element A is in element A's first position.

[0073] As used herein, the phrase "operably engage" means "to engage and move." That is, when used in reference to a first component assembled to move a second, movable or rotatable component, "operably engage" means that the first component applies a force sufficient to move the second component. For example, a screwdriver is placed in contact with a screw. When no force is applied to the screwdriver, the screwdriver is simply "coupled" to the screw. When an axial force is applied to the screwdriver, the screwdriver presses against the screw and "engages" it. However, when a rotational force is applied to the screwdriver, the screwdriver "operably engages" the screw and rotates it. Furthermore, in electronic components, "operably engage" means that one component controls another component via a control signal or current.

[0074] As used herein, the term "number" shall mean one or an integer greater than one (eg, plural).

[0075] As used herein, in the phrases "[x] moves between its first and second positions" or "[y] is assembled to move [x] between its first and second positions," "[x]" is the name of an element or assembly. Furthermore, when [x] is an element or assembly that moves between positions, the pronoun "the" refers to "[x]," i.e., the named element or assembly that precedes the pronoun "the."

[0076] As used herein, the "radial sides / surfaces" of a circular or cylindrical body are those sides / surfaces that extend around or surround its center or a height line passing through its center. As used herein, the "axial sides / surfaces" of a circular or cylindrical body are those sides that extend in a plane that extends approximately perpendicular to the height line passing through the center. That is, generally, in the case of a cylindrical soup can, the "radial sides / surfaces" are the generally circular sidewalls and the "axial sides / surfaces" are the top and bottom of the soup can.

[0077] As used herein, a "diagnostic" test includes detecting or identifying a disease state or condition in a subject, determining the likelihood that a subject will suffer from a given disease or condition, determining the likelihood that a subject with a disease or condition will respond to a treatment, determining the prognosis (or likely progression or regression) of a subject with a disease or condition, and determining the effectiveness of a treatment for a subject with a disease or condition. For example, a diagnostic can be used to detect the presence or likelihood of a subject having cancer, or the likelihood that such a subject will respond favorably to a compound (e.g., a pharmaceutical, e.g., drug) or other treatment.

[0078] As used herein, the term "disease" generally refers to a disease, illness, injury, abnormality, or change in health status.

[0079] As used herein, the term "treating" or "treatment," with respect to a disease, refers to preventing the disease, slowing the onset or rate of progression of the disease, reducing the risk of developing the disease, preventing or delaying the onset of symptoms associated with the disease, alleviating or terminating symptoms associated with the disease, causing complete or partial regression of the disease, or any combination thereof. In some embodiments, "treatment" includes exposing a patient or a portion thereof (e.g., a tissue, organ, body part, or other localized region of a patient's body) to radiation (e.g., electromagnetic radiation, ionizing radiation).

[0080] As used herein, the term "beam" refers to a stream of radiation (e.g., electromagnetic waves and / or particle radiation). In some embodiments, the beam is generated by a line source and is confined to a small solid angle. In some embodiments, the beam is collimated. In some embodiments, the beam is generally unidirectional. In some embodiments, the beam is diverging.

[0081] As used herein, the term "patient" or "subject" refers to a mammal identified and / or selected for imaging and / or treatment with radiation. Thus, in some embodiments, the patient or subject comes into contact with a radiation beam, e.g., a primary beam generated by a radiation source. In some embodiments, the patient or subject is a human. In some embodiments, the patient or subject is a veterinary animal or livestock, a farm animal or pet, or an animal used in clinical research. In some embodiments, the subject or patient has cancer and / or is identified as having or at risk of having cancer.

[0082] As used herein, the term "treatment region" or "imaging region" refers to a region of a patient (e.g., tissue) selected for imaging and / or treatment with radiation. For example, in some embodiments, the "treatment region" or "imaging region" includes a tumor in a cancer patient. As used herein, the term "healthy tissue" refers to a region of a patient (e.g., tissue) that is not a treatment region and / or does not include a treatment region. In some embodiments, the imaging region is larger than the treatment region and includes the treatment region.

