Abstract:
A mobile compression integument for applying controllable scrolling or intermittent sequential forces, such as compression forces, to the body and limbs of a user comprises an elongated fabric body sized to encircle a limb of a user, one or more shape-changing elements carried by the fabric body and configured to apply a compression pressure to the limb through the fabric body upon changing shape in response to a stimulus, and a micro-processor based controller for selectively actuating the one or more shape-changing elements to reduce the effective diameter of the integument encircling the limb, to thereby apply pressure to the limb.

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
       [0001]    This application is a continuation-in-part of and claims priority to U.S. application Ser. No. 14/027,183, filed on Sep. 14, 2013, which is a utility conversion of and claims priority to provisional application Ser. No. 61/701,329, entitled “Automated Constriction Device, filed on Sep. 14, 2012, the entire disclosure of which is incorporated herein by reference. 
     
    
     BACKGROUND 
       [0002]    Blood flow disorders can lead to numerous health and cosmetic problems for people. Relatively immobile patients, such as post-operative patients, the bedridden, and those individuals suffering from lymphedema and diabetes can be prone to deep vein thrombosis (DVT). Post-operative patients are often treated with a DVT cuff during surgery and afterwards for up to 72 hours. Clinicians would prefer to send patients home with DVT cuffs and a treatment regimen to reduce the risk of blood clots. However, patient compliance is often a problem because the traditional DVT cuff renders the patient immobile and uncomfortable during the treatment, which can be an hour or more. Travelers confined to tight quarters during airline travel or long-distance driving, for example, are also particularly at risk for the development of thromboses, or blood clots due to decreased blood flow. Varicose veins are another disorder resulting from problems with patient blood flow. Varicose veins are often a symptom of an underlying condition called venous insufficiency. Normal veins have one-way valves that allow blood to flow upward only to return to the heart and lungs. A varicose vein has valves that are not functioning properly. The blood can flow upwards, but tends to pool in the vein because of valve dysfunction. The varicose veins bulge because they are filled with pooled blood. Although varicose veins are often a cosmetic concern, the condition also causes pain, leg heaviness, fatigue, itching, night cramps, leg swelling, and restless legs at night. Varicose vein disease can be treated with various nonsurgical techniques such as sclerotherapy or endovenous laser treatment (EVLT). In some cases enhanced blood flow is essential for quality of life, such as for those individuals suffering from RVD (peripheral vascular disease) and RLS (restless leg syndrome), or women undergoing reconstructive breast surgery suffering from arm pain and fatigue due to poor blood flow. 
         [0003]    For some individuals the condition can also be treated by the nightly use of compression stockings Compression stockings are elastic stockings that squeeze the veins and stop excess blood from flowing backward. These, and other known devices, tend to only provide an initial compression force at a low level that decreases over time upon continued deformation of the stocking Moreover, stockings of this type are difficult to put on and take off, particularly for the elderly. 
         [0004]    Many athletes, whether professionals or lay persons, suffer from muscle soreness, pain and fatigue after exercise due to toxins and other workout by-products being released. Recent research has shown that compression garments may provide ergogenic benefits for athletes during exercise by enhancing lactate removal, reducing muscle oscillation and positively influencing psychological factors. Some early research on compression garments has demonstrated a reduction in blood lactate concentration during maximal exercise on a bicycle ergometer. Later investigations have shown improved repeated jump power and increased vertical jump height. The suggested reasons for the improved jumping ability with compression garments include an improved warm-up via increased skin temperature, reduced muscle oscillation upon ground contact and increased torque generated about the hip joint. Reaction time is important to most athletes, as well as to race car drivers, drag racers and even fighter pilots. Exercise science and kinesiology experts point to training modules, such as PitFit™, that benefit from acute sensory drills and increased oxygen intake related to increased blood flow. Combined, these results show that compression garments may provide both a performance enhancement and an injury reduction role during exercises provoking high blood lactate concentrations or explosive-based movements. 
         [0005]    Research has also shown that compression garments may promote blood lactate removal and therefore enhance recovery during periods following strenuous exercise. In one test, significant reduction in blood lactate levels in highly fit were observed in males wearing compression stockings following a bicycle ergometer test at 110 per cent VO 2 max. Similar results were obtained in a later study in which a significant reduction in blood lactate concentration and an increased plasma volume was found in twelve elderly trained cyclists wearing compression garments following five minutes of maximal cycling. In another test, wearing compression garments during an 80-minute rest period following the five minutes of maximal cycling were shown to significantly increase (2.1 percent) performance during a subsequent maximal cycling test. It was suggested that increased removal of the metabolic by-products during intense exercise when wearing compression garments may help improve performance. These results suggest that wearing compression garments during recovery periods following high intensity exercise may enhance the recovery process both during and following intense exercise and therefore improve exercise performance. 
         [0006]    Compression devices have also been used during recovery periods for athletes following strenuous activity. These devices are generally limited to the athlete&#39;s legs and typically comprise a series of inflatable bladders in a heel-to-thigh casing. An air pump inflates the series of bladders in a predetermined sequence to stimulate arterial blood flow through the athlete&#39;s legs. Compression devices of this type are extremely bulky, requiring that the athlete remain generally immobile, either seated or in a prone position. 
         [0007]    There is a need for improved devices and associated methods for compressing a portion of a patient&#39;s or athlete&#39;s body, and even an animal&#39;s body, such as a race horse or working dog. Of particular need is a device that is comfortable and mobile. Current technology uses plastic (PVC) wrapped around the extremity causing enhanced perspiration and discomfort, so a device that is comfortable and mobile will increase athlete and patient compliance with a treatment regimen. In patients, such compliance may reduce the risk of DVT and/or related peripheral vascular disease (PVD), or venous flow anomalies which could have positive economic impact on costs of healthcare. 
       SUMMARY 
       [0008]    In general terms, constrictor devices were developed by vascular surgeons to increase arterial blood flow. These devices apply a massage-like compression to the foot, ankle and calf to circulate blood flow with no known side effects. Current constrictor devices rely upon air pressure from an external air pump to cause constriction compression for patient treatment. 
