Abstract: An angioplasty balloon including a non-deployable stent to prevent or reduce the potential for slippage of the inflated balloon with respect to the vessel wall being treated. The balloon includes a non-deployable stent that is adapted to be secured to the balloon or angioplasty balloon catheter. The stent has a proximal end, a distal end, and at least one extension section, at least one set of serpentine rings and at least one set of elongation links that allow expansion of the strut to accommodate the inflation of the balloon. The stent is made of a material so that the stent collapses upon deflation of the balloon.

Abstract: A medical balloon for a balloon catheter is described. The balloon has at least a first layer made from a first material and a second layer made from a second material, said first and second layers being in overlying relationship with one another and being integral with one another; wherein the first layer has a softening or melting temperature which is higher than a softening or melting temperature of the second layer. A method of forming the medical balloon is also described, including locating a raw tubing in a mold; preheating and inflating the raw tubing so as to cause it to stretch; heating the raw tubing to soften or melt the second layer; setting the inflated raw tubing to form the medical balloon; and cooling the set balloon.

Abstract: A foldable urinary catheter is provided for draining the human bladder defining an internal flow path for urine, with a catheter tube for insertion into the urethra, the catheter tube having at least one hinge which can enable the catheter into a folded, compact storage condition and an unfolded, straight ready-for-use condition as well as to a foldable urinary catheter kit. A foldable urinary catheter and a foldable urinary catheter kit are provided which are very small and compact in a transport or storage condition and which provide a long insertable length of the catheter tube. The hinge in the catheter tube is provided in the insertable length of the catheter tube and is configured for stabilizing the ready-for-use condition. The kit includes the foldable urinary catheter and a catheter package which tightly surrounds the folded catheter.

Abstract: The invention describes a sinus balloon catheter and methods of use. Specifically a sinus balloon catheter for dilating a sinus cavity lumen is provided with a tip that can be extended. The catheter comprises a guide tube with a proximal and distal end, a sleeve member, a balloon disposed upon the sleeve member and a rounded tip arranged at the distal end and extendable along with the extension of the sleeve member.

Abstract: A steam therapy equipment including a vessel for heating a mixture of water and organic materials, a compressor to inject pressurized air into the vessel producing pressurized steam. The pressurized steam is conducted into the equipment via one or more valves. The therapy equipment is formed from at least one panel and may include a supporting frame. The therapy equipment includes a temperature sensor to measure the temperature inside the therapy equipment when pressurized steam is admitted via the valves. A patient enters the equipment and is exposed to the pressurized steam, causing dilation of the skin pores of the patient, whereby toxins are removed from the patient. One or more applicators may conduct pressurized steam to specific portions of the body of the patient. The patient may be provided with a portion of the mixture to consume as part of the steam therapy treatment.

Abstract: An applicator is configured to transfer an active ingredient into a body through skin by a puncture in the skin with microneedles. The applicator includes a piston plate that is provided with a first protrusion part and second protrusion parts on a lower surface side of a main body of the piston plate. The microneedles are provided on a surface of the first protrusion part. The second protrusion parts are provided in a periphery of the first protrusion part while spaced apart from the first protrusion part.

Abstract: The various implementations described herein include methods used to manufacture a percutaneous port for promoting tissue in-growth around the percutaneous port. In one aspect, the method includes providing a tubular structure having an outer surface and providing a coil having an outer surface and comprised of a plurality of loops. The method further includes joining at least a portion of the outer surface of the coil to the outer surface of the tubular structure.

Abstract: An access port includes a molded housing portion forming a reservoir for receiving fluid. The housing portion includes a shielding plate arranged on an inner base of the housing portion; an open end in which a septum is arranged; an exit passage; and a wall, the shielding plate including a circular portion having a periphery. The lower side and the periphery of the shielding plate are embedded into the housing portion. Furthermore, a shielding plate is insert molded into the housing portion.

Abstract: An implantable multi-lumen access port including indicators for ascertaining characteristics of the port is disclosed. In one embodiment, the access port comprises a housing that defines a first reservoir and a second reservoir. A first septum and second septum are respectively coupled with the housing to provide selective access to the first and second reservoirs. Each septum includes a plurality of protrusions defined about a periphery thereof that are palpable after implantation of the port in a patient to determine a relative position of the first septum with respect to the second septum. A radiographically observable indicator is also included on a base of the housing, so as to provide information relating to a characteristic of the dual-lumen port, such as suitability for power injection of fluids. The indicator in one embodiment includes a substantially rigid radiopaque component.

