Note : Les descriptions sont présentées dans la langue officielle dans laquelle elles ont été soumises.
CA 02838424 2014-08-25
HEEL ULCER PREVENTION AND CUSHIONING BOOT
RELATED APPLICATION
This application is a continuation-in-part of co-pending U.S. Patent
7,798,984.
BACKGROUND OF THE INVENTION
This invention relates to patient care, and in particular to a cushioning boot
for the
comfort and protection of a bed-ridden patient.
Boot-like structures have been developed for protecting a patient who is
bedridden for
any number of reasons. The boots provide heel support and comfort, as well as
proper
positioning of the patient's leg to avoid creating other problems, such as
ulcers, for a patient
that must remain bedridden for a long period of time. Such structures are
disclosed in U.S.
Patent Nos. 4,186,738; 5,226,245; 5,853,380; 5,876,364 and 6,640,810, for
example. Such
devices, while better than nothing at all, still have not solved the problem
of creation of other
problems for patients who are bedridden.
Other boot-like devices have been developed for strengthening or protecting a
person's foot and leg. Examples of such devices are found in U.S. Patents Nos.
5,078,128,
5,464,385, 6,126,627, 5,472,414 and 5,050,620. A similar device, when used to
help
transporting of an invalid patient, is set forth in U.S. Patent No. 5,052,128.
The present invention is directed to an improved cushioning boot, used
primarily with
patients who are bedridden for an extended period of time. The invention
provides comfort
and extended wear unavailable in the prior art.
SUMMARY OF THE INVENTION
The invention is directed to a cushioning boot, comprising a leg engaging
portion and
a foot engaging portion, with the portions being padded and having a leg-
accepting aperture
extending along a front side of the boot. An adjustable closure panel is
removably secured to
the boot, a first portion of the panel extending substantially along the leg
engaging portion
and a second portion of the panel extending along a part of the foot engaging
portion.
In accordance with one form of the invention, at least the leg engaging
portion has an
exterior surface having a low coefficient of friction and an interior surface
having a high
coefficient of friction. A leg seated within the foot cushioning boot is
therefore held properly
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in place, but allowed to move with the boot along bed linens or on wherever
else the boot is
being used.
Preferably, a third stretchable, adjustable closure panel is provided,
extending
between and at least partially overlapping the first and second closure panel
portions. The
third closure panel provides increased force at critically desired areas.
Preferably, the panels are made substantially of stretchable fabric or
material, such as
spandex. Also, the first panel portion includes a view port for viewing parts
of the patient's
leg without removing the closure panel. In all forms of the invention, it is
preferred that the
closure panels are secured to one another, and a tether may be provided for
securing the
panels to the foot cushioning boot.
Means is provided for orienting the closure panels for securing the panels to
the boot.
Preferably, this comprises fasteners for securing each of the panels to the
boot, with each
fastener including a first fastening portion on one of the panels and a second
fastening portion
on the boot. Hook and loop fasteners are the preferred form to provide
adequate
adjustability. Also, for orienting, the fastening portions can be color coded
to aid the user.
In another form of the invention, the cushioning boot comprises a leg engaging
portion and a foot engaging portion, with a leg-accepting aperture extending
along a front
side of the boot. The leg engaging portion comprises a leg orienting section
and a leg
cushioning section, with the leg cushioning section being positioned toward
the leg-accepting
aperture and at least partially extending over the leg orienting section.
In this form of the invention, the leg orienting section comprises a pair of
elongated,
padded tubes extending substantially from a heel aperture proximate the foot
engaging
portion to a distal leg opening. The leg cushioning section comprises a
padding which
overlies the tubes. The foot engaging portion is also padded and includes a
foot orientation
section. The foot orientation section comprises a furrow extending
longitudinally in the foot
engaging portion.
In yet another form of the invention, the foot cushioning boot comprises a leg
engaging portion and a foot engaging portion, with the portions having a leg-
accepting
aperture extending along a front side of the boot. An adjustable closure panel
is provided for
fastening the leg engaging portion to a wearer's leg. A guide is provided for
orienting the
closure panel.
In this form of the invention, the guide comprises a first loop formed to
direct
positioning of a portion of the closure panel. The first loop is secured to
the boot such that a
portion of the closure panel passes freely between the first loop and the
boot. Preferably, the
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first loop is secured to the boot in a plurality of space locations forming a
plurality of sub-
loops, the portion of the closure panel having at least one interstice in
registration with the
spaced locations. A second portion of the panel is also provided extending
along the foot
engaging portion of the boot, counter acted by a second loop secured to the
boot. A further
closure panel can be provided overlapping part of the adjustable closure
panel.
