US20060116617A1 - Suspension walker - Google Patents

Abstract

A suspension walker having a hard, outer boot shell with upright brace members attached on either side and a soft boot receivable thereon. The soft boot has a main pad in it with a removable, fitting pad or pads on top of the main pad. A cuff member is also provided that is securable to the patient's calf and to the upright brace members. In use, the fitting pad is removed during the initial fitting and subsequent uses to suspend the patient's foot in the walker. The cuff member is also infinitely adjustable along the brace members to vary the fit as desired.

Description

RELATED APPLICATION
• This application is a continuation of U.S. patent application Ser. No. 10/658,069 filed Sep. 9, 2003, which is incorporated herein by reference.
BACKGROUND OF THE INVENTION
• 1. Field of the Invention
• This invention relates to the field of suspension walkers and more particularly to the field of such walkers that transfer weight normally borne by the patient's foot to his or her calf.
• 2. Discussion of the Background
• Many people and diabetics in particular develop sores or ulcers on the soles of their feet. To heal, they must either stay off their feet altogether or use a pressure relieving orthosis or brace. Generally, these orthoses are of two designs.
• In the first design as typified by U.S. Pat. No. 5,761,834 to Grim, the orthosis is provided with adjustable pads (see itsFIGS. 7-12) in which the contour and/or density of the pad sections is modified. In the modification ofFIG. 8 of this patent, for example, a piece of a sectionalized pad is removed at186 in an effort to relieve pressure on the area of the sore. This first approach has not met with great success as the gap (in the case ofFIG. 8 of this patent) or the contour/density changes of the other figures of this patent tend to present their own pressure or rubbing points and may make new sores or make the existing sore worse. The removed section in particular often creates a suction on the sore as the patient walks that aggravates it in addition to the sides of the gap rubbing on the area around the sore creating new sores.
• In a second design commonly known as custom suspension walkers, the concept is to transfer some of the weight normally borne by the foot to the patient's calf. In doing so, a leather or similar wrap or cuff fits around the calf of the patient wherein the cuff is secured to the patient's calf and to upright braces extending downwardly to a hard boot or shoe. In use, a large portion (e.g., 50%) of the patient's weight is then transferred to his calf and off of his foot. In essence, the patient's foot is suspended at least to the extent of the weight borne by the calf via the cuff and braces extending downwardly to the shoe.
• In one prior technique for making a suspension walker, a negative cast of the patient's foot is first taken. The cast is then cut down the front so the patient can remove his foot and the cut cast is sent to a custom manufacturer. The manufacturer can subsequently follow one of many procedures to make a custom walker. In one procedure, a positive cast is made from the hollow, negative cast and a leather cuff is sweated (tightly fitted) about the calf area. The cuff is then mounted on the vertical braces at a height slightly greater (e.g., ½ inch) than the true position of the original cast. In use, the person puts his calf in the cuff and laces it up. In doing so, the cuff fits the calf but since the cuff has been raised on the braces, the effect is that the foot is slightly suspended in the shoe with the calf via the cuff and braces now bearing some of the patient's weight.
• In another procedure, the negative cast is cut below where the cuff would be and a spacer inserted to in essence raise the normal position of the calf and cuff. The leather cuff is then sweated (fitted) to the calf of the positive cast but unlike the first procedure, the cuff can be attached to the brace members at the same level as the cast and does not need to be raised. Because the positive cast has the calf area slightly higher than normal, the end result is thus the same as in the first procedure (i.e., weight is transferred to the calf and the foot is suspended).
• Current suspension walkers and the fitting techniques discussed above are very effective; however, they have two, primary drawbacks. First and foremost is the time. That is, the injured patient normally needs a walker at the same time (i.e., immediately) he complains of or is diagnosed with the sore. However, the custom manufacture and the fitting procedures mentioned above normally take days and often weeks. The patient also usually needs to make a follow-up visit to the doctor or manufacturer to make sure the fit is correct and he knows how to use the walker. Second, custom walkers are relatively expensive as they are very labor intensive at the manufacturer level and as previously indicated normally require multiple fitting trips to the physician, practitioner, or therapist in addition to the original casting person.