         [0009]    According to this invention the compression device or integument is an apparatus that utilizes shape changing materials in conjunction with elongated compression textiles or fabrics to apply controllable intermittent sequential compression or constriction pressure to a body portion of a person, typically an extremity such as the arms or legs. One form of compression pattern is an infinite series of scrolling actions as the compression is successively applied to segments of the patient&#39;s limb. The compression integument herein is a self-contained unit within a wearable extremity integument. An on-board microprocessor controls the constriction of the shape changing materials and an on-board power supply provides the power for the compression actuation. By using this self contained low profile unit, a patient or athlete can remain mobile and compliant with the treatment regiment because of the integument&#39;s comfort, allowing the user to engage in everyday activities. The integument described herein also reduces costs to the use by eliminating the need to rent or purchase a specialized external air pump. 
         [0010]    In one aspect, the shape changing material may be a shape memory metal that contracts in response to heat or an electrical current. In another aspect, the shape changing material may be a phase change material that contracts as the material changes phase. 
     
    
     
       DESCRIPTION OF THE FIGURES 
         [0011]      FIG. 1  is a plan view of a compressible fabric body with a plurality of compression pads affixed thereto for use in one embodiment of an integument described herein. 
           [0012]      FIG. 2  is an enlarged side and end views of a compression pad shown in  FIG. 1 . 
           [0013]      FIG. 3  is a plan view of an integument according to one disclosed embodiment. 
           [0014]      FIG. 4  is a top view of a circuit board for use in the integument shown in  FIG. 3 . 
           [0015]      FIG. 5  is a circuit diagram for the electrical circuit of the integument shown in  FIG. 3 . 
           [0016]      FIG. 6  is a perspective view of an interior sock for a compression integument according to one disclosed embodiment. 
           [0017]      FIG. 7  is a perspective view of an exterior sock for use with the interior sock shown in  FIG. 6  for the compression integument according to one disclosed embodiment. 
           [0018]      FIG. 8  is a plan view of an integument according to a further embodiment utilizing a micro-motor to activate a shape-changing element. 
           [0019]      FIG. 9  is a top view of a compression device according to a further aspect of the present disclosure. 
           [0020]      FIG. 10  is a top view of an array of the compression devices depicted in  FIG. 9   
           [0021]      FIG. 11  is a top view of a compression integument incorporating a compression device according to a further aspect of the present disclosure. 
           [0022]      FIG. 12  is an enlarged view of the end of a strap of the compression integument shown in  FIG. 11 . 
           [0023]      FIG. 13  is an enlarged top view of the primary circuit board and overstress protection board of the compression integument of  FIG. 11 . 
           [0024]      FIG. 14  is a top view of a compression device according to another embodiment of the present disclosure. 
           [0025]      FIG. 15  is a diagram of an array of compression device as shown in  FIG. 14 . 
           [0026]      FIG. 16  is a diagram of a compression device according to yet another embodiment of the present disclosure. 
           [0027]      FIG. 17  is a top view of a compression integument according to a further aspect of the present disclosure. 
           [0028]      FIG. 18   a  is a top view of a compression integument according to another aspect of the present disclosure. 
           [0029]      FIG. 18   b  is a partial perspective view of the compression integument encircling a limb of a user. 
           [0030]      FIGS. 19   a - 19   c  are sequential views of the compression integument shown in  FIG. 18  with different SMA wires actuated to generate a peristaltic-like compression. 
           [0031]      FIG. 20  is a perspective view of a rib for use in the integument shown in  FIG. 18 . 
           [0032]      FIG. 21  is a top view of a rib according to a further embodiment for use in the compression integument shown in  FIG. 18 . 
           [0033]      FIG. 22  is a side cross-sectional view of the rib shown in  FIG. 21 , taken along line  22 - 22 . 
           [0034]      FIG. 23  is a side cross-sectional view of the rib shown in  FIG. 21 , taken along line  23 - 23 . 
           [0035]      FIG. 24  is a top view of a compression integument according to another aspect of the present disclosure. 
           [0036]      FIG. 25  is a cross-sectional view of the integument shown in  FIG. 24 , taken along line  25 - 25 . 
           [0037]      FIG. 26  is a top view of a compression integument according to yet another aspect of the present disclosure. 
           [0038]      FIG. 27  is a view of one face of a strap component of the compression integument shown in  FIG. 26 . 
           [0039]      FIG. 28  is a view of an opposite face of the strap component shown in  FIG. 27 . 
           [0040]      FIG. 29  is a cut-away view of the strap component shown in  FIGS. 27-28 . 
           [0041]      FIG. 30  is a top view of an accessory component for use with the compression integument shown in  FIG. 26 . 
       
    
    
     DETAILED DESCRIPTION 
       [0042]    For the purposes of promoting an understanding of the principles of the invention, reference will now be made to the embodiments illustrated in the drawings and described in the following written specification. It is understood that no limitation to the scope of the invention is thereby intended. It is further understood that the present invention includes any alterations and modifications to the illustrated embodiments and includes further applications of the principles of the invention as would normally occur to one skilled in the art to which this invention pertains. 
         [0043]    The present disclosure contemplates a compression integument that provides the same efficacy for blood flow circulation improvement afforded by current pneumatic arterial constriction devices, but in a device that is not restrictive to the patient or athlete during a compression treatment. Current products require the patient to remain relatively immobile in a seated position or prone while air bladders in the wrap are inflated and deflated. Inflation and deflation of the air bladders requires a bulky external pump and hoses, which effectively ties the user to one location. The present invention contemplates a device that can be easily and comfortably worn while allowing full mobility of the patient or athlete. 
         [0044]    One embodiment of compression integument  10  is shown in  FIGS. 1-5 . The integument  10  in the illustrated embodiment is configured to be wrapped around the calf, but it is understood that the integument can be modified as necessary for treatment of other extremities. The integument  10  includes a textile or fabric body  12  having a lower segment  12   a  configured to fit around the foot of the user and an upper segment  12   b  configured to encircle the lower leg. The ends of each segment may include a hook and loop fastener arrangement to permit adjustable fit around the user&#39;s foot and calf. Other means for adjustably fastening the body segments about the user&#39;s body are contemplated, such as an array of hooks, eyelets, zipper, Velcro or similar fastening devices. The fastening devices may also be similar to the tightening mechanisms used in thoracic spinal bracing, backs packs and even shoes. It is further contemplated that the integument may be a closed body that is integral around the circumference. 