Abstract: Percutaneous access apparatus is described that includes a percutaneous fluid access device having an extracorporeal portion, one or more ports accessible from the extracorporeal portion and a septum for sealing each port. A connector device having one or more hollow needles is attachable to the percutaneous fluid access device. The apparatus also includes an attachment mechanism for attaching the connector device to the extracorporeal portion and an actuation mechanism that, after the connector device has been attached to the extracorporeal portion, can be used to drive the one or more hollow needles through the septum to establish fluid communication between the one or more hollow needles and the one or more ports. The apparatus may be used for neurosurgery applications.

Abstract: Some embodiments disclosed herein relate to a medical connector having a backflow resistance module configured to prevent fluid from being drawn into the connector when a backflow inducing event occurs. In some embodiments, the backflow resistance module can include a variable-volume chamber configured to change in volume in response to a backflow-inducing event and a check valve configured to resist backflow. In some embodiments, the medical connector can include a fluid diverter configured to direct fluid flowing through the medical connector into the variable volume chamber to prevent fluid stagnation therein. In some embodiments, the medical connector includes a body member, a base member, a seal member, a support member, and a valve member.

Abstract: A medical device lead. The lead includes one or more jacketed conductive elements. The jacket comprises one or more covers. A first cover of polyether ketone (PEEK) is in direct contact with the at least one conductive element. At least one conductive element and a PEEK cover are coiled. The coiled conductive element can substantially retain its original coiled shape.

Abstract: Medical leads include distal tip anchors that are retained by fixation mechanisms of implantation tools. The fixation mechanism may include a fixed body that has features retaining the distal tip anchor. The fixation mechanism may include a movable body that can apply tension to the distal tip anchor to force the distal tip anchor to be released from the features of the fixed body. The movable body may include an axial portion that is received by an axial hole of the fixed body to allow for axial movement of the movable body to release the distal tip anchor. The fixation mechanism may instead include an elongated flexible body that passes through the distal tip anchor and is attached to the fixed body. Tension applied to the elongated body creates a releasing motion of the distal tip anchor to free the distal tip anchor from the features of the fixed body.

Abstract: Medical leads have one or more openly coiled filars and a distal body coupled to the openly coiled filars. The openly coiled filars provide a lead with compliance and elasticity while the distal body provides the firmness needed for placement and support of the electrodes. The openly coiled filars may transition to a linear distal portion that extends to the distal body, and the distal body may have proximal tines that fold proximally to become adjacent to the linear distal portion of the filars. The openly coiled filars may instead extend to the distal body and the proximal tines may be laterally arced to then fold against the lateral surface of the coiled filars. The tines may fold distally during explantation to allow the distal body to release and exit the body.

Abstract: Devices and methods for manipulating devices such as micro-scale devices are provided. The devices can include a tether of various materials surrounded by a stiff body. The tether interfaces with microscale devices to draw them against the stiff body, holding the microscale devices in a locked position for insertion into or extraction out of tissue. The tensional hook and stiff body are configurable in a multitude of positions and geometries to provide increased engagement. Such configurations allow for a range of implantation and extraction surgical procedures for the device within research and clinical settings.

Abstract: Apparatus for securing a therapy delivery device relative to a burr hole and method for making same. In one embodiment, the apparatus includes a base for seating in or near the burr hole. The apparatus may further include a stabilizer that may be engaged with the therapy delivery device. The stabilizer may include a surface coating or treatment operable to enhance frictional engagement with the therapy delivery device.

Abstract: A shield located within an implantable medical lead may be terminated in various ways. The shield may be terminated by butt, scarf, lap, or other joints between insulation layers surrounding the lead and an insulation extension. For lap joints, a portion of an outer insulation layer may be removed and a replacement outer insulation layer is positioned in place of the removed outer insulation layer, where the replacement layer extends beyond an inner insulation layer and the shield. The replacement layer may also lap onto a portion of the insulation extension. Barbs may be located between the replacement layer and the inner insulation layer or the insulation extension. The shield wires have ends at the termination point that may be folded over individually or may be capped with a ring located within one of the insulation layers of the jacket.