• With the above in mind, the present invention was developed. With it, a suspension walker is provided that can be immediately fitted to the patient in the office of the physician, practitioner, or therapist. The walker avoids the need for taking castings and the custom work mentioned above. It can also be made available in prefabricated sizes and for less expense as there is very little labor involved in fitting the walker to the patient and training the patient in its proper use.
SUMMARY OF THE INVENTION
• This invention involves a suspension walker. The walker includes a hard, outer boot shell with upright brace members attached on either side. A soft boot is received in the shell and has a main pad in it with a removable, fitting pad or pads on top of the main pad. The soft boot has a tongue and two side flaps that open up to expose the inside of the soft boot and to receive the patient's foot. A cuff member is also provided that is securable to the patient's calf and to the upright brace members. To fit the patient, the cuff member is attached comfortably about the patient's calf and then the patient puts his foot into the open boot. Normally, the patient is sitting down as he puts his foot into the boot atop the main pad and the removable, fitting pad. Up to this point, the upright brace members preferably have plastic covers over them. In this regard, the cuff member has one portion of hook and loop or VELCRO® fasteners on each outer side. Additionally, the brace members have the other portions of hook and loop fasteners on their respective insides. In this way and with the patient's foot in a fitted position in the soft boot, the plastic covers can be removed from the brace members wherein the cuff member will be secured to the brace members at the desired position via the hook and loop fasteners.
• The fitting pad can then be manually removed and the tongue and side flaps of the soft boot closed with the result that the foot is at least partially suspended via the cuff and brace members on the main pad. In a typical procedure, the fitting pad may be ½ inch thick for the fitting step wherein 50% or so of the patient's weight is transferred off the foot to the calf and via the cuff and brace members to the hard, outer boot shell.
• With this new design, the suspension walker is immediately available for use by the patient to begin healing the sore. Additionally, the physician, practitioner, or therapist can easily and quickly set the proper or desired degree of weight suspension by using different thicknesses of the removable, fitting pad or pads (e.g., ¼ or ½ inch pad or the two together to equal a ¾ inch pad). This is done at the first office visit with immediate feedback from the patient on how it feels versus the often imprecision and follow-up fittings nearly always needed with present custom walkers, which have many steps done without the patient present.
• Another fundamental advantage of the present design is that the patient on subsequent days can then duplicate the fitting originally done by the physician, practitioner, or therapist. In doing so, the patiently only has to re-insert the fitting pad(s) into the soft boot with the cuff member already attached in the desired position to the brace members by the hook and loop fasteners. The cuff member can subsequently be laced up with the patient's foot in the soft boot followed by the removal of the fitting pad(s). In contrast, the prior walkers required some experimentation and mental input by the patient on subsequent days to try to duplicate the exact location of the cuff member on the calf to give the desired amount of suspension. With diabetic patients that often have little feeling in their feet and legs, this can be a substantial problem. Further, if the original fit needs to be modified (e.g., thicker or thinner fitting pad), the hook and loop fasteners between the cuff and brace members can be readily and infinitely adjusted. This is an important advantage as the area of the patient's leg/foot often changes (e.g., swells or atrophies) over time. Further, the present design can be prefabricated in various sizes greatly reducing the cost over current, custom walkers made from castings of the patient's foot and lower leg.
BRIEF DESCRIPTION OF THE DRAWINGS
• FIG. 1 is a perspective view of the suspension walker of the present invention.
• FIG. 2 is an exploded view of the suspension walker.
• FIG. 3 is a side elevational view of the hard, outer boot shell and the soft boot received thereon.
• FIG. 4 is a perspective view of the soft boot of the suspension walker.
• FIG. 5 is a side elevational view of the soft boot ofFIG. 4.
• FIG. 6 is a side elevational view of the soft boot with its side flaps and tongue open to receive the patient's foot.
• FIG. 7 is a top plan view ofFIG. 6.