         [0045]    The fabric body  12  may be formed of a generally inelastic or only moderately “stretchable” material that is suited for contact with the skin of the user. The material of the fabric body may be a breathable material to reduce perspiration or may be a generally impermeable material to enhance heating of the body part under compression treatment. It is understood that the configuration of the body  12  shown in  FIG. 3  can be modified according to the body part being treated. For instance, the fabric body  12  may be limited to the upper segment  12   b  to wrap the calf, thigh, bicep or forearm only. The body may also be configured to fit at the knee or elbow of the user. The fabric body may be provided with a “tacky” coating or strips on the surface facing the limb, with the “tacky” coating helping to hold the body against sliding along the user&#39;s limb, particularly if the user sweats beneath the fabric body. 
         [0046]    In one embodiment, the fabric body can be a compressible body having a thickness to accommodate the shape-changing elements described herein. In another embodiment, the compressibility of the integument is accomplished by one or more compressible pads. In the embodiment illustrated in  FIGS. 1-3 , the fabric body includes an array of pads  16  that are configured to transmit pressure from the integument as it is compressed. As explained in more detail herein, the pressure is sequentially applied to certain groups of pads when wrapped around the extremity to apply alternating pressure to specific locations of the patient&#39;s or athlete&#39;s extremity, such as the ankle and lower calf in the illustrated embodiment. In certain compression protocols, the compression force applied to the user can be as high as 10 psi, although the compression force in most applications is only about 5 psi. Thus, the pads are configured to uniformly transmit this range of pressures. In one specific embodiment, each pad is in the form of a 1 cm×1 cm rectangle. The pads may be provided in rows separated by 0.25 cm to about 0.75 cm, and preferably about 4 cm in order to provide an optimum pressure profile to the patient/athlete&#39;s limb. Each pad includes an inner portion  17  and an outer portion  18 , as shown in the detail view of  FIG. 2 . In one embodiment, the inner portion is formed of a material to provide a hard generally non-compressible surface, such as a nylon having a durometer value of about 110. The outer portion  18  is formed of a wicking compressible material, such as a soft compressible memory foam that is adapted to lie against the patient&#39;s skin. The inner portion  17  is fastened or affixed to the fabric body  12  in a suitable manner, such as by use of an adhesive. The inner portion  17  of each pad  16  is provided with one or more, and preferably two, bores  19  therethrough to receive a shape-changing element as described herein. An additional layer of material may line exposed surface of the inner portion which contacts the extremity surface. For instance, the integument may be provided with a soft, breathable sheet of material that is affixed to the fabric body to cover the compressible pads  16 . The additional sheet may be removable fastened, such as by hook and loop fasteners at its ends. 
         [0047]    In accordance with one feature of the present invention, the integument is provided with a plurality of shape-changing elements that are operable to change shape in response to an external stimulus. This change of shape effectively reduces the circumference of the integument encircling the user&#39;s limb, thereby applying pressure or a compressive force to the limb. In one embodiment, the shape-changing element is an element configured to change length, and more particularly to reduce its length in response to the stimulus. In one specific embodiment element is one or more wires formed of a “shape memory” material or alloy that shrinks when a current is applied to the wire, and that returns to its original “memory” configuration when the current is removed or changed. As shown in  FIG. 3 , the compression integument  10  includes a wire array  14  that spans the width and length of each segment  12   a,    12   b  of the fabric body  12 , and that extends through the bores  19  in each compression pad  16 . The wire array is configured to reduce the diameter of the corresponding segment or portion of a segment when the wire array is activated. In certain embodiments, the wire array can include wires formed of a “memory” material that changes length upon application of an electrical signal and then returns to its original length when the signal is terminate. In a specific embodiment, the memory material can be a memory metal such as Nitinol or Dynalloy wire having a diameter of 0.008 in. In one specific embodiment, the memory wires  14  are configured so that a current of 0.660 amp passing through each wires causes it to shrink sufficiently to exert a force of about 1.26 lbf to 4 lbf In other embodiments, the wire array may be formed of an auxetic material that expands when placed in and then returns to its initial thickness when the is removed. 
         [0048]    The fabric body  12  may be provided with pockets or sleeves to receive and retain the compressible pads  16 . It is further contemplated that each row of compressible pads is replaced by a single elongated compressible cushion element with the bores  16  passing therethrough to receive the corresponding pairs of memory wires  14   a.  It is further contemplated that the fabric body  12  may be configured so that the compressible pads or elongated cushion elements are sewn into the body. 
         [0049]    As reflected in  FIG. 3  each pair of wires  14   a  passing through a row of compression pads  16 , or elongated cushion elements, corresponds to a single channel that can be individually actuated during a compression treatment. Each channel, or wire pair,  14   a  is connected to a microcontroller as described herein. In the illustrated embodiment, the upper segment  12   b  includes seven such channels  15   a - 15   g.  The lower segment  12   a  includes a wire array with seven channels and a wire array with six channels. Each row or channel of wires  14   a  in the wiring array  14  terminates at a negative anode or ground plane  20  at the opposite ends of each body segment  12   a,    12   b.  Each channel, such as the channels  15   a - 15   g,  is electrically connected to a corresponding distribution circuit board  22   a - 22   c.  A flexible multi-conductor cable  23  connects the distribution circuit boards between segments of the fabric body  12  so that the distribution circuit boards do not interfere with the ability of the integument  10  to be wrapped snugly about the user&#39;s extremity. 
         [0050]    One of the distribution circuit boards  22   a  carries a microprocessor  24  that controls the sequence and magnitude of the current applied to the memory wires in each channel. As shown in  FIG. 4 , the distribution circuit boards  22  can include surface mount resistors and power mosfets electrically connected to the wire pairs of each channel. The microcontroller  24  is preferably not hard-wired to the circuit board  22   a  to permit replacement of one pre-programmed microcontroller with a differently programmed microcontroller. In one embodiment, a microcontroller may be preprogrammed with a particular compression sequence for a particular user and a particular integument. For instance, the compression sequence may be an infinite or continuous rolling in which the integument is successively compressed along the length of the user&#39;s limb similar to a peristaltic movement, a step-wise sequence in which the integument is compressed and held for a period, or even a random sequence. Other compression protocols may be preprogrammed into other microcontrollers that can be selected by the user or physical therapist as desired. 