In accordance with another aspect of the present invention, there is provided
a
cushioning boot, comprising: a. a leg engaging portion and a foot engaging
portion, and
having a leg-accepting aperture extending along a front side of said boot,
wherein said leg
engaging portion comprises a leg orienting section and a leg cushioning
section, said leg
cushioning section being positioned toward said leg-accepting aperture and at
least
partially extending over said leg orienting section, and said leg orienting
section
comprising a pair of elongated, padded tubes joined at the center of the leg
engaging
portion and extending in a longitudinal direction substantially from a heel
aperture
proximate said foot engaging portion to a distal leg opening.
BRIEF DESCRIPTION OF THE DRAWINGS
The invention is described in greater detail in the following description of
examples
embodying the best mode of the invention, taken in conjunction with the
drawing figures, in
which:
Figure 1 is a perspective view of a cushioning boot according to the
invention, when
installed on a patient's leg;
Figure 2 is a side elevational view of one side of the cushioning boot
according to the
invention, with closures in place;
Figure 3 is a view similar to figure 2 of the opposite side of the cushioning
boot;
Figure 4 is a front elevational view of the cushioning boot, with the closures
in
place;
Figure 5 is a top plan view of the cushioning boot, with the closures removed
to illustrate detail;
Figure 6 is cross sectional illustration taken along lines 6-6 of figure 5;
Figure 7 is a front elevational view of a second embodiment of the cushioning
boot, similar to figure 4, with the closures in place;
Figure 8 is a top plan view of the cushioning boot of figure 7, with the
closures removed to illustrate details;
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Figure 9 is a cross sectional illustration taken along lines 9-9 of figure 8;
Figure 10 is an elevational end view of the cushioning boot of the second
embodiment of the invention, taken from the right end of figure 8;
Figure 11 is a cross sectional view taken along lines 11-11 of figure 8;
Figure 12 is an oblique partial cross section of the second embodiment of
the cushioning boot illustrated in figure 7;
Figure 13 is a rear elevational view of the cushioning boot of figure 7, but
with
the closures removed to illustrate detail;
Figure 14 is an end elevational illustration of the cushioning boot taken from
the
right of figure 7;
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.1
Figure 15 is a perspective view of another form of a cushioning boot according
to the
invention; and
Figure 16 is a side elevational view of one side of the cushioning boot of
figure 15.
DESCRIPTION OF EXAMPLES EMBODYING THE BEST MODE OF THE
INVENTION
A first form of a cushioning boot according to the invention is shown
generally at 10
in drawing figures 1-6. The cushioning boot comprises two sections, a leg
engaging portion
12 and a foot engaging portion 14 which are generally a unitary structure
being thickly
padded at 16 and having a leg-accepting aperture 18 extending along the front
of the
cushioning boot 10. The padding 16 can be any material, but preferably is as
pillow-like as
possible to replicate the feel of typical hospital pillows which are regularly
used for
supporting a patient's foot.
For maintaining a leg 20 in the cushioning boot 10 as shown in figure 1, the
boot 10
also includes a panel comprising at least two stretchable, adjustable closure
panel portions
removably secured to the boot 10. A first panel portion 22 extends
substantially along the leg
engaging portion 12, and a second panel portion 24 extends along the portion
of the foot
engaging portion 14. A third stretchable, adjustable closure panel 26 is also
included,
extending between and at least partially overlapping the first and second
closure panel
portions 22 and 24. Preferably, the first and second closure panel portions 22
and 24 are a
continuous piece of material cut to shape, and the third closure panel 26 is a
section of similar
material which is joined, at stitching 28, to an area between the first
closure panel 22 and the
second closure panel 24. Other means of attachment of the third panel 26 will
be evident to
one skilled in the art.
The panels 22 through 26 are, as their names suggest, panels rather than
typical straps,
and are both stretchable due to the nature of the material used, and
adjustable due to the
nature of their closures, described below. Preferably, the panels are made
wholly or
substantially of spandex, which is a textile filament fiber in which the fiber
forming
substance is a long-chain synthetic polymer comprised of at least 85% of a
segmented
polyurethane. Other materials similar to spandex can be employed, although
spandex has
been found to be the preferred material to perform as desired.
To allow inspection of patient's leg without opening the first panel 22, the
first panel
portion 22 includes a view port 30 as illustrated. The view port 30 is simply
an area where a
section of the material of the first panel portion 22 has been removed.