• FIGS. 8-13 illustrate the preferred fitting method of the present invention.
• FIG. 14 is a view taken along line14-14 ofFIG. 13 illustrating one of the strap members that can be wrapped around the brace members.
• FIG. 15 illustrates the use of a second, removable fitting pad in the fitting method of the present invention.
• FIGS. 16 and 17 illustrate the manner in which the patient can subsequently put on the suspension walker to duplicate the original fitting position set by the physician, practitioner, or therapist.FIGS. 16 and 16aalso illustrate how the physician, practitioner, or therapist can choose from a variety of different, prefabricated sizes of each piece of the suspension walker to best fit the patient.
• FIGS. 18 and 19 illustrate the elastic, heel section of the cuff member to aid the patient in putting on and taking off the cuff member.
• FIGS. 20-22 includingFIG. 20aillustrate an alternate manner of releasably securing the cuff member to the patient's calf combing the benefit of the even pressure of laces with the convenience of a quick attachment arrangement such as hook and loop fasteners.
DETAILED DESCRIPTION OF THE INVENTION
• As best seen inFIG. 1, the suspension walker1 of the present invention includes a hard,outer boot shell3 withupright brace members5 respectively extending upwardly to positions adjacent each side of the patient'scalf2. Positioned within theboot shell3 is asoft boot7 to receive the patient's foot. The suspension walker1 further includes acuff member9 securable bylaces11 or other means to the patient'scalf2 and securable by pairs of mating hook andloop fasteners13 and15 (see alsoFIG. 2) to theupright brace members5 of the hard,outer boot shell3. The pairs of hook andloop fasteners13 and15 or other releasable attaching means as illustrated inFIGS. 1 and 2 preferably have one member (e.g.,hook fastener13 inFIG. 2) of each pair extending vertically along the inside surfaces of thebrace members5 and the other member (e.g., loop fastener15) of each fastener pair mounted on each outer side of thecuff member9.
• The hard,outer boot shell3 andsoft boot7 as shown inFIG. 3 are removably attached to each other (e.g., by hook and loop fasteners17 and19). Thesoft boot7 itself (seeFIG. 4) has foldable side flaps21 and23 and afoldable tongue25 with an adjustable heel area of overlapping and releasablysecurable pieces27 and29. Thesoft boot7 as further illustrated inFIGS. 5-7 has a main pad31 (which can be multi-layered as shown withlayers31′ and31″ or a single layer) and a removable,fitting pad33 stacked atop the main pad31 (seeFIG. 5). Thefitting pad33 preferably has afinger loop35 on the toe end thereof and flaps21,23 andtongue25 of thesoft boot7 can be opened as shown inFIGS. 6 and 7.
• In the preferred fitting method of the present invention as shown inFIGS. 8-13, thecuff member9 is secured by thelaces11 about the patient's socked calf2 (seeFIG. 8). With theflaps21,23 andtongue25 of thesoft boot7 opened (see againFIG. 8) and with tubular,plastic cover member37 preferably over eachbrace member5, the patient'sfoot4 is received in the soft boot7 (FIG. 10) atop the removable,fitting pad33. The tubular cover members37 (seeFIGS. 8 and 9) in this regard are preferably positioned over thebrace members5 at this point to act as barriers to the engagement of the pairs of hook andloop fasteners13 and15 respectively on the insides of thebrace members5 and the outer sides of thecuff member9. Consequently, thecuff member9 can be readily slid between and past thebrace members5 from the position ofFIG. 8 to the position ofFIG. 10. The patient can be standing during this but is preferably sitting as inFIG. 10 to comfortably place his or herfoot2 in thesoft boot7 atop the removable,fitting pad33 preferably with less than his or her full normal weight on thefoot4 and removable,fitting pad33.
• With the patient'scalf2 andfoot4 positioned as desired by the physician, practitioner, or therapist inFIG. 10, the fitting method then proceeds wherein the tubular cover members37 (which to this point have acted as barriers to the engagement of the pairs of hook andloop fasteners131 and15) are removed as illustrated inFIG. 11. The pairs of mating hook andloop fasteners13 and15 are then secured together as also shown inFIG. 11. With thecuff member9 secured to the vertically extending,upright brace members5, thefitting pad33 can now be removed (seeFIG. 12) by, for example, hooking a finger in theloop35 on the end of thefitting pad33. The side flaps21,23 andtongue25 are thereafter closed over the patient's foot4 (seeFIG. 13) withflaps21 and23 fastened together with hoop and loop fasteners. Straps such as39 inFIGS. 1 and 2 if desired can be included over theclosed flaps21 and23 to comfortably hold the patient'sfoot4 in place. Further, if desired, one or more strap members41 (seeFIGS. 13 and 14) can be wrapped around and secured to the outsides of thebrace members5 via hook andloop fasteners13′ and43 (seeFIG. 14) to aid in keeping thebrace members5 andcuff member9 securely attached to one another. Thestrap members41 in this regard can be a simple arrangement ofbuckle45 andelongated strip47 as inFIG. 14 extending about thebrace members5 and back on itself through thebuckle45. Thestrip47 can then be additionally secured in place to itself by hook andloop fasteners49 and51 along the overlapping sides of thestrip47.