         [0051]    Details of the circuit board  22   a  and microcontroller  24  are shown in the circuit diagram of  FIG. 5 . The microcontroller may be a Parallax microcontroller Part No. BS2-IC, or a Bluetooth enabled Arduino microcontroller, for instance. The microcontroller is provided with a switch array  25  which includes a mode switch S 1  and a reset switch S 2 . The switches are accessible by the user to operate the integument  10 . Alternatively, the switches may be integrated into a remote communication module capable of wireless communication from outside the compression integument. The circuit board may thus incorporate a transmitter/receiver component coupled to the switches S 1 , S 2 , such as an RF, Bluetooth, wifi or Spec 802.11 device. The integument  10  can be equipped with a USB type connection for charging the power supply  30  and for data download or upload. The mirocontroller may thus include a memory for storing actuation data, and may further integrate with sensors on the circuit boards that can sense and “report” pressure and temperature, for instance. In one aspect, the microcontroller  24  is thus configured to communicate with a handheld device, such as an iPad, iPod, smart phone, or with another device equipped with wireless transmission/receiving capabilities, such as a PC or laptop computer. The remote device can serve to receive and record actuation data, and can act as a master controller for the micro-controller  24 , whether to activate either of the two switches, or in a more advanced configuration to remotely configure or program the micro-controller. 
         [0052]    A power supply  30  is provided that is connected to the distribution circuit boards  22   a - 22   c  and grounded to the negative anodes  20 . In one embodiment, the power supply  30  is a 7.5 volt, 40 AH lithium cell array contained with a pouch defined in the fabric body  12 . The pouch may be configured to insulate the user from any heat build-up that might occur when the battery is powering the integument  10 . The power supply  30  is preferably a rechargeable battery that can be recharged through the remote link to the microcontroller described above. 
         [0053]    The micro-controller  24  implements software for controlling the sequence and pattern of compression that will be followed through a treatment process. In one embodiment, the micro-controller is activated and controlled by a remote device, as described above. Additionally, the micro-controller can have basic user controls embedded in the integument, such as a control panel affixed to the outside of one of the fabric segments  12   a,    12   b.    
         [0054]    The manner in which pressure is applied to the user&#39;s body depends upon the number and arrangement of the pads  16  and channels  15 . In the illustrated embodiment of  FIG. 2 , the pads may be actuated from the lowermost channel  15   g  to the uppermost channel  15   a,  with successive channels being gradually deactivated, or expanded, and gradually activated, or contracted. Different activation patterns can be pre-programmed into the micro-controller or administered by the remote device as described above. When a channel is activated, the micro-controller  24  directs current to the specific channel which causes the memory wires  14   a  to contract or shrink, thereby reducing the effective diameter of the memory wires or elongated materials when wrapped around a limb. This reduction in diameter translates to an application of pressure by way of the pads  16  in the same manner as the air-inflatable devices of the prior art. When the current is removed or changed, the “memory” feature of the wire allows it to return to its deactivated or neutral condition, thereby removing pressure from the associated compressible pads. 
         [0055]    In an alternative embodiment the multiple 1×1 pads in two or three adjacent rows may be replaced by an elongated compressive pad extending along each side of the fabric body  12 . The memory wires  12   a  are embedded with the elongated pad in the manner described above and each row of elongated compressive pads can be actuated in the same manner as the plurality of smaller pads described above. 
         [0056]    In an alternative embodiment, an integument  40  may be formed by the combination of an interior sock  42 , shown in  FIG. 6 , and an exterior sock  45 , show in  FIG. 7 . The interior sock  42  incorporates compression pads  43  that encircle the limb and which may be an elongated cushion, as described above, or may be similar to pads  16 . The pads  43  may be thermally conductive to convey heat generated by the memory wires to the user&#39;s skin. Alternatively, the pads may be thermally insulating to minimize the transmission of heat to the user. The outer sock  45  is integrated over the inner sock  42  and includes the memory wires  46 , each aligned with a corresponding pad. The electronics, including the power supply and micro-controller, may be incorporated into a ring  48  at the top of the sock-shaped integument  40 . 
         [0057]    In another embodiment, the shape-changing elements may be replaced by non-extensible wires that are pulled by a motor carried by the integument. In particular, an integument  50  shown in  FIG. 8  includes a fabric body  51  with an extension  52  that may be configured with a fastening feature, such as the hook and loop fastener described above, that engages the opposite ends of the body to wrap the integument about a patient&#39;s limb. The integument may be provided with a number of elongated compressive pads  54  arranged in rows along the length of the fabric body. The pads may be configured as described above, namely to incorporate the bores  19  for receiving wires therethrough. However, unlike the embodiment of  FIGS. 1-2 , the wires of integument  50  need not be memory wires, but are instead generally non-extensible wires  56 . One end of each wire  56  is connected to a drive motor  60 , then the wire passes through a compressible pad  54 , around a pulley  62  at the opposite end of the fabric body  51 , and then back through the compressible pad. The end of the wire  56  is “grounded” or fastened to the fabric body  51 , as shown in  FIG. 8 . Each compressible pad includes its own wire  56  and each wire may be driven by its own motor  60 . The motors  60  are connected to a micro-controller  66  and to a power supply  70 , which may be similar to the power supply  30  described above. The micro-controller is configured to activate each motor  60  according to a prescribed compression protocol. 
         [0058]    In order to ensure that the integument  50  preserves the mobility and ease of use, the motors  60  may be strip-type motor, such as the Miga Motor Company “HT Flexinol model. The motor is thus compact and adapted for placement across the width of the fabric body  51 , as shown in  FIG. 8 . The motors will not inhibit the compression of the integument  50  or otherwise cause discomfort to the wearer. The wires  56  may be plastic wires for low-friction sliding relative to the compressible pads  54 , and are generally non-extensible so that pulling the wires translates directly into a compressive force applied through the pads. 
         [0059]    In an alternative embodiment, the wires  56  may be replaced by a mesh that is fastened at one end to a corresponding motor  60  and is “grounded” or fastened to the fabric body  51  at the opposite end. In this embodiment, the mesh is “free floating” between the compressible pads and an outer fabric cover. The mesh may be sandwiched between Mylar layers to reduce friction as the mesh is pulled by the motors. 