[0083] As used herein, the term "radiation source" or "ray source" refers to a device that generates radiation (e.g., ionizing radiation) in the form of photons (e.g., described as particles or waves). In some embodiments, the radiation source is a linear accelerator ("linac") that generates X-rays or electrons to treat cancer patients by contacting tumors with the X-ray or electron beam. In some embodiments, the radiation source generates particles (e.g., photons, electrons, neutrons, hadrons, ions (e.g., protons, carbon ions, other heavy ions)). In some embodiments, the radiation source generates electromagnetic waves (e.g., X-rays and gamma rays having wavelengths ranging from about 1 pm to about 1 nm). It is understood that radiation can be described as having both wave-like and particle-like aspects, although it is sometimes convenient to describe radiation in terms of waves and sometimes in terms of particles. Thus, both descriptions are used throughout, without limiting the present technology, with the understanding that the laws of quantum mechanics dictate that all particles or quantum entities can be described as either particles or waves.

[0084] As used herein, the term "stationary source" refers to a source that does not rotate around a patient during use for imaging or therapy. In particular, a "stationary source" remains fixed relative to an axis that passes through the patient while the patient is being imaged or treated. The patient can rotate about the axis to cause relative motion between the stationary source and the rotating patient equivalent to the relative motion of the source rotating around the stationary patient, but the stationary source does not move relative to a third object, frame of reference (e.g., the treatment room in which the patient is located), or patient axis of rotation during imaging or therapy, while the patient rotates relative to the third object, frame of reference (e.g., the treatment room in which the patient is located), or patient axis of rotation that passes through the patient during imaging or therapy. For example, a stationary source may be mounted on a moving stage, whereby the stationary source can move relative to the Earth and a fixture on the Earth as the moving stage moves to carry the stationary source. Thus, the term "stationary source" can refer to a movable "stationary source" as long as the movable "stationary source" does not rotate about an axis of rotation through the patient during patient imaging or treatment. Additionally, a stationary source can be translated and / or rotated around the patient to position the stationary source before imaging or treating the patient or after imaging or treating the patient. Thus, the term "stationary source" can refer to a source that translates or rotates around the patient during non-imaging and non-treatment use, for example, to position the source relative to the patient when the patient is not being imaged and / or treated. In some embodiments, the "stationary source" is a photon source and is therefore referred to as a "stationary photon source."

[0085] explanation Conventional arm supports for horizontal and vertical scanning are complex, requiring significant time both to set up the support and to position the patient on the patient support and support before imaging or treating the patient. One problem with conventional arm supports that contributes to their complexity is the numerous base points and movements required for installation (see, for example, patent application WO 2018120604). This results in reduced patient throughput, with fewer patients receiving the necessary diagnosis and treatment. Reduced patient throughput also creates an unfavorable cost-income balance for facilities that operate conventional CT scanning and X-ray therapy systems, as the fixed costs of managing the systems are not offset by sufficient payments for their use.

[0086] The arm support assembly disclosed herein has fewer parts, fewer base points, and is easier to move and install than conventional technology. The configurable arm support disclosed herein includes a pair of brackets (or clamps) that connect to (attach to) the side edges of the backrest of a patient positioning system and move substantially vertically along the side edges to adjust the vertical height of the arm support (e.g., above the floor). An arm support arch includes a rod with two linear sections (e.g., "legs"), each of which connects to one of the pair of brackets. The linear sections slide in and out of the brackets to adjust the position of the arm support relative to the plane of the backrest. The arm support provides a support structure for supporting the patient's arm (e.g., triceps). The position of the arm support relative to the plane of the backrest is adjusted at regular intervals (a detent configuration) using a series of linearly arranged complementary protrusions ("ridges" or "pegs") on the linear sections (e.g., arch legs) that fit into holes in each bracket. The vertical position of the arm rest is moved at regular intervals using a series of complementary protrusions arranged linearly on the backrest and holes on each bracket (a detent configuration). Thus, the illustrated embodiment has only two base points. The protrusions and holes may be interchanged between connecting parts to provide alternative arrangements. Advantageously, the arm support assembly has no more than two base points and / or has weights that at least partially hold the arm support rods in place.