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. =
As described in greater detail below, the panels 22 through 28 are fully
removable
from the cushioning boot 10. So as to not be inadvertently lost when removed,
it is preferred
that a tether 32 be included, in the form of the invention illustrated being
simply a strap that
is permanently affixed to the foot engaging portion 14 at 34 and which is
stitched at 36 to the
second panel 24. The material of the tether 32 is unimportant so long that it
is sufficiently
robust to secure the combination of the first through third panels 22 through
28 permanently
to the boot 10. Obviously, it is not mandatory that a tether be used.
As indicated above, the closure panels 22 through 28 are adjustable and
removably
secured to the boot 10. That is by means of fasteners with each of the panels
22 through 28
being removably secured at its opposite ends to the boot 10. Preferably, hook
and loop
fasteners are employed, with the hook portion preferably secured to the
underside of each end
of each of the panels 22 through 26, and the loop portion being sewn or
otherwise affixed on
appropriate exterior locations of the boot 10. Thus, as illustrated in drawing
figures, the first
panel portion 22, at its opposite ends, has elongated fastener hook portions
38 stitched
thereto, and large fastener loop segments 40 secured to opposite sides of the
outside of the leg
engaging portion 12. Similarly, the opposite ends of the second panel portion
24 have a
fastener hook portion 42 secured to the underside thereof which engage
fastener loop
segments 44 secured to the foot engaging portion 14. Finally, the opposite
ends of the third
panel 26 include fastener hook portions 46 stitched on the underside thereof
which engage
fastener loop segments 48 secured to the leg engaging portion 12. The hook and
loop
portions can be the well-known Velcro fastener, or other similar structures.
Other types of
fasteners can be used, as well, although hook and loop fasteners provide
substantial
versatility by permitting incorporation of large loop segments 40, 44 and 48
which permit
significant adjustment of the panels 22 through 26 for proper tension and
orientation.
To also aid in proper placement of the panels 22 through 26, the panels can be
provided with appropriate means for orienting them. For example, the panels
portions 22 and
24 can be fabricated in one color, and secured to portions of the boot 12
having like-colored
loop segments, while the third panel 26 can be fabricated of a different
color, and secured to a
loop segment of the same different color. Alternatively, the ends of the
panels 22 through 26
having the hook portions 38, 42 and 46 can be color-coded, and the receiving
respective loop
segments 40, 44 and 48 can be similarly color-coded. Alternatively still, the
panels and loop
segments can be numbered, lettered or otherwise identified for proper
attachment and
orientation, as will be apparent to one skilled in the art.
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It is important that the patient's leg 20 be properly oriented and retained in
the
cushioning boot 10. At the same time, it is preferable that the foot
cushioning boot 10, with
the leg 20 therein, be readily movable by the doctor or patient, when desired.
To that end, the
cushioning boot 10, at least in the leg engaging portion 12, has an interior
surface 50 with a
high coefficient of friction, while having an exterior surface 52 with a low
coefficient
friction. The interior surface 50 can be rubber-like and made of any material
that is relatively
"grippy", so that when the leg 20 is properly installed within the cushioning
boot 10 and the
panels 22 through 26 stretched and closed, the leg 20 is held firmly yet
comfortably in place.
The exterior surface 52, on the other hand, is relatively slippery, and can be
a plastic material
such as polyester or any other material that does have a coefficient of
friction low enough so
that the boot 10, when worn, can be easily slid along bed clothing or any
other surface upon
which the boot 10 rests.
One form of the inner surface 50 may be a warp knit tricot material.
Preferably, the
material is brushed, napped or sanded to raise its pile for comfort. For
greater utility of the
boot 10, the tricot can be treated, before raising of its pile, with a water
repellant, such as a
PTFE or other commercially available treatment to improve water repellency.
Then, to give
the inner surface 50 a high co-efficient of friction, an additional material,
such as a hot melt
adhesive or appropriate plastic, can be applied as a discontinuous coating,
thus promoting
breatheability of the inner surface 50. Other means of forming a relatively
grippy inner
surface can be employed, as well and still fall within the scope of the
invention.
It is preferred that the boot 10 have an open heel, where the leg engaging
portion 12
and the foot engaging portion merge into one another. An appropriate aperture
54 is best
shown in figure 4.
A second form of a cushioning boot according to the invention is shown
generally at
10' in figures 7 through 14. Those elements of the cushioning boot 10' that
are identical to
the first form of figures 1 through 6 bear the same reference numerals, and
those elements
that vary in some manner from what is shown in figures 1 through 6 bear primed
reference
numerals. The various elements, to the extent that they are the same, will
therefore not be
described in greater detail and reference is made to the above description of
the embodiment
of figures 1 through 6 for greater detail.