         [0060]    In a further alternative, the motor  60  and wire  56  arrangement shown in  FIG. 8  can be modified, as illustrated in  FIGS. 9-13 . In particular, the wire actuator device  100  shown in  FIG. 9  includes a primary circuit board  102  and an overstress protection circuit board  104  supported within a complementary configured cutout  105  in the primary circuit board. The gap formed by the cutout  105  between the circuit boards  102  and  104  enables limited movement of the circuit board  104  independently of the board  102 . The primary circuit board  102  includes a power strip  108  that is electrically connected to a power supply, such as the power supply  70  shown in  FIG. 8 , by way of a connector cable  140 . The connector cable  140  may also be configured to electrically connect the wire actuator device  100  to a microcontroller, such as the microcontroller  66  described above. The overstress circuit board  104  is mounted to the primary circuit board  102  by a plurality of resiliently deformable arms or bands  113  that allow some limited relative movement between the two boards  102  and  104  when the motors are operated to actuate the wires. The arms  113  may also be configured to provide a restoring force that opposes tension in the wire  110  to restore the device to its neutral “non-compression” position when power to the wires is removed or reduced. 
         [0061]    In one embodiment, the device  100  includes a shape-changing element in the form of a single wire  110  that is configured to form two loops  111 ,  112 , as shown in  FIG. 9 . The wire may be the memory wire or shape memory alloy (SMA) as described above. The ends  114 ,  115  of the wire are anchored to the primary circuit board  102  by suitable means, such as an anchor screw  120  threaded into the circuit board as is known in the art. The wire  110  is looped from the anchor screw  120  over a capstan  122  and into a corresponding loop  111 ,  112 . The loops  111 ,  112  have a length sufficient to extend along the length of the integument, in the manner shown in  FIG. 8  for the integument  50 . The loops may engage a pulley, such as the pulley  62  at an end of the integument opposite from the primary circuit board  12 . The two loops combine at the overstress circuit board  104 , each loop engaging a corresponding capstan  122   b  and electrically engaging a contact mount  124 . In an alternative embodiment, the loops can wrap around the contact mounts  124  and engage an interior contact mount  125 . Electrical current is applied to the SMA wire  110  at the contact mounts  124 , or  125  to heat the wire ohmically beyond the SMA transition temperature and to cause the wire to change length or contract, thereby applying compression to the integument. 
         [0062]    Power is supplied to the contact mounts  124  by way of an over-force contact feature  130 . The over-force contact feature is operable to disengage power to the wires in the event that the wires become over-tightened. The contact mounts are electrically connected to a contact  135  that is movable with the overstress circuit board  104 . In normal operation, the contact  135  is in conductive contact with a power input lead  132  so that power is supplied to the wire  110 . However, in an overstress condition in which the wire  110  is over-tightened, the wire tension will deflect the arms  113  and the contact  135  will move into contact with the bypass lead  133  that disengages power to the wire  110 . The input and bypass leads  132 ,  133  thus operate as a switch to terminate power when the switch is triggered by excessive movement of the overstress circuit board due to over-tightening of the wire  110 . Overtightening may be caused by the user pulling the body  51  too taut about his/her limb, or during actuation of the device when in use. The overstress feature prevents the tension on the SMA wire  110  from exceeding the tensile strength of the wire to thereby protect the wire from failure. 
         [0063]    A plurality of the devices  100  may be provided on a single integument, such as spanning the width of the fabric body  51  of an integument configured similar to the integument  50  described above. Thus, as shown in  FIG. 10  three devices  100   a,    100   b,    100   c  are provided, each with their corresponding wire  110   a,    110   b,    110   c.  Each device may be connected in series or in parallel to the power supply and microcontroller, with each device being separately addressable by the microcontroller to allow each device to be separately actuated. The microcontroller may thus implement a software or hardware routine that activates the devices in a predetermined pattern to achieve a desired compression protocol for the user. For instance, the devices  100   a ,  100   b,    100   c  may be actuated in a sequence to apply compression to the user&#39;s limb sequentially from a distal device to a proximal device (i.e., farthest from the heart to closest to the heart) to in essence push blood upward from the limb. 
         [0064]    An exemplary embodiment of an integument is shown in  FIGS. 11-13 . In this embodiment, a single wire actuator device  100 ′ is utilized with a single wire  100 ′ extending from the device  100 ′ at one end of an integument wrap  150  to an anchor  155  ( FIG. 12 ) at the opposite end of the wrap. The integument  150  includes a fabric strap  151  sized to be wrapped around a limb of a user, such as the calf. The integument may include a loop  152  at the device end of the fabric strap through which the opposite end  153  passes. An adjustable length hook-and-loop engagement between the two ends allows the user to wrap the integument snugly around his/her limb. It can be appreciated from  FIGS. 11-13  that the wire actuator device  100 ′ and wire  110 ′ are disposed on the outside of the fabric strap  151  and not in contact with the user&#39;s limb. A fabric cover may be provided to conceal and protect the working components of the integument, it being understood that the exposed components in the figures are for illustrative purposes. 
         [0065]    As shown in  FIG. 11 , the wire actuator device  100 ′ is modified from the device  100  in that the wire  110 ′ is anchored on the overstress protection circuit board  104  at posts  140  separate from the capstans  124  and contact mounts  122   b.  The wire is instead threaded between each capstan  124  and an interior capstans  125 ′. The ends of the wire are fastened to the anchors  140 . Threading the wire through the capstans helps eliminate twisting of the wire  110 ′ during actuation and release. 
         [0066]    The wire actuator device  100 ′, and particular the circuit board  102 , is provided with fastening openings  103  at the corners of the circuit board to accept a fastener for attaching the device to the fabric strap  151 . In one embodiment, the circuit board may be sewn to the fabric strap, or held in place by a rivet or snap arrangement. The circuit board is preferably permanently affixed to the strap to provide a solid anchor for the wire  110 ′. Alternatively the actuator device  100 ′ may be releasably fastened to the strap to provide a fail-safe feature to prevent over-tightening of the wire or cable around the user&#39;s limb. 