• In the position ofFIG. 13 following the fitting method ofFIGS. 8-13, the patient'sfoot4 is now at least partially suspended in the walker1. That is, at least a portion of the patient's weight normally applied to his or herfoot4 is now transferred to and borne by the patient'scalf2 via thecuff member9 secured to thebrace members5 of the hard,outer boot shell3. Consequently, as the patient walks or otherwise moves around, the patient'sfoot4 does not bear the weight it normally would. Depending upon how the patient is moving and any other aids he or she may be using (e.g., crutches, cane), whatever weight that would normally be applied to thefoot4 is at least partially transferred to his or hercalf2 and off of thefoot4. With the patient only using the suspension walker1 ofFIG. 13 of the present invention, the weight transferred during a normal stride with the other foot off the ground could be virtually any percentage, but preferably is in the range of at least 10%-75% and more preferably in the range of 40%-60%. In most cases, the higher the percentage of weight transferred, the better including up to 100% if the patient can otherwise safely handle it (e.g., maintain his or her balance). In most applications, the patient's heel as shown inFIG. 13 will actually be spaced or suspended (e.g., 3/16 or ¼ inch) above themain pad31.
• To assist in fitting the patient to transfer as much as desired of his or her such normal weight to thecalf2, the removable,fitting pad33 can be made as thick or thin as needed. Also, a second, removable fitting pad such as33′ inFIG. 15 withfinger loop35′ (or any additional number of them) can be placed atop the firstfitting pad33. In this regard, it is anticipated thefitting pad33, for example, may be ½ inch thick and the secondfitting pad33′ on the order of ¼ inch thick. Thefitting pads33 and33′ could then be used individually (i.e., as separate ½ or ¼ inch adjustments) or together as inFIG. 15 to make an adjustment of ¾ inch. It is noted as to the range of the relative positioning of thecuff member9 vertically on thebrace members5 that thecuff member9 is preferably infinitely adjustable to as precisely as possible fit the patient's needs. That is, thecuff member9 of the preferred embodiment can be positioned at virtually any desired location vertically along eachbrace member5 within the limits of the overlapping, vertically extending hook andloop fasteners13,15. Thecuff member9 is thus infinitely, adjustably securable to eachbrace member5 in any desired location vertically along a predetermined length of eachbrace member5. Also, thefasteners15 of thecuff member9 could be portions of one, continuous member but preferably are separate strips as shown. It is additionally noted that the hook and loop fasteners mentioned throughout the description of the invention could be any other releasable securing means but hook and loop ones are preferred.
• A great advantage of the fitting method ofFIGS. 8-13 is that it can be done in one, simple visit with the physician, practitioner, or therapist. In contrast as discussed above, custom suspension walkers often take weeks and multiple trips to make and fit. Additionally and to the extent it is desirable to adjust the fit ofFIGS. 8-13, the fitting method can be easily and quickly redone to position thecuff member9 at virtually any number of infinite locations along thebrace members5. A further advantage of the present invention is that virtually all of the pieces (e.g.,boot shell3,soft boot7, andcuff member9 ofFIG. 16) of the suspension walker1 can be prefabricated in various sizes, as for example, the respective smaller sizes ofboot shell3′,soft boot7′, andcuff member9′ ofFIG. 16a. In this manner, the physician, practitioner, or therapist can easily select the proper size of each piece from a variety of them on hand. The patient can then be properly fitted and begin using the suspension walker1 immediately to relieve weight from the damaged foot and to begin the healing process. No waiting or delay to receive the walker is involved. With diabetic and other patients as discussed above, this is extremely important.