Abstract: Implantable medical systems include implantable medical leads that have magnetic orientation-independent magnetically actuated switches that are placed in the conduction path to the electrode of the lead. Thus, regardless of the orientation of a substantial magnetic field like that from an MRI machine to the lead and switch within the lead, the switch opens when in the presence of that substantial magnetic field. The switch may be placed in close proximity to the electrode such that the opening of the switch disconnects the electrode from the majority of the conduction path which thereby produces a high impedance for RF current and reduces the amount of heating that may occur at the electrode when in the presence of substantial levels of RF electromagnetic energy as may occur within an MRI machine.

Abstract: An apparatus includes a frame, a sensor, and an electric stimulator. The frame is removably couplable to a portion of a limb. The sensor is configured to produce a first signal associated with a gait characteristic at a first time, and a second signal associated with the gait characteristic at a second time, after the first time. The electric stimulator is removably coupled to the frame and is in electrical communication with an electrode assembly and the sensor to receive the first signal substantially at the first time and the second signal substantially at the second time. Based in part on the gait characteristic at the first time, the electric stimulator sends a third signal to the electrode assembly to provide an electric stimulation to a portion of a neuromuscular system of the limb substantially during a time period defined between the first time and the second time.

Abstract: A method for reducing overactive bladder syndrome applied with an electrical stimulation device to electrically stimulate a target zone of an organism suffering from overactive bladder syndrome. The electrical stimulation device comprises at least one electrical stimulation unit. The electrical stimulation unit includes at least one first electrode and at least one second electrode. The method includes the following steps. The electrical stimulation unit is placed near the target zone. The electrical stimulation unit generates an electrical stimulation signal and the electrical stimulation signal is introduced to the target zone so as to stimulate the target zone. An electrical field is generated between the first electrode and the second electrode and covers the target zone. The strength of the electrical field ranges from 100 V/m to 1000 V/m.

Abstract: A bioelectric signal generation and application method generates a signal that comprises a succession of pulses arranged either in continuous trains or in separated bursts; in which each pulse within a train or burst comprises at least three distinct intervals of time; in which the first said interval of time has one definite polarity and sufficient current density and duration to cause motion of calcium ions (Ca++) in relation to less strongly charged components of a body, cell or tissue, such as proteins and especially the protein calmodulin (CaM); in which the second said interval of time has substantially zero current density and is of sufficient duration to allow any proteins or other molecules which became distorted by electric fields present during said first interval, and especially CaM, to relax back into their normal, undistorted shapes, said first and second intervals of time thus comprising a “two-step electric process.

Abstract: A symptom-treatment system includes a control unit configured to provide a treatment signal and a treatment unit coupled to the control unit to receive the treatment signal. The treatment unit is coupled to a patient to communicate the treatment unit to the patient.

Abstract: The present invention relates to a neural prosthesis. In its most general form, the neural prosthesis comprises an electrode array including a stimulating electrode (801) and a bipolar return electrode (802). The neural prosthesis also comprises a monopolar return electrode (806), a first electrical return path (812) associated with the bipolar return electrode (802) and a second electrical return path (814) associated with the monopolar return electrode (806) wherein, in use, the stimulating electrode (801) provides a stimulating current to the tissue of a recipient and a total return current is divided between a first current in the first electrical return path (812) and a second current in the second electrical return path (814).

Abstract: An electronic stimulation device is adapted for electrically stimulating a target zone of an organism with relative low pain sensations without generating relative much sensations of paresthesia. The electronic stimulation device comprises at least one electronic stimulation unit. The electronic stimulation unit includes at least one first electrode and at least one second electrode. The electronic stimulation unit receives a high-frequency electrical stimulation signal to impel the first electrode and the second electrode to generate an electric field. The range of the electric field covers the target zone, and the electric field strength ranges from 100 V/m to 1000 V/m. The frequency of the high-frequency electrical stimulation signal ranges from 200 KHz to 1000 KHz.

Abstract: An example of a method performed by an implantable medical device (IMD) to deliver a therapy to a patient may include delivering the therapy to the patient, detecting a trigger that is controlled by the patient or a caregiver to the patient, and determining if at least one feature of the IMD for responding to a trigger is enabled. The IMD may be configured to allow the patient or the caregiver to the patient to enable the at least one feature. The method may further include, when the at least one feature is enabled, automatically implementing the at least one enabled feature in response to the detected trigger, including automatically suspending the therapy in response to the detected trigger and automatically restoring the therapy after a defined period after the detected trigger.