There are two primary differences between the cushioning boot 10' of figures 7
through 14 and the cushioning boot 10 of figures 1 through 6. Those two
differences are the
construction of the leg engaging portion 12' and the construction of the foot
engaging portion
14'.
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The leg engaging portion 12' is composed of two parts, a first padded portion
60 and
a second padded portion 62, as best shown in figures 9 through 12. The first
padded portion
60 is "beneath" the second padded portion 62 in relation to a person wearing
the cushioning
boot 10', and the first padded portion 60 includes an internal padding 64, and
is formed into
two tube-like portions by means of a stitching 66 or other similar means of
separating and
gathering the internal padding 64. The stitching 66, as best shown in figure
13, preferably
extends over half of the length of the leg engaging portion 12', and can
extend substantially
more. It is preferred, however, that where a wearer's Achilles Tendon is
located, the
stitching 66 be absent for appropriate support of the Achilles Tendon. The
padding 64 can be
any material, and is preferably a bit more dense than the padding of the
second padded
portion 62 described below. Side portions of the leg engaging portion 12' also
have internal
padding 64, as in the first form of the invention.
The first padded portion 60 is overlain by the second padded portion 62, and
the
second padded portion 62 includes an internal padding 68. The padding of the
internal
padded portion 68 can be any material, and is preferably a bit less dense than
that of the
internal padding 64 so that it is as pillow-like as possible to replicate the
feel of typical
hospital pillows which are regularly used for supporting a patient's foot. The
internal
padding 64, however, is more dense, so that when a patient's leg is captured
within the
cushioning boot 10', the tubular nature of the first padded portion 60 tends
to guide and seat
the leg properly within the cushioning boot 10', while the leg is
appropriately supported and
protected by the second padded portion 62.
The foot engaging portion 14' of the second embodiment of the invention is
padded
with an internal padding 70 similar to the first embodiment of the invention,
except that the
padding 70 is gathered into two tubular-like portions 72 and 74 as best shown
in figure 7 and
8. A stitching 76, or any other means of gathering the internal padding 70
into the tubular
portions 72 and 74, also helps seat and orient the cushioning boot 10' when
worn. The foot
naturally tends to "center" in the foot engaging portion 14' due to its center
stitching.
A label or labels can be applied to the cushioning boot 10 to provide
appropriate
information. As shown in figure 14, a label 78 can be applied to the bottom to
appropriately
identify the cushioning boot 10 and its use. Alternatively, the label 78 can
be replaced or
supplemented by opposite labels 80 and 82, with the label 80 having
identification
information such as manufacturer, etc., and the label 82 being instructional,
providing
information concerning use of the cushioning boot 10.
=
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A unique feature of the cushioning boot 10 is that, due to the complete
removability
of the panels 22 through 26, the cushioning boot 10 can be packaged in a ready-
to-don
fashion. That is, it can be packaged so that the user can remove it from the
packaging, apply
it to the patient, and then readily fasten it to the patient without having to
disturb the patient
or turn the patient to an uncomfortable position. To this end, it is preferred
that the
cushioning boot 10 is package inside out. That is, with the interior surface
50 out and with
the exterior surface 52 turned inwardly, and the panels 22 through 28 at least
being partially
unattached to the exterior surface 52. To protect the hook portions 38, 42 and
48 from
premature connection and to avoid tangling, those hook portions not in place
can be covered
with temporary protective covers, such as portable and disposable loop
portions (not
illustrated) that can be discarded when the cushioning boot 10 is deployed.
One of the advantages of the structure of the cushioning boot 10 is that the
interior
surface 50, where it contacts the patient's leg and foot, is smooth and not
wrinkled so as to
not irritate the patient when worn for long periods of time. By packaging the
cushioning boot
inside out for deployment, that helps prevents wrinkles in the interior
surface 50 (which is
the temporary exterior surface when packaged inside out).
Another form of a cushioning boot according to the invention is shown
generally at
10" in figures 15 and 16. Those elements of the cushioning boot 10" that are
identical to the
first forms of the invention bear the same reference numerals, and those
elements that may
vary in some manner from what is shown in figures 1 through 14 bear primed
reference
numerals. The various elements, to the extent that they are the same, will
therefore not be
described in greater detail and reference is made to the above description of
the embodiments
of figures 1 through 14 for greater detail.
In this form of the invention, the boot 10" includes a first panel portion 122
which
extends substantially along the leg engaging portion 12, and a second panel
portion 124
which extends along the foot engaging portion 14. A further stretchable,
adjustable closure
panel 126 extends between and at least partially overlaps the closure panel
portions 122 and
124. The closure portions 122 through 126 correspond to the closure portions
22 through 26
of the first form of the invention, with modifications in their guiding and
attachment as
explained below.