         [0067]    A compression device  200  according to a further feature of the present disclosure is shown in  FIG. 14 . The device  200  includes a pair of ribs  210  and  212 , which may be similar to the multi-device circuit board shown in  FIG. 10 . The ribs are fastened to a integument strap, such as the strap  150 , separated by a gap G. Unlike the device of  FIG. 10 , the compression device  200  operates by bringing the two ribs  210 ,  212  together or closing the gap G. To accomplish this result, a shape-changing wire  215  is connected between the two plates. In one embodiment, each leg  215   a,    215   b  of the wire  215  is fastened to the rib  210  at an anchor mount  218 . The wire  215  passes around a capstan  219  mounted on the associated overstress protection circuit board  204  of an adjacent rib  212 . Alternatively, each leg  215   a,    215   b  may be fastened to an anchor mount at the location of the capstan  219 ; however, it is preferable that the wire  215  be free to move around the capstan to ensure uniform movement of the opposite ends of the rib  210  toward the rib  212 . 
         [0068]    The compression device  200  includes a pair of spring elements  220  fastened to opposite ends of each plate  210 ,  212  and spanning the gap G. The spring elements are thus anchored at their ends  221  to a respective plate. The restoring force of the spring elements  220  opposes the contraction of the wires  215  and provides a biasing force to restore the ribs to their neutral position with the gap G. The spring elements may be in the form of a V-spring, hammer spring, leaf spring, a resiliently compressible material, or similar type of element capable of pushing the ribs apart when the wire  215  is relaxed. 
         [0069]    The example shown in  FIG. 14  includes two ribs and a single wire  215  separated by a gap G. In one embodiment, the gap G may be about 0.25 inches. The wire  215  may be a memory metal wire capable of a length reduction of about 0.5 inches, so that full actuation of the wire is capable of substantially fully closing the gap G. As with the previous embodiments the compression device  200  is fastened to an integument of fabric strap configured to encircle the limb of a user. It has been found that the configuration of compression device  200  shown in  FIG. 14  is capable of producing a compression pressure of about 30 mmHg (assuming that the fabric strap is generally inelastic). It is contemplated that greater pressures may be obtained by adding further ribs and wires. Thus, as depicted in the diagram of  FIG. 15 , a compression device  250  may be formed by four ribs  251   a - 251   d,  each fastened to a fabric strap with a gap G spacing between each plate. Three wires  252   a - 252   c  are engaged between adjacent ribs. Each wire is capable of closing the respective gap G, so that the total compression is equivalent to closing a gap of 3 xG, or 0.75 inches in the specific embodiment. This leads to an equivalently greater reduction in diameter of the integument, which leads to an effective compression pressure of about 90-100 mmHg for the specific example. Of course, additional ribs and wires can be added in series with the four ribs shown in  FIG. 15 , to thereby increase the maximum compression pressure capability of the integument. It is contemplated that typical treatments for human users may invoke compression pressures of 30-150 mmHg. 
         [0070]    The multiple wires may be controlled by a common microcontroller, such as described above. The microcontroller may implement instructions to control how many of the wires are activated to thereby control the compression pressure. It is further contemplated that this series array of ribs and wires of the device  250  may be repeated across the width of a given integument. These additional devices  250  would be controlled in the same manner by the micro-controller to adjust the amount of pressure applied, and may also be controlled as discussed above to vary which row of the integument is activated and to what degree. For instance, for a calf integument, three rows of devices  250  may be provided along the length of the calf. The distalmost row (i.e., the row closest to the ankle) may be activated first, followed by the next adjacent rows in sequence to effectively “push” blood upward from the calf. The devices may be activated and released in a predetermined sequence to form a pressure “wave” up the user&#39;s leg. In other words, the rows of devices may be actuated to form an infinite scrolling sequence or wave of pressure, as opposed to simply a series of sequential compressions. Alternatively, each row may be maintained in their actuated state, but the amount of pressure can be adjusted along the user&#39;s calf. It can be appreciated that the multi-component compression device  250  provides a great deal of flexibility in the compression regimen to provide a treatment tailored to the user and the condition being treated. 
         [0071]    A compression device  300  is shown in  FIG. 16  that essentially provides a mechanical advantage for a given length change of a wire  310 . In this embodiment, the wire is laced along the fabric strap  302  around support ribs  315 ,  316  and  317 . The endmost ribs  315 ,  316  are provided with anchors  317  for attachment to the strap  302 . The wire  310  may be sized to extend along substantially the entire length of the strap  302 , like the wire  110  in  FIG. 9 , or may be limited to the space between the endmost ribs  315 ,  316 . As shown in  FIG. 16 , the wire  310  winds around the ends  318  of the ribs and around the endmost ribs  315 ,  316 . The wire crosses over itself in the space between the ribs, similar to lacing a shoe. A spacer  322  is included between the crossing portions of the wire to eliminate friction between the portions as the wire contracts and expands. An insulator panel  320  may be provided between the wire  310  and the strap  302  for thermal and electrical isolation. 
         [0072]    Resilient elements  325  are provided between the ribs  315 ,  316 ,  317  that are configured to resiliently deflect when the wire  310  contracts and to flex back to their neutral shape when the wire is deactivated. In one embodiment the resilient elements may be in the form of a leaf spring or a bow spring between each rib. Alternatively, a single resilient element may extend along each side of the device  300  with the ribs affixed at spaced-apart locations on the resilient element  325 . 
         [0073]    In another embodiment, the compression device can be formed with a series of ribs with tensioning elements spanning between plates in a manner to increase the mechanical advantage for a given change in length of the tensioning elements. In one embodiment shown in  FIG. 17 , a compression arrangement  350  is provided that can be extended partially or entirely around the entire circumference of the compression device or can be integrated into a fabric strap, such as in the manner depicted in  FIG. 16 . The compression arrangement  350  includes two ribs  351   a ,  351   b,  although more plates may be utilized. The ends of a first SMA wire  352   a  are anchored to the plate  351   a  at anchors  353   a,    354   a.  The SMA wire  352   a  passes over pulleys  355   a,    356   a  at the opposed ends of the rib  351   a,  respectively. The first SMA wire  352   a  extends to an adjacent rib (not shown) or to an anchor affixed to a fabric strap, such as strap  302 . 