Abstract: A therapeutic window for at least one electrode of a medical system may be determined based on a volume of tissue expected to be activated (“VTA”) by electrical stimulation delivered by the at least one electrode. In some examples, a processor determines the therapeutic window for a particular electrode by at least determining an efficacy threshold based on the VTA expected to result from the delivery of electrical stimulation according to a set of electrical stimulation parameter values including the stimulation parameter at the efficacy threshold, and determining an adverse-effects threshold based on the VTA expected to result from the delivery of electrical stimulation according to a set of electrical stimulation parameter values including the stimulation parameter at the adverse-effects threshold.

Abstract: Systems and methods for stimulation of neurological tissue generate stimulation trains with temporal patterns of stimulation, in which the interval between electrical pulses (the inter-pulse intervals) changes or varies over time. Compared to conventional continuous, high rate pulse trains having regular (i.e., constant) inter-pulse intervals, the non-regular (i.e., not constant) pulse patterns or trains that embody features of the invention provide a lower average frequency.

Abstract: Systems and methods for stimulation of neurological tissue generate stimulation trains with temporal patterns of stimulation, in which the interval between electrical pulses (the inter-pulse intervals) changes or varies over time. Compared to conventional continuous, high rate pulse trains having regular (i.e., constant) inter-pulse intervals, the non-regular (i.e., not constant) pulse patterns or trains that embody features of the invention provide a lower average frequency.

Abstract: Techniques and systems for monitoring cardiac arrhythmias and delivering electrical stimulation therapy using a subcutaneous device (e.g. subcutaneous implantable (SD)) and a leadless pacing device (LPD) are described. In one or more embodiments, a computer-implemented method includes sensing a first electrical signal from a heart of a patient through a SD. The first signal is stored into memory and serves as a baseline rhythm for a patient. Subsequently, a second signal is sensed from the heart through the SD. A cardiac condition can be detected within the sensed second electrical signal through the SD. A determination is made as to whether cardiac resynchronization therapy (CRT) is appropriate to treat the detected cardiac condition. A determination can then be made as to the timing of pacing pulse delivery to cardiac tissue through a leadless pacing device (LPD).

Abstract: An example of a system for comparing neurostimulation waveforms can include a user interface configured to receive user input that at least partially defines a first neurostimulation waveform with at least one of differing pulses and differing pulse intervals, where the user input including at least one received parameter of the first neurostimulation waveform. The system can include a storage device configured to store at least one parameter of at least one second neurostimulation waveform, a comparator configured to compare the at least one received parameter of the first neurostimulation waveform to a corresponding at least one parameter of at least one second neurostimulation waveform stored in a memory, the user interface configured to generate and display to the user an indication of a similarity between the compared parameters.

Abstract: Techniques for facilitating authorized telemetry with an implantable device are provided. In one embodiment, for example, a method includes comparing, by a first device having a processor, first electronic information with second electronic information. The first electronic information is indicative of a first motion of a second device external to a body in which the implantable device is located, and the second electronic information is indicative of a second motion of the implantable device. The method also includes determining whether a defined level of correlation exists between the first electronic information and the second electronic information, and initiating a telemetry session between the second device and the implantable device based on a determination that the defined level of correlation exists between the first electronic information and the second electronic information.

Abstract: A medical device can include a housing, an energy storage module within the housing to store an electrical charge, and a defibrillation port to guide via electrodes the stored electrical charge to a person in need of medical assistance. The medical device can also include a processor to perform a patient signal analysis on an electrocardiogram (ECG) signal corresponding to the person and further determine, based on a result of the patient signal analysis, whether post-shock transcutaneous pacing should be performed on the person.

Abstract: A system for managing care of a person receiving emergency cardiac assistance is disclosed that includes one or more capacitors for delivering a defibrillating shock to a patient; one or more electronic ports for receiving signals from sensors for obtaining indications of an electrocardiogram (ECG) for the patient; a patient treatment module executable on one or more computer processors to provide a determination of a likelihood of success from delivering a future defibrillating shock to the person with the one or more capacitors, using (a) information about a prior defibrillating shock, and (b) a value that is a function of current ECG signals from the patient.