[0087] Referring to Figures 1A, 1B, and 1C, the need for arm supports varies for different vertical treatment positions. Figure 1A shows a chair supporting a patient in a high, seated position, for example, for treatment in the pelvis or lower abdomen. Figure 1B shows a chair supporting a patient for treatment in the chest or upper abdomen. Figure 1C shows a chair supporting a patient for treatment in the head and neck. Arm supports may vary for each treatment position. For treatment areas between the abdomen and genital area, a single support for the patient's arms as disclosed herein can be quickly installed and provides the necessary support without overly complicating installation with multiple base points.

[0088] Controlled arm placement is recommended for all treatments to reduce motion and improve reproducibility of anatomical positioning. The arm support detailed herein is comfortable for the patient throughout the entire session (approximately 15-20 minutes), whether imaging or treatment. The arm support detailed herein is safely and securely positioned by the clinician in an efficient manner to reduce the time required for each session and improve patient throughput. The arm support detailed herein is compatible with various third-party devices, such as backrests.

[0089] 2, there is shown an adjustable support assembly 10 configured to support a patient. The adjustable support assembly 10 includes a generally vertical backrest 14 (e.g., a vertical table) and an arm support assembly 18 adjustably coupled to the backrest 14. In the illustrated embodiment, the arm support assembly 18 includes a first bracket assembly 22, a second bracket assembly 26, and an arm support 30.

[0090] Referring to FIG. 8 , as described in further detail herein, the adjustable support assembly 10 includes two adjustable dimensions that are adjusted and tailored to each patient. In other words, the arm support assembly 18 is adjustable relative to the backrest 18 in two dimensions (e.g., two indices). A first adjustable dimension 34 relative to the patient is defined between the bracket assembly 22, 26 and the backrest 14 (e.g., the bottom edge of the backrest) (e.g., adjustable height). The first adjustable dimension 34 is adjustable along an adjustment axis 36. A second adjustable dimension 38 relative to the patient is defined between the arm support 30 and the backrest 14 (e.g., adjustable width or spacing). The second adjustable dimension 38 is adjustable along an adjustment axis 40. In the illustrated embodiment, the adjustment axis 36 is perpendicular to the adjustment axis 40. Advantageously, the first adjustable dimension 34 and the second adjustable dimension 38 are the only adjustable dimensions for positioning the arm support 30 relative to the patient. In other words, the arm support assembly 18 is quickly and easily adjusted to meet the needs of different patients, thereby improving efficiency and reproducibility.

[0091] Referring to FIG. 3 , a first bracket assembly 22 is adjustably coupled to the backrest 14, and a second bracket assembly 26 is adjustably coupled to the backrest 14. In the illustrated embodiment, the first bracket assembly 22 is coupled to a first edge 42 of the backrest 14, and the second bracket assembly 26 is coupled to a second edge 46 opposite the first edge 42. In some embodiments, the backrest 14 is a conventional horizontal table (e.g., a CIVCO table) that has been reoriented to be approximately vertical. In some embodiments, the arm support assembly 18 moves using a CIVCO scale (a series of numbers and letters that indicate where components are located). In some embodiments, the backrest 14 is a curved backrest.

[0092] The bracket assemblies 22, 26 can extend from the rear of the backrest or from the front of the backrest 14. If the arm support 30 extends farther from the body, providing more space inside the scanner ring to accommodate the arm support, then the bracket assemblies 22, 26 may advantageously extend from the front of the backrest 14 to provide additional structural support. In other words, if the bracket assemblies extend from the front, the backrest can be positioned closer to the scanner ring, providing more space for the arm support.

[0093] 4, arm support 30 includes rod 50 and tray 54 coupled to rod 50. In the illustrated embodiment, rod 50 has a first straight portion 58, a second straight portion 62, and a connecting portion 66 located between first straight portion 58 and second straight portion 62. In other words, connecting portion 62 extends between first straight portion 58 and second straight portion 62. In the illustrated embodiment, connecting portion 66 is arc-shaped (e.g., arched). In other embodiments, connecting portion 66 is straight. In some embodiments, rod 50 is made of carbon fiber to minimize beam attenuation and minimize the risk of scattering.