         [0074]    A second SMA wire  352   b  passes around pulleys  357   a,    358   a  at opposite ends of the first rib  351   a.  The second SMA wire extends to the second rib  351   b  to pass around pulleys  355   b ,  356   b  and is anchored at  353   b,    354   b.  A third SMA wire  352   c  is connected to the second rib  351   b  across pulleys  357   b,    358   b.  The anchors  353   a,    354   a,    353   b,    354   b  also provide the point of electrical connection for the shape-changing SMA wires discussed above. Each rib may thus include its own circuit board for controlling current to its respective SMA wire, or the ribs may be wired to a common controller. 
         [0075]    It can be appreciated that the two ribs  351   a,    351   b  are identically configured so that multiple such ribs  351  can be daisy-chained together with SMA wires  352  to increase the compressive capability of the compression device. Moreover, the contraction of each SMA wire  352  along its entire length is applied uniformly to the gap between adjacent ribs  351 . In other words, in a specific embodiment if the SMA wires  352  between each pair of ribs can undergo a change in length or contraction of 0.25 in., then combining four such plates can result in a combined 1.0 in. contraction between the ribs, which as a consequence results in a greater compressive force around the patient. In essence, this feature of the multiple ribs provides for a displacement multiplication of the assembled ribs, which results in a much greater tangential constriction for the device. Each rib  351  can be actuated discretely or in any combination or sequence as desired to create a compression profile. 
         [0076]    The compression assembly  400  shown in  FIG. 18  is similar to the assembly  350  in that it improves the mechanical advantage for the SMA wire arrangements. In this embodiment, each rib  401  ( 401   a,    401   b,    401   c ) supports a portion of four SMA wires. For instance, rib  401   a  supports wires  402   a,    403   a,    402   b  and  403   b,  while rib  401   b  supports wires  402   b,    403   b,    402   c  and  403   c,  and rib  401   c  supports wires  402   c,    403   c,    402   d  and  403   d.  It can be appreciated that the wires  402  are arranged to span the gaps between like ends of the ribs  401  (i.e., the top end in  FIG. 18 ) while the wires  403  are arranged to span the gaps between the like opposite ends of the ribs  401 . The ends of the SMA wires are affixed to the corresponding plate by corresponding anchors, such as anchors  404   a,    405   a,    406   a  and  407   a  for plate  401   a,  and similar anchors  404 - 407  for the other ribs in the device. The wires also extend around associated pulleys, such as pulleys  408   a,    409   a,    410   a  and  411   a  on plate  401   a,  and corresponding pulleys  408 - 411  for the other ribs in the device. The anchors and pulleys may be configured similar to the embodiment of  FIG. 17 . 
         [0077]    As shown in  FIG. 18   a , two wires  402   b  and  403   b  extend between the same pair of plates  401   a  and  401   b.  The SMA wires in the compression assembly  400  essentially form an overlapping daisy-chain, as opposed to the single daisy-chain arrangement of the compression assembly  350 . This overlapping daisy-chain arrangement provides the mechanical advantage or displacement multiplication improvement of the prior embodiment, particularly when more than two ribs are provided. In addition, this overlapping daisy-chain allows for a non-uniform compression pattern across the span of the ribs (i.e., from top end to bottom end as viewed in  FIG. 18   a ). In particular, with this arrangement, any single SMA wire, such as wire  402   b,  can be actuated so that the top ends of the ribs  401   a,    401   b  will be drawn together while the bottom ends of the ribs are inactive. Alternatively, all of the upper SMA wires  402   a,    402   b,    402   c,    402   d  can be actuated or all of the lower SMA wires  403   a,    403   b,    403   c,    403   d  (or any combination thereof) may be actuated to draw the top or bottom of the ribs together. 
         [0078]    For instance, as depicted in  FIGS. 19   a - 19   c  the device  400  may be actuated to generate a peristaltic-type compression displacement of the ribs. In  FIG. 19   a , only the SMA wires  402   a ,  402   b,    402   c,    402   d  spanning the gaps between the left ends of the respective ribs are actuated so that the like ends (i.e., left side in the figure) of the ribs are drawn together. The compression applied by the device  400  is thus limited to the left side of the ribs. In  FIG. 19   b , the SMA wires  403   a,    403   b,    403   c,    403   d  at both ends of the ribs are actuated or contracted, essentially drawing the right sides of the ribs  401   a,    401   b,    401   c  together so that compression is applied essentially evenly across the entire width of the compression device  400 . Then in  FIG. 19   c , the upper SMA wires  402   a,    402   b,    402   c,    402   d  are released so that the compression is released at the left ends of the ribs. Next the right side SMA wires  403   a,    403   b,    403   c,    403   d  are relaxed so that the device  400  returns to its neutral configuration depicted in  FIG. 18 . This sequence can be repeated during a compression protocol. 
         [0079]    It can be appreciated that this overlapping daisy-chain arrangement combined with the displacement multiplication arrangement adds a greater ability to tailor a compression regimen not only circumferentially around the patient&#39;s limb, but also axially along the length of the limb. Providing a series of the compression assemblies  400  axially along the length of the limb adds an even greater degree of variability to the compression regimen. 
         [0080]    In the embodiments of  FIGS. 17-18 , the pulleys, such as pulleys  355   a  and  408   a,  may be wheels or discs that are rotatably mounted, 3D printed or overmolded onto the respective rib. In an alternative configuration, the rib may be configured to provide bearing surfaces for the SMA wires. Thus, as shown in  FIG. 20 , a rib  401  may be molded to integrally define outer ribs  412  and  414  that have curved ends  413 ,  415 , respectively. The curved ends correspond to the pulleys  408   a,    410   a  of the compression assembly  400 , for instance. Similarly, interior ribs  420  and  424  are provided, each having a curved end  421 ,  425 , respectively. The curved ends correspond to the pulleys  409   a,    411   a,  for instance. Openings, such as opening  428 , may be provided in the rib  401  for anchoring the ends of the SMA wires. 