Abstract: A phototherapy apparatus with interactive user interface for treating biological tissue of an animal or human target. The user interface comprises intuitive graphic menus which allow the clinicians or practitioners to define the properties of the biological tissue through easily observable physical characteristics such as weight, skin color, and hair color of the patient. The central control unit of the phototherapy apparatus then automatically optimizes the parameters of the light source according to the properties of the biological tissue and generates an appropriate treatment protocol to produce the optimum phototherapy result.

Abstract: A system for photodynamic therapy is provided that includes a light delivery device that delivers the illumination necessary to perform photodynamic therapy. The light delivery device includes one or more etched fibers arranged to illuminate a selective region of a body for photodynamic therapy. An illumination device is coupled to the light delivery device to provide the necessary illumination to the light delivery device.

Abstract: Brachytherapy oncology treatment systems and methods are provided. One such system and method employs a catheter or tandem and a mobile balloon device having an enclosed inner volume and an internal surface with an internal perimeter size larger than the external surface perimeter size and adequate to allow sliding longitudinal movement between the catheter or tandem and the mobile balloon device. The mobile balloon device has a radiation dose delivery tube that is at or moves by inflation to a strategic radiation dose delivery location for brachytherapy. An embodiment allows for a multi-part catheter or tandem having a detachable distal section suitable for retaining within a body cavity such as the uterus, both during radiation treatment and during recovery time between radiation treatments. This distal portion can be intended for single-patient use and be disposed of after completion of a radiation treatment session having multiple radiation dose treatment times.

Abstract: The invention relates to a method and apparatus for generation of two-dimensional images using X-rays, proton tomography, and/or carbon ion tomography to form one or more independent and/or integrated three-dimensional images of a tumor, where the proton and carbon cation beams use common elements of a tumor treatment beam, such as an injector, accelerator, and/or beam transport device. A previously collected image of the tumor and/or a current/real-time image control slice is used in control of a multi-axes and/or a multi-field tumor irradiation system for cancer irradiation.

Abstract: A control circuit accesses patient information and treatment-platform information and uses that information to automatically suggest a treatment plan having at least one of a given number of treatment-pathway traversals wherein the given number is permitted to be greater than one and sub-treatment-pathway traversal-based physical alterations to at least one of the dynamic elements of the dynamic radiation-treatment platform. By one approach the aforementioned patient information can refer, at least in part, to the patient's external contour and a treatment target's size and position with respect to the patient. The patient information regarding the treatment target can represent the latter as a simple symmetrical geometric shape (such as a cuboid). The treatment-platform information, in turn, can refer, at least in part, to dynamic elements of the dynamic radiation-treatment platform itself.

Abstract: A medical device includes a treatment module configured to apply a treatment to a patient. The medical device includes an interface configured to operatively connect to a removable storage device storing authorization data that identifies a level of treatment authorization. The medical device includes a processing device configured to perform operations in response to receiving user input indicating a treatment should be initiated. The operations include determining whether the removable storage device is valid for use with the medical device. If the removable storage device is determined to be valid, the authorization data is accessed. The processing device determines whether the treatment is authorized based on the accessed authorization data. If the treatment is determined to be authorized, the treatment module is controlled to apply the treatment. If the treatment is determined to not be authorized, the treatment module is controlled such that the treatment is not applied.

Abstract: An ultrasonic motion generator includes a non-resonant inverter, an ultrasonic transducer, and a comparator. The non-resonant inverter inverts direct current (DC) to alternating current (AC) having a first frequency. The ultrasonic transducer is electrically coupled with the non-resonant inverter and generates an ultrasonic motion based on the inverted AC. The comparator automatically detects a deviation of the first frequency from a resonant frequency of the ultrasonic transducer based on motion current passing through the ultrasonic transducer and generates an output signal based on the deviation to drive the non-resonant inverter.

Abstract: A respiration system is provided with a container (1) in which, by an exothermic chemical reaction of a reaction material, CO2 is removed from the respiration air or oxygen is generated, and with an indicator of the consumption of the reaction material. The consumption indicator has a predetermined amount (7) of material which can be melted by the reaction heat of the exothermic chemical reaction. The material is kept in thermal contact with the container interior in such a manner that a measurement of the total reaction heat, and thus the consumption of reactive material, can be read from the degree of melting of the meltable material.

