WO2017134429A1 - Dispositif de support - Google Patents
Dispositif de support Download PDFInfo
- Publication number
- WO2017134429A1 WO2017134429A1 PCT/GB2017/050245 GB2017050245W WO2017134429A1 WO 2017134429 A1 WO2017134429 A1 WO 2017134429A1 GB 2017050245 W GB2017050245 W GB 2017050245W WO 2017134429 A1 WO2017134429 A1 WO 2017134429A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- offloading
- foot
- wearer
- boot
- support device
- Prior art date
Links
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Classifications
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Definitions
- Ankle Foot Orthoses may look similar to offloading devices, but the material they are constructed from is not be sufficiently rigid to allow pressure redistribution/offloading to occur. As such, they are never prescribed for this purpose clinically. Indeed the Medicare reimbursement authorities in the US have expressly forbidden the prescription of AFOs in the treatment of diabetic foot ulcers as they have no functionality.
- the offloading element is less prone to fracturing during use.
- the absence of a toe portion and/or heel portion in the base portion prevents the occurrence of the high forces in the region where the base portion joins the stem portion which can be generated when the weight of a wearer is borne by the toe portion or heel portion of the base portion during toe-off/heel-strike phase of the gait cycle.
- the base portion of the offloading element is reduced in size and weight and, as a result, the support is less cumbersome for the wearer and easier to use, particularly for weaker, and/or elderly wearers.
- the support engages the wearer's leg below the knee.
- the stem portion of the offloading element passes from a shin of the wearer to the lateral aspect of the boot.
- the support device further comprises a pedometer and a memory configured to store data output by the pedometer.
- the pedometer readings can be used by the attending clinicians to issue alarms to the patient if they walk more than is beneficial to wound healing.
- the support device further comprises a proximity sensor to detect when the support device is being worn and a memory configured to store data output by the proximity sensor.
- the memory is further configured to store data output by the blood flow stimulating means, and the pedometer.
- the bladder has a volume of up to 40 cm 3 .
- the support device further comprises a temperature sensor disposed within the boot in or on the sole and or upper configured to detect skin breakdown and/or a likelihood of skin breakdown on a foot of a wearer of the support device.
- Figure 1 a depicts a comparative example of an integrated offloading device
- Figure 3 depicts depicts an improved offloading element for use in an integrated offloading device
- Figure 4 depicts an improved offloading element for use in an integrated offloading device
- Figure 5 depicts an exemplary integrated offloading device
- Figure 6 depicts an exemplary offloading element
- Figure 7 depicts a schematic diagram of an alternative blood flow stimulating means
- Figure 8 depicts exemplary timings and pressure values for a full cycle of operation of the blood flow stimulating means shown in Figure 7;
- Figure 13 depicts a shin support structure connected to an offloading element, wherein the shin support structure has a proximity sensor and a pedometer disposed in or on it; and Figure 14 depicts an exemplary boot comprising multiple temperature sensors.
- boot is intended to cover every suitable item of footwear which can be used in the conjunction with each of the devices described herein.
- Examples of alternative items of footwear include, but are not limited to, boots, shoes, sandals, footwear comprising an upper which extends above the ankle, footwear comprising an upper which stops below the ankle and footwear comprising an open or partially open upper.
- FIG 1 a shows a comparative example of an integrated offloading device 10 which provides both the offloading functionality as well as promoting blood flow.
- the integrated offloading device 10 comprises a shin support structure 14 connected to a sock (otherwise known as an innersole) 1 1 via an offloading element (or offloader) 12 (shown in Figure 1 b).
- the offloading device 10 may equally be used with the offloading element 312 (shown in Figure 3).
- the offloading element 12 is shown in isolation in Figure 1 b.
- the sock 1 1 is disposed on top of a plate portion 12b of the offloading element 12 (shown in Figure 1 b).
- the plate portion 12b of the offloading element 12 comprises two holes 31 , as shown in Figure 1 b.
- the plate portion 12b may be securely fastened into the bottom of a boot (not shown) via the holes 31 .
- the sock 1 1 may then be placed on top of the plate portion 12b of the offloading element 12 (as shown in Figure 1 a).
- the lower half of the stem portion 12a and the entirety of the plate portion 12b of the offloading element 12, as well as the sock 1 1 are configured to be disposed within a boot (not shown).
- the bladder 19 is disposed within or on the sock 1 1 and is arranged such that, in use, the bladder 19 abuts the plantar plexus or the a medial plantar arch of a foot of a wearer of the integrated offloading device 10.
- the module 17 is connected to the bladder 19 via the conduit 18 and which is disposed on or in the shin support structure 14.
- the second valve 23 is open for a sufficiently long period so as to enable the portion of the bladder 19 abutting the plantar plexus/medial plantar arch to urge compression of plantar plexus veins located in the plantar arch region of the foot, such that the subdermal veins at least partially close, thus urging the blood contained therein to return towards the abdomen. It is known that a period of compression of around half a second is sufficient to improve venous drainage, especially if repeated on a regular basis.