         [0081]    Another approach is shown in  FIGS. 21-23 . The rib  450  may be similar to the ribs in the embodiments of  FIGS. 17-18 . In particular, the rib  450  includes a substrate  451  that may be conventional for circuit boards and the like. However, rather than providing separate anchors, such as anchor  405   a  shown in  FIG. 18 , the rib  450  shown in  FIG. 20  incorporates a clamp plate  454  at each end of the rib that spans the width of the rib. As shown in the cross-sectional view of  FIG. 22 , the clamp plate  454  includes alternative V-shaped slots  456  and circular slots  457 . The V-shaped slots  456  are sized to allow a SMA wire, such as wires  403   a  and  403   b  in  FIG. 21 , to slide with little resistance. The circular slots  457 , however, are configured to clamp the end of a corresponding wire, such as wires  402   a,    402   b.  Thus, as can be appreciated from  FIG. 21 , the wires  403   a,    403   b  are clamped at the lower end of the rib  450  while the wires  402   a,    402   b  must be free to translate as the wires contract and expand. The clamp plate  454  is also mounted at the top of the rib, but is re-oriented 180° so that the ends of the wires  402   a,    402   b  are being anchored and the other wires  403   a,    403   b  are free to slide. The clamp plate  454  may be fastened to the rib  450  by screws  455 , a bonding agent or other suitable fasteners. 
         [0082]    In another aspect of the rib  450 , the pulleys of the prior embodiments are replaced by a guide plate  460 . The guide plate  460  defines curved guide slots  463  (see  FIGS. 21 ,  23 ) that provide a sliding surface to guide the SMA wires laterally from the ribs to interact with an adjacent rib. A guide plate is provided at each end of each rib and may be engaged by screws  461  or other suitable fasteners. 
         [0083]    A compression integument  500  shown in  FIGS. 24-25  utilizes two SMA wires to accomplish the compression function. The integument  500  includes a plurality of ribs  501  arranged on an elongated body as described above. Each of the ribs is a multi-layer construction, as depicted in  FIG. 25  with a center panel  510  sandwiched between opposite panels  512 ,  514 . The panels  510 ,  512 ,  514  define internal arcuate surfaces about which each SMA wire  502   a ,  502   b  is wound. In  FIG. 24 , the ribs  501  are depicted with the upper panel  514  removed to expose the first SMA wire  502   a  wrapped around arcuate surfaces  520  facing each side  501   a,    501   b  of the rib and adjacent a first end  501   c  of the rib. The panels  510 ,  512 ,  514  further define an internal central arcuate surface  525  which can be in the form of a cylindrical hub. The wire  502   a  is wrapped around the central arcuate surface, which acts as a pulley surface for sliding movement of the wire  502   a.  Thus, as shown in  FIG. 24 , the SMA wire  502   a  enters the upper most rib  501  at one side  501   a,  traverses the first arcuate surface  525 , wraps around the central arcuate surface  525  and exits the rib  501  via a second arcuate surface  520 . The wire  502   a  repeats this configuration through each successive rib  501 . 
         [0084]    The multi-layer construction of the rib  501  provides a similar structure for the second SMA wire  502   b.  As shown in  FIGS. 24-25 , the arrangement of the first wire  502   a  overlaps the arrangement of the second SMA wire  502   b.  The second wire  502   b  enters the ribs  501  at the opposite end  502   d,  passing around arcuate surfaces  520  adjacent the opposite sides  501   a,    501   b  of the ribs and extending around a central arcuate surface  525  at the end  501   c  of the rib. 
         [0085]    In operation, each SMA wire  502   a,    502   b  is separately controllable, as described above. When one wire, such as wire  502   a,  is activated, the wire contracts in length so that the ribs essentially slide relative to the wire  502   a  to be drawn together at the end  501   c  of each rib. A similar action occurs when the second wire  502   b  is actuated. Since the wires are not constrained within the ribs  501 , a single wire can be used to contract each end of the compression integument. The two wires can be actuated in a predetermined sequence to achieve a pulsing compression as desired. 
         [0086]    The compression integuments disclosed herein may be provided in a multi-component configuration. For example, as shown in  FIGS. 26-30 , a compression integument  600  may be provided with a base panel  602  with an engagement surface  603 , such as a hook-and-loop fastening surface. A pair of elongated panels  610  are provided, with each panel including a number of the plurality of ribs and at least two shape-changing wires, such as any of the rib and wire configurations described above. The elongated panels  610  are provided with an inward surface  612  configured to contact the user&#39;s skin, with the surface having a gripping texture to prevent slipping of the integument in use. One end  614  of each panel is configured for attachment to the base panel  602 , as depicted in  FIG. 26 . The opposite end  615  of each elongated panel is also configured for attachment to eh base panel  602  when the integument  600  is wrapped around the body of a user. The ends  614 ,  615  may b e configured with a hook-and-loop fastening feature. 
         [0087]    As shown in the partial cut-away view of  FIG. 29 , each elongated panel  610  includes an array of ribs  630  with SMA wires (not shown) that are connected to electrical couplings  625 . The couplings  625  electrically connect the SMA wires of the two elongated panels  610  and can provide electrical connection to an external component, such as an external controller for controlling actuation of the SMA wires as described above. 
         [0088]    In a further feature, the elongated panels  610  may be provided with a pre-tensioning element  620  configured to apply a tension across the panel when the integument is engaged around a portion of the body of the user. The tensioning element  620  may be connected to one of the ribs  630  by cables  622  that are adapted to be placed in tension by the element  620 . In one embodiment, the tensioning element  620  may be a rotating ratchet mechanism configured to wind the cables  622  to thereby place them in tension. The tensioning element  620  allows the user to apply some pre-tension to the integument when worn. The pre-tension is maintained as the SMA wires are actuated. 
         [0089]    In an additional feature, the compression integument  600  may be provided with a removable pouch  640  shown in  FIG. 30 . The pouch  640  may be removably mounted to the base panel  602 , such as at a location  605 . The pouch  640  may be configured to receive a cooling or heating element as desired by the user. 
         [0090]    In the disclosed exemplary embodiments, the wires are arranged generally parallel to the extent of the integument or fabric strap. In other words, the wires are arranged around parallel circumferences encircling the limb of the user. In alternative embodiments, the wires may be arranged at an angle relative to the circumference. With this configuration, the compression pressure applied by the device when actuated extends not only circumferentially around the limb but also includes a pressure component along the length of the limb. 
         [0091]    In the disclosed exemplary embodiments, the compressive force is created by activation of a shape-changing element, whereby under a certain stimulus the element changes shape in a direction adapted to tighten the integument about the user&#39;s limb. In some embodiments the shape-changing elements are single strand wires, such as memory metal wires, that are activated by flowing a current through and thus ohmically heating the wire. In other alternatives, the shape-changing elements may be braided