[0094] 4, a tray 54 is coupled to a connector 66 of the rod 50. The tray 54 provides a comfortable surface on which the patient can rest their arm (e.g., triceps). In some embodiments, the tray 54 is formed as two separate pieces attached to the rod 50. In some embodiments, no tray is used.

[0095] As described in detail herein, arm support 30 is adjustably coupled to first bracket assembly 22 and adjustably coupled to second bracket assembly 26. In the illustrated embodiment, first linear portion 58 of rod 50 is at least partially received within first bracket assembly 22 and second linear portion 62 of rod 50 is at least partially received within second bracket assembly 26.

[0096] 8 , a second adjustable dimension 38 between the arm support 30 and the bracket assemblies 22, 26 and backrest 14 is adjustable (e.g., according to a first scale) along an adjustment axis 40. As shown, the second adjustable dimension 38 is defined between the backrest 14 and a connection portion 66 of the rod 50.

[0097] The first bracket assembly 22 and rod 50 form a first detent arrangement 74, and the second bracket assembly 26 and rod 50 form a second detent arrangement 78. In the illustrated embodiment, the first detent arrangement 74 includes a protrusion 82 (e.g., a detent) on the first bracket assembly 22 and at least one opening 86 on the rod 50 ( FIG. 7 ).

[0098] In some embodiments, the openings 86 are spaced about 1 cm apart. The second detent arrangement 78 includes a similar arrangement. In other embodiments, the locations of the protrusions and openings are reversed.

[0099] In the illustrated embodiment, the first bracket assembly 22 and the second bracket assembly 26 are generally similar. Details of the first bracket assembly 22 and the second bracket assembly 26 are presented herein, and similar details are applicable to other bracket assemblies but are not necessarily repeated herein. Accordingly, the following description refers to "bracket assembly 22" to refer collectively to both the first bracket assembly 22 and / or the second bracket assembly 26.

[0100] 9-12, the bracket assembly 22 includes a first panel 90 and a second panel 94 coupled to the first panel 90 at a pivot 98 .

[0101] 7, the support channel 102 is configured to receive at least a portion of the arm support 30. In the illustrated embodiment, the first panel 90 includes a first protrusion 106 (e.g., a lower support leg) and a second protrusion 110 (e.g., an upper support leg), and the support channel 102 is at least partially defined by the first protrusion 106 and the second protrusion 110. In the illustrated embodiment, the protrusions 106, 110 are spaced apart in at least two orthogonal directions and extend in generally parallel directions. A detent 82 (e.g., a protrusion) is disposed within the support channel 102.

[0102] 7, the first protrusion 106 of the support channel 102 has a first surface 114 configured to engage with the arm support 30. The second protrusion 110 of the support channel 102 has a second surface 118 configured to engage with the arm support 30. The first surface 114 is spaced apart from and faces towards the second surface 118. In the illustrated embodiment, the first surface 114 faces generally upward and the second surface 118 faces generally downward. In the illustrated embodiment, the detent 82 is formed on the first surface 114 of the first protrusion 106.

[0103] 9, 10, and 11, the first panel 90 has a first side 122 extending between the first protrusion 106 and the second protrusion 110. The first panel 90 also has a second side 126 extending between the first protrusion 106 and the second protrusion 110. In the illustrated embodiment, the first side 122 is spaced apart from and parallel to the second side 126. In other words, the protrusions 106, 110 extend between the parallel sides 122, 126. The support channel 102 is at least partially formed between the first side 122, the second side 126, the first protrusion 106, and the second protrusion 110.

[0104] 7, straight portions 58, 62 of arm support 30 are at least partially received within support channel 102, with straight portion 58 engaging both first surface 114 and second surface 118. Support channel 102 establishes a support axis 130 extending along support channel 102, with straight portions 58, 62 aligned with support axis 130 in FIG.

[0105] In some embodiments, the arm support 30 is heavier in the front (e.g., near the joint 66) so that gravity acting on the arm support 30 and / or on both the arm support 30 and the patient's arm / body secures the arm support 30 in place within the support channel 102 of the bracket assemblies 22, 26.