- the offloading element 312 comprises a stem portion 312a and a base portion 312b, shown as a plate portion 312b in Figure 1 b.
- the base portion 312b is shown as a plate portion 312b, the base portion any other suitable form may be used for the base portion 312b.
- the stem portion 312a of the offloading element 312 twists from a position in front of the tibia of a wearer of the device, at its end closest to the shin support structure 314, to a position flush with the side of the sole of foot of the wearer of the device.
- the design of the base portion 312b enables the foot of a wearer of the offloading device 10 to move normally from the mid stance phase into the toe- off/propulsion phase of the gait cycle. This reduces the risk of mid-foot stall and of a fore foot slap.
- this engagement is such that sufficient rigidity is provided to enable offloading of the foot, locking tri-axial ankle movement as described previously, of the wearer via the engagements between the rigid member 100, the offloading element 1 12 and the shin support structure 1 14.
- By locking the ankle pressure hot spots are prevented.
- the speed of the "foot slap" which creates peak pressures in the metatarsal area and toe extremities, is controlled. Limiting the movement of the ankle causes the less flexible knee and hip joints to articulate to allow chain motion, but at a slower pace.
- the offloading element 1 12 is not disposed within the boot 101 and the aforementioned issues arising in relation to the substantially rigid offloading element 12 being disposed against the skin of the wearer of the integrated offloading device 10, specifically the skin around the foot and ankle, do not arise.
- the boot 101 can be used on its own (i.e. removing the offloading element 12 and shin support structure 14 after a period treatment), for example for treatment of acute conditions, meaning that the patient can be discouraged from going back to wearing ill-fitting shoes and/or shoes with exposed internal stitching, capable of rubbing away frail diabetic skin when offloading is no longer required or possible.
- a pedometer would enable a clinician to ascertain how many steps the patient has taken during a treatment period.
- the integrated offloading device 1 10 may also comprise a proximity sensor to detect whether the device is being worn or not and/or how many hours pumping has taken place. This data may be stored on the memory and downloaded at clinic or transmitted remotely to a clinician.
- the solenoid valve 52 is connected to the bladder 19, the reservoir 29 and the bleed valve 53. As shown in Figure 7, the solenoid valve 52 is able to switch between a configuration A-B where the bladder 19 is in fluid communication with the bleed valve 53 and a configuration A-C where the bladder 19 is in fluid communication with the reservoir 29 via the solenoid valve 52.
- Figure 8 shows exemplary timings and pressure values for a full cycle in the operation of the blood flow stimulating means shown in Figure 7.
- Figures 1 1 a to 1 1 1 c show another exemplary sock wherein the sock is comprised of a top 1 1 b, a middle 1 1 c and a bottom 1 1 d.
- Figures 1 1 b and 1 1 c show the recess 1 1 a for housing the bladder 19 and the conduit 18.
- the sock 1 1 e is disposed much more closely to the underside of the foot of a wearer than the bladder shown in Figure 10.
- a smaller bladder 19a can be used as, upon inflating, the bladder 19a needs to cover less distance than the bladder 19 (shown in Figure 10) as the bladder is disposed much closer to the foot of the wearer.
- the use of a contoured sock such as the sock 1 1 e shown in Figure 12 enables a bladder of a smaller volume to be used than is needed for regular flat socks such as the sock 1 1 shown in Figure 10.
- the same or a similar sized bladder as is used with the flat sock shown in Figure 10 can be used.
- a bladder 19 When a foot abuts the sock 1 1 e when the boot 101 is being worn, such a bladder 19 would not need to be inflated fully before the pressure limit (for example, 23.4kPa (3.4 psi)) is reached as it would abut the foot of the wearer before it was fully inflated causing the pressure in the bladder to increase sooner.
- the pressure limit for example, 23.4kPa (3.4 psi)
- the bladder may have a volume of up to 40 cm 3 .
- a swan line can be incorporated into the boot 101 of the integrated offloading device 1 10.
- a swan line is where the heel of a wearer of the boot 101 is held in a position higher than the front of their foot. This would act to tilt the wearer forward slightly, thus taking pressure off the heel and providing better weight distribution.
- the swan line can come from the shape of the boot 101 itself or from the shape of the contoured sock 1 1 e.
- the flat plate portion 12b as shown in Figure 1 b, could be shaped such that a swan line is formed.
- the sock 1 1 disposed on top of the flat plate portion 12b could be shaped such that a swan line is formed. Accordingly, any of the integrated offloading devices 10, 1 10 described herein could configured to include a swan line.
- Figure 13 shows a shin support structure 1 14 connected to an offloading element 1 12 wherein the shin support structure has a proximity sensor 1 101 and a pedometer 1 102 disposed in or on it.
- the proximity sensor 1 101 is configured to detect when the shin support structure 1 14 is being worn.
- a memory (not shown) may be provided to store data produced by the proximity sensor 1 101 . As such, a record of how often and when the shin support structure 1 14 is being worn can be kept.