Abstract: Apparatus and associated methods relate to an automatic fluid alarm that provides a fluid-communication path between a secondary fluid source and a whistle port when a primary fluid source experiences a reduction in pressure, the automatic fluid alarm being user resettable by disconnecting the primary fluid source or otherwise reducing the primary source pressure and activating a reset member, thereby interrupting the fluid-communication path. In some examples, a piston member may provide a movable seal for providing the fluid-communication path and its interruption. An exemplary piston member may be slidably reset in a non-interrupting mode by an adequate primary fluid pressure, and slidably set in an interrupting mode by a user activation. The interrupting mode may silence the whistle which may facilitate user communication during what may be a stressful primary fluid source failure event. Some exemplary automatic fluid alarms may conserve secondary fluid when the whistle is silenced.

Abstract: A protective breathing mask assembly comprises a face mask portion 10 having a brow support 5 at the top thereof which, in use, extends around the brow of the wearer, and a face seal 6 which extends around the back edge of the mask portion 10 so as, in use, to engage around the sides of the wearer's face to prevent the ingress of material into the mask portion. The mask assembly further includes a rear of head strap 4 which extends between the ends of the brow support 5, in use, around the back of the wearer's head. A crown strap 2 is connected to opposing sides of the mask assembly so as, in use, to extend across the top of the wearer's head in opposing relation to the face seal 6, thereby pulling the face seal up against the wearer's face.

Abstract: A snap hook includes a body, a gate, a connection link, and a coupling. The body has a central portion positioned between an upper portion and a lower portion. The gate is pivotally coupled proximate the central portion. The gate and the body selectively form a closed configuration that defines a hook connection passage and an open configuration that provides access to the hook connection passage. The connection link has an upper end pivotally coupled proximate the central portion of the body and a lower end including a body connection aperture. The coupling interconnects the lower end and the lower portion. The coupling is configured to break when a select amount of force is applied to the lower end and release the lower end from the lower portion to redirect the select amount of force from the lower portion to the central portion of the body.

Abstract: A method of conditioning oxygen depleted air (ODA) exhausted from a fuel cell comprising the steps of; taking fuel from an aircraft fuel tank collector cell, delivering said fuel to a rear mounted engine via a primary heat exchanger, taking exhaust ODA from a fuel cell, passing the ODA through the primary heat exchanger in the opposite direction to the fuel, such that the fuel acts as a heat sink for the ODA, to cool the ODA, passing the ODA through a dryer, to dry the ODA and using the cooled, dried ODA to inert fuel in the aircraft fuel tank.

Abstract: Fixed systems and method for extinguishing large scale industrial tank fires, with and without fixed roofs, and featuring aerated foam projecting nozzles and including fixed center directed nozzles.

Abstract: A fire detection device and method therefor are able to provide automatic activation so as to extinguish a fire. The fire detection can be rapid and temperature-based. In one embodiment, a heat collector can be provided to enhance thermal responsiveness. Activation of the fire detection device can be electrically induced to release an extinguishing agent at the fire. The activation can be protected such that it is durable and unaffected by vibrations.

Abstract: A bottom-hinged intermediate-locking barbell holder includes a pair of opposed holding bodies connected along their bottoms by a hinge. In a closed position, the handle sections form a handle for gripping and the bases define a generally cylindrical channel, near the hinged bottom, in which compressible gaskets and a handle of a dumbbell may be received and securely contained. A cam latch releasably secures the intermediate sections together.

Abstract: A weight bar support assembly for safely supporting a weight bar on exercise equipment in the event the user cannot return the weight bar to its original position includes an attachment bracket and a weight support member forming a catch arm which is selectively engaged with and moved away from an upright of the exercise equipment. An energy absorbing arrangement is incorporated within either the attachment bracket or the weight support member, and is configured to cushion forces transmitted to the upright upon contact of the weight bar with the weight support member to prevent deformation and/or damage of the exercise equipment.

Abstract: A seated exercise apparatus comprises a frame having a seat attached to the frame. A pair of opposed cranks are rotatably coupled to the frame such that they rotate about a first axis. A first end of each of a pair of elongated members is rotatably connected to the frame at a respective pivot joint. A second end of each of the elongated members is connected to a respective. The pivot joints are located outside of a plane of motion of their respective right and left pedals, such that the apparatus can fit within a more compact form factor, especially in a longitudinal dimension. The pedals move in a reciprocating path having an elliptical shape, in which the major axis is more vertical than horizontal, giving a more up and down, natural, pedal motion.