[0106] As described in detail herein, the bracket assembly 22 is movable between a first configuration (e.g., an open configuration, FIG. 5 ) in which the first panel 90 is movable relative to the second panel 94 about a pivot 98, and a second configuration (e.g., a fixed configuration, FIG. 6 ) in which the first panel 90 is fixed relative to the second panel 94. In the illustrated embodiment, the pivot 98 establishes a pivot axis 100 about which the panels 90, 94 pivot. In the illustrated embodiment, the support axis 130 of the support channel 102 is perpendicular to the pivot axis 100.

[0107] In the first configuration, the first panel 90 is pivoted further away from the second panel 94 than in the second configuration. In other words, the spacing between the first panel 90 and the second panel 94 is greater in the first configuration than in the second configuration. In the illustrated embodiment, the top edges of the panels 90, 94 are positioned closer to each other in the second configuration (FIG. 6) than in the first configuration (FIG. 5).

[0108] A fastener 138 is provided for selectively positioning the bracket assembly 22 in the second configuration. In the illustrated embodiment, the fastener 138 is a cam lever handle that is manually actuated by a user. In the illustrated embodiment, the cam lever handle is secured to the second panel 94 and is received by at least the first panel 90 in the second configuration.

[0109] 6 and 7, a clamping channel 142 is at least partially defined between the first panel 90 and the second panel 94. In the illustrated embodiment, the clamping channel 142 is at least partially defined by a flat surface 146 of the first panel 90 and an arcuate surface 150 of the second panel 94. The flat surface 146 is disposed opposite and facing the arcuate surface 150. In other words, the space formed between the flat surface 146 and the arcuate surface 150 forms the clamping channel 142 in which the backrest 14 is received and secured.

[0110] The bracket assembly 22 and the backrest 14 form a detent arrangement 154. In the illustrated embodiment, the detent arrangement 154 includes protrusions (e.g., ridges, pegs, etc.) formed on the edges 42, 46 of the backrest 14 and corresponding recesses 158 (e.g., indentations) formed in the bracket assembly 22. With reference to FIGS. 11 and 12 , the recesses 158 are formed in the clamp channel 142. In the illustrated embodiment, the recesses 158 are at least partially formed by the first panel 90 and the second panel 94 when the bracket assembly is in the second configuration. In other words, the recesses 158 are partially formed in the first panel 90 and partially formed in the second panel 94. In some embodiments, the protrusions on the backrest 14 are spaced approximately 7 cm apart.

[0111] In some embodiments, the straight sections 58, 62 of the rod 50 are different lengths for different patients. In some embodiments, an extender piece can be threaded onto the straight sections to make them longer.

[0112] Some embodiments include an optical system to verify placement of the bracket assemblies 22, 26 and the arm support 30 are in the correct position for a given patient. In some embodiments, a warning (e.g., visual, audio, or tactile) is provided if the arm support 30 is not installed correctly. In some embodiments, a projector projects guide marks where the bracket and arm support should be installed.

[0113] In some embodiments, the arm support can be "split" into two halves, with each half moving independently (e.g., for breast imaging or treatment). The halves may pivot in a plane parallel to the floor (away / out from the patient), or may pivot downwards or upwards (within the device parallel to the backrest).

[0114] In some embodiments, the arm support provides an alert (tactile, audible) when the patient's breathing pattern deviates from a predetermined pattern required for imaging or treatment. In some embodiments, the arm support indicates a prescribed rhythm. The alert can vary in intensity depending on how far the patient's breathing deviates from the proper pattern.