• Once the initial, fitting process is accomplished as inFIGS. 8-13, the same fit and unweighting ofFIG. 13 can be subsequently duplicated by the patient by himself or herself on later uses of the suspension walker1 of the present invention. More specifically and as illustrated inFIGS. 16 and 17, the patient in subsequent uses need only place his or herfoot4 into the cuff member9 (FIG. 16) and atop the removable,fitting pad33 ofFIG. 17. The removable,fitting pad33 in this regard has been replaced atop the multi-layeredmain pad31 after the prior use of the suspension walker1. In the position ofFIG. 17, thelaces11 or other securing means can then be tightened to secure thecuff member9 to thecalf2. The steps ofFIGS. 12 and 13 can thereafter be repeated and the suspension walker1 is again properly fitted in the identical position originally set by the physician, practitioner, or therapist. As an aid to sliding the patient'sfoot4 into and out of thecuff member9, an elastic,expandable heel section53 is provided at the lower rear area of the cuff member9 (seeFIGS. 18 and 19). In use as best seen inFIG. 18, theheel section53 expands as the patient would pull up on thecuff member9 while inserting his or herfoot4. Conversely, in removing thecuff member9, theheel section53 expands as the patient would push down on thecuff member9 while withdrawing his or herfoot4.
• As mentioned above and although hook and loop fasteners have primarily been used throughout the description of the present invention to releasably secure or attach the various members together, other releasable securing means (e.g., buckles, straps, snaps, buttons) could be used if desired. Also, the suspension walker1 preferably useslaces11 to removably secure thecuff member9 to the patient'scalf2 although other securing means (e.g., hook and loop fasteners, buckles, snaps) could be used. Laces in this use are preferred as they create a more evenly distributed pressure over the calf area.
• In this last regard,FIGS. 20-22 illustrate an alternate way of releasably securing thecuff member9 to the patient'scalf2. This alternative manner combines the benefit of laces (i.e., even pressure) with the convenience of a quick attachment arrangement (e.g., hook and loop fasteners). More specifically as shown inFIG. 20, each set of upper andlower laces11 is passed througheyelets55 on eachside piece9′ of thecuff member9. The free ends11′ of thelaces11 are then gathered and releasably secured in place adjacent one of theside pieces9′ by respective clamp members57 (seeFIG. 20a). Theclamp members57 can be free standing as inFIGS. 20 and 20aor mounted to theside piece9′ if desired. The two sets oflaces11 as shown inFIG. 20 are preferably provided in a mirror image manner. In use, thestrips59 to which the other ends11″ of thelaces11 are attached (e.g., sewn) are thereafter crossed over (seeFIG. 21) to the respectiveother side9′ of thecuff member9 to pull the respective sets oflaces11 tight. Thestrips59 are subsequently wrapped around thebrace members5 andcuff member9 and around on themselves as inFIG. 22. The strips59 (seeFIG. 20) likestraps41 inFIGS. 13 and 14 have mating hook andloop fasteners61 and63 on opposite sides of eachstrip59 and can thereby be secured in place (FIG. 22) to each other and to thebrace members5. An additional,top strip65 betweenbuckles67 as shown inFIG. 22 can also be provided if desired and similarly secured in place by hook and loop fasteners.
• In the alternative manner ofFIGS. 20-22, thecuff member9 can be easily and quickly put on and taken off the patient'scalf2. Additionally if needed, the effective lengths of thelaces11 of each set can be individually or collectively shortened by releasing the clamp members57 (e.g., depressingmember58 inFIG. 20a) and pulling the lace ends11′ away from thecuff member9 inFIG. 20. Similarly, the effective lengths can be lengthened by pulling the other lace ends11″ or attachedstrips59 away from thecuff member9 with theclamp members57 released. As indicated above and with the alternate design ofFIGS. 20-22, the benefit of laces (i.e., even pressure) with the convenience of a quick attachment method (e.g., hook and loop fasteners) is achieved. Although specifically shown in use to releasably secure thecuff member9 about the patient'scalf2, the alternate design ofFIGS. 20-22 could be used to removably secure any member about any part of the patient's body or about any object.
• While several embodiments of the present invention have been shown and described in detail, it to be understood that various changes and modifications could be made without departing from the scope of the invention.

Claims (7)

1-41. (canceled)

42. (not entered)

43. The suspension walker ofclaim 42 wherein said cuff member is infinitely, adjustably securable to said brace members by respective pairs of mating hook and loop fasteners respectively mounted vertically along said cuff member and each of said brace members.

44. The suspension walker ofclaim 43 wherein each brace member has inner and outer sides and one of each pair of mating hook and loop fasteners is mounted vertically on the inner side of each brace member.

45. The suspension walker ofclaim 42 wherein said cuff member is releasably securable about the calf of the patient by laces.

46. (not entered)

47-48. (canceled)

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