Guiding is provided for each of the closure panels 122 through 126. A first
loop 128
is formed to direct positioning of the closure panel 122. The first loop 128
is secured to the
boot 10" such that the closure panel 122 passes freely between the first loop
128 and the
boot. As illustrated in figures 15 and 16, the first loop 128 is secured to
the boot in a plurality
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of spaced locations, such as by stitching 130, with the closure panel 122
having an interstice
132 in registration with one of the stitching 130. With the stitching 130, the
first loop 128 is
formed into a series of sub loops 128a, 128b, 128c and 128d.
The second portion 124 of the closure panel extends substantially along the
foot
engaging portion 14, having a second loop 134 formed to direct positioning of
the second
portion 124. Similar to the first loop 128, the second loop 134 is secured to
the boot such that
the second portion 124 of the closure panel passes freely between the second
loop and the
boot. To this end, the second loop 134 is secured at a plurality of spaced
locations such as by
stitching 136, forming the second loop 134 into a pair of sub-loops 134a and
I34b. An
interstice 138 is formed in the second 124 in registration with the stitching
136, as illustrated.
The closure panel 126 includes an interstice 140. Positioning of the closure
panel 126
is therefore guided by the sub-loops 128c and 128d of the first loop 128.
As shown in Figures 15 and 16, the first panel portion 122 and the second
panel
portion 124 preferably form part of the same panel. However, the panel
portions 122 and 124
can be separate panel portions, some of which may or may not be joined to one
another.
Also, although the panel portions 122 and 124 are illustrated as never
crossing one another, if
multiple panel portions are employed, various connection scenarios, including
criss crossing
of panel portions, would be possible.
As illustrated and described, preferably hook-and-loop fasteners are employed
for
fastening the panel portions 122-126 to the boot. However, at least one side
of the panel
portions 122-126 can be permanently affixed to the boot 10 double prime, or
both sides could
be permanent affixed, so long as there were other means of adjustability of
the panel portions
122-126.
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ACHIEVEMENTS
The panels 22 through 26 provide several unique features. Because large panels
are
used rather than rigid and narrow straps as in the past, the panels moderate
pressure across
leg tissue. The second panel portion 24 grips a person's foot about the arch,
having a
significant effect in keeping the boot 10 in place on the leg 20. The
combination of the panel
portions 22 and 24 helps prevent foot drop. The third panel 26 provides
additional force and
helps seat the leg 20 properly in place. Because the panels 22 through 26 are
made of a
stretchable material such as spandex or the like, various amounts of closure
force can be
provided, and even with fairly high force, because of the sizes of the panels
22 through 26,
the force is adequately spread to avoid any pressure points.
As explained above, the padding 16 filling the cushioning boot 10 is intended
to give
it a pillow-like feel. Not only does the thick padding provide comfort, but it
also helps
properly orient the leg 20 within the boot 10. The padding 16 will self level
and contours to
the shape of the person's leg to provide uniformity of support.
The cushioning boot 10' more robustly orients a person's leg within the boot
10'.
With the leg engaging portion 12' being formed into at least two partial tubes
by means of the
stitching 66, and with the tubular portions 72 and 74 of the foot engaging
portion 14' being
formed with the stitching 76, the person's leg and foot are properly oriented
centrally within
the cushioning boot 10', while comfort is not compromised because the second
padded
portion 62, although not as dense as the first padded portion 60, overlies the
first padded
portion for proper leg support and comfort.
With the exterior surface 52 having a low coefficient of friction and the
interior
surface 50 having a high coefficient of friction, a large frictional
difference is provided. The
high coefficient of friction of the interior surface 50 holds the leg 20 in
place, while the low
friction exterior surface 52 allows the leg, in the cushioning boot 10, to be
readily moved.
The combination of the low friction exterior surface 52 and high friction
interior surface 50
combine to keep the leg 20 protected from pressure due to friction and sheer
when the leg is
moved, and also help prevent improper positioning of the leg 20 within the
boot 10, which
can lead to skin damage from misalignment of the boot 10 or skin exposure to
bed surfaces.
With the loops 128 and 134, the closure panel portions 122, 124, and 126 are
guided
and cannot be inadvertently affixed in the wrong place. Similar to the earlier
embodiments of
the invention, hook and loop fasteners are used to affix the panel portions
122, 124 and 126,
CA 02838424 2014-08-25
,
with the loops 128 and 134 appropriately guiding the panel portions 122, 124
and 126 as they
are secured in place
Various changes can be made to the invention without departing from the scope
of the
invention described herein.
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