[0115] The present disclosure provides a method for adjusting a patient support to accommodate a patient, which is an improvement over conventional methods. The method includes adjusting a first height of a first bracket assembly relative to a backrest and adjusting a second height of a second bracket assembly relative to the backrest. The method also includes inserting an arm support at least partially into the first bracket assembly and at least partially into the second bracket assembly. The method then includes adjusting the spacing of the arm support relative to the backrest. In other words, the arm support is moved relative to the bracket assemblies and the backrest. In some embodiments, the adjustment of the spacing of the arm support from the backrest is perpendicular to the adjustment of the first height of the first bracket assembly relative to the backrest. In some embodiments, the adjustment of the height of the bracket assemblies is vertical, and the adjustment of the spacing of the arm support from the backrest is horizontal (see, e.g., FIG. 8). In some embodiments, the method further includes moving the arm support between an in-use position (e.g., FIG. 14) and a stored position (e.g., FIG. 13). In the in-use position, the straight sections 58, 62 of the rod 50 are aligned with the support axis 130 of the corresponding support channel 102. In some embodiments, the retracted position completely separates (e.g., removes) the arm support from the bracket assembly.

[0116] 15 and 16 , adjustable support assembly 210 includes a substantially vertical backrest 214 (e.g., a vertical table) and an arm support assembly 218 adjustably coupled to backrest 214. In the illustrated embodiment, arm support assembly 218 includes a first bracket assembly 222, a second bracket assembly 226, and an arm support 230. Arm support 230 has a rod 250, a first tray 254 coupled to rod 250, and a second tray 256 coupled to rod 250.

[0117] In the illustrated embodiment, the rod 250 has a first straight portion 258, a second straight portion 262, and a connecting portion 266 located between the first straight portion 258 and the second straight portion 262. In other words, the connecting portion 262 extends between the first straight portion 258 and the second straight portion 262. In the illustrated embodiment, the connecting portion 266 is arc-shaped (e.g., arched). The trays 254, 256 are coupled to the connecting portion 266 of the rod 250. In the illustrated embodiment, the first tray 254 is spaced apart from the second tray 256. In some embodiments, the trays 254, 256 each include a cushion (e.g., a gel pad) to improve patient comfort.

[0118] In the illustrated embodiment, the arm support 230 further includes a handle grip 270 that extends between the first tray 254 and the second tray 256. In some embodiments, the handle grip 270 is movable relative to the first tray 254 and the second tray 256. For example, the handle grip 270 may be foldable for transport and / or storage. In use, the handle grip 270 may extend generally perpendicular to and / or generally parallel to the backrest 214.

[0119] Although the disclosure herein refers to certain illustrated embodiments, it should be understood that these embodiments are presented by way of example and not limitation.

[0120] All publications and patents mentioned in the above specification are incorporated herein by reference in their entirety for all purposes. Various modifications and variations of the described compositions, methods, and uses of the technology will be apparent to those skilled in the art without departing from the scope and spirit of the described technology. Although the technology has been described in connection with specific exemplary embodiments, it should be understood that the invention as claimed should not be unduly limited to such specific embodiments. Indeed, various modifications of the described modes for carrying out the invention that are apparent to those skilled in the art are intended to be within the scope of the following claims.

Claims

1. 1. A bracket assembly for an arm support, the bracket assembly comprising: a first panel; a second panel pivotally coupled to the first panel; a support channel configured to receive at least a portion of the arm support; a clamping channel at least partially defined between the first panel and the second panel; The bracket assembly is movable between a first configuration in which the first panel is movable relative to the second panel about a pivot and a second configuration in which the first panel is fixed relative to the second panel.

2. The bracket assembly of claim 1 further comprising a fastener for selectively positioning the bracket assembly in the second position.

3. The bracket assembly of claim 1 , wherein the first panel includes a first protrusion and a second protrusion, and the support channel is at least partially defined by the first protrusion and the second protrusion.

4. 4. The bracket assembly of claim 3, wherein the first protrusion comprises a first surface configured to engage the arm support, and the second protrusion comprises a second surface configured to engage the arm support, the first surface being spaced apart from and facing towards the second surface.

5. The bracket assembly of claim 4 , further comprising a detent formed on the first surface of the first projection.

6. 4. The bracket assembly of claim 3, wherein the first panel comprises a first side extending between the first protrusion and the second protrusion and a second side extending between the first protrusion and the second protrusion, the first side being spaced apart from and parallel to the second side.

7. The bracket assembly of claim 6 , wherein the support channel is at least partially defined between the first side, the second side, the first protrusion, and the second protrusion.

8. The bracket assembly of claim 1 , further comprising a detent disposed within the support channel.

9. 2. The bracket assembly of claim 1, wherein in the first configuration, the first panel is pivoted further away from the second panel than in the second configuration.

10. The bracket assembly of claim 1 , wherein the support channel establishes a support axis and the pivot establishes a pivot axis, the support axis being perpendicular to the pivot axis.

11. The bracket assembly of claim 1 , wherein the clamping channel is at least partially defined by a planar surface of the first panel and an arcuate surface of the second panel, the planar surface disposed facing the arcuate surface.

12. The bracket assembly of claim 1 , further comprising a detent formed in the clamp channel.

13. The bracket assembly of claim 12 , wherein the detent is at least partially formed by the first panel and the second panel when the bracket assembly is in the second configuration.

14. 1. An arm support assembly comprising: a first bracket assembly; a second bracket assembly; an arm support with a rod having a first linear portion, a second linear portion, and a connecting portion located between the first linear portion and the second linear portion; An arm support assembly, wherein the first linear portion is at least partially received in the first bracket assembly and the second linear portion is at least partially received in the second bracket assembly.

15. The arm support assembly of claim 14 , wherein the arm support comprises a tray coupled to a rod.

16. The arm support assembly of claim 15 , wherein the tray is coupled to a linkage.

17. 17. The arm support assembly of claim 16, wherein the tray is a first tray and the arm support comprises a second tray coupled to the linkage, the first tray being spaced apart from the second tray.

18. The arm support assembly of claim 17, further comprising a handle grip extending between the first tray and the second tray.

19. 20. The arm support assembly of claim 18, wherein the handle grip is movable relative to the first tray and the second tray.

20. 15. The arm support assembly of claim 14, wherein the spacing between the arm support and the first bracket assembly is adjustable.

21. 21. The arm support assembly of claim 20, wherein the spacing is between the first bracket assembly and the linkage.

22. The arm support assembly of claim 14 , wherein the first bracket assembly and the rod form a first detent arrangement and the second bracket assembly and the rod form a second detent arrangement.

23. 23. The arm support assembly of claim 22, wherein the first detent formation comprises a protrusion on the first bracket assembly and an opening on the rod.

24. The arm support assembly of claim 14 , wherein the linkage is arcuate.

25. The arm support assembly of claim 14 , wherein the arm support is movable relative to the first and second bracket assemblies between an in-use position and a stowed position.

26. 1. An adjustable support assembly configured to support a patient, the adjustable support assembly comprising: The backrest and a first bracket assembly adjustably coupled to the backrest; a second bracket assembly adjustably coupled to the backrest; an arm support adjustably coupled to the first bracket assembly and adjustably coupled to the second bracket assembly; a first adjustable dimension for the patient is defined between the first bracket assembly and the backrest; and An adjustable support assembly in which a second adjustable dimension for the patient is defined between the arm support and the backrest.

27. 27. The adjustable support assembly of claim 26, wherein the first adjustable dimension and the second adjustable dimension are the only adjustable dimensions for positioning the arm support relative to the patient.

28. 27. The adjustable support assembly of claim 26, wherein the arm support comprises a rod having a first portion and a second portion, the first portion being at least partially received within the first bracket assembly and the second portion being at least partially received within the second bracket assembly.

29. 27. The adjustable support assembly of claim 26, wherein a first bracket assembly is coupled to a first edge of the backrest and a second bracket assembly is coupled to a second edge of the backrest, the second edge being opposite the first edge.

30. 27. The adjustable support assembly of claim 26, wherein the backrest is vertical.

31. 1. A method of adjusting a patient support to accommodate a patient, the method comprising: adjusting a first height of the first bracket assembly relative to the backrest; adjusting a second height of the second bracket assembly relative to the backrest; inserting an arm support at least partially into the first bracket assembly and at least partially into the second bracket assembly; and adjusting the spacing of the arm support relative to the backrest.

32. 32. The method of claim 31, wherein the adjustment of the spacing of the arm support relative to the backrest is perpendicular to the adjustment of the first height of the first bracket assembly relative to the backrest.

33. 32. The method of claim 31, further comprising moving the arm support between an in-use position and a stowed position.

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