- the pedometer 1 102 is configured to detect how many steps are taken by a wearer of the shin support structure 1 14. Likewise, a record of how many steps have been taken can be recorded on the memory.
- Figure 14 shows an exemplary boot 101 comprising multiple temperature sensors 121 a, 121 b and 121 c. These are disposed abutting the areas of the foot of a wearer that are most prone to skin breakdown.
- a battery pack or other energy source (not shown in the Figures) for powering the blood flow stimulating means may be disposed on the outside of the shin support structure 1 14 such that it can be easily replaced without the wearer of the integrated offloading device 1 10 having to remove the shin support structure 1 14.
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- Health & Medical Sciences (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Life Sciences & Earth Sciences (AREA)
- Veterinary Medicine (AREA)
- Animal Behavior & Ethology (AREA)
- Nursing (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Engineering & Computer Science (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Epidemiology (AREA)
- Pain & Pain Management (AREA)
- Physical Education & Sports Medicine (AREA)
- Rehabilitation Therapy (AREA)
- Diabetes (AREA)
- Rheumatology (AREA)
- Orthopedics, Nursing, And Contraception (AREA)
Abstract
L'invention concerne un dispositif de support comprenant : un support permettant, lors de l'utilisation, d'être en contact avec un porteur du dispositif de support ; une chaussure comprenant une semelle et une tige ; et un élément de délestage accouplé au support et accouplé à la chaussure, l'élément de délestage comprenant une partie tige et une partie base, la partie base comprenant uniquement une partie moitié de pied, uniquement une partie moitié de pied et une partie talon, ou uniquement une partie moitié de pied et une partie orteil.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
GB1601786.5 | 2016-02-01 | ||
GB1601786.5A GB2546819A (en) | 2016-02-01 | 2016-02-01 | Support device |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2017134429A1 true WO2017134429A1 (fr) | 2017-08-10 |
Family
ID=55590495
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/GB2017/050245 WO2017134429A1 (fr) | 2016-02-01 | 2017-02-01 | Dispositif de support |
Country Status (2)
Country | Link |
---|---|
GB (1) | GB2546819A (fr) |
WO (1) | WO2017134429A1 (fr) |
Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US11484426B2 (en) | 2017-05-12 | 2022-11-01 | Ast Design, Llc | Foot ankle orthoses |
US11857448B2 (en) | 2018-02-02 | 2024-01-02 | Otto Bock Healthcare Lp | Methods and apparatus for treating osteoarthritis of the knee |
US11872151B2 (en) | 2017-05-12 | 2024-01-16 | Ast Design, Llc | Method of manufacturing an ankle foot orthosis |
Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4771768A (en) * | 1986-12-16 | 1988-09-20 | United States Manufacturing Company | Controlled motion ankle fracture walker |
FR2930723A1 (fr) * | 2008-05-05 | 2009-11-06 | Gibaud Soc Par Actions Simplif | Orthese de cheville |
US20100174219A1 (en) * | 2008-11-26 | 2010-07-08 | Franke Hans G | Weight-bearing lower extremity brace |
WO2015189608A1 (fr) * | 2014-06-10 | 2015-12-17 | The Diabetic Boot Company | Dispositif d'aide |
Family Cites Families (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20130046222A1 (en) * | 2011-08-18 | 2013-02-21 | Christopher M. Gizzi | Apparatus for an adjustable custom molded arch suspension system |
-
2016
- 2016-02-01 GB GB1601786.5A patent/GB2546819A/en not_active Withdrawn
-
2017
- 2017-02-01 WO PCT/GB2017/050245 patent/WO2017134429A1/fr active Application Filing
Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4771768A (en) * | 1986-12-16 | 1988-09-20 | United States Manufacturing Company | Controlled motion ankle fracture walker |
FR2930723A1 (fr) * | 2008-05-05 | 2009-11-06 | Gibaud Soc Par Actions Simplif | Orthese de cheville |
US20100174219A1 (en) * | 2008-11-26 | 2010-07-08 | Franke Hans G | Weight-bearing lower extremity brace |
WO2015189608A1 (fr) * | 2014-06-10 | 2015-12-17 | The Diabetic Boot Company | Dispositif d'aide |
Cited By (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US11484426B2 (en) | 2017-05-12 | 2022-11-01 | Ast Design, Llc | Foot ankle orthoses |
US11872151B2 (en) | 2017-05-12 | 2024-01-16 | Ast Design, Llc | Method of manufacturing an ankle foot orthosis |
US12042417B2 (en) | 2017-05-12 | 2024-07-23 | Ast Design, Llc | Ankle foot orthosis and method of manufacturing |
US11857448B2 (en) | 2018-02-02 | 2024-01-02 | Otto Bock Healthcare Lp | Methods and apparatus for treating osteoarthritis of the knee |
Also Published As
Publication number | Publication date |
---|---|
GB201601786D0 (en) | 2016-03-16 |
GB2546819A (en) | 2017-08-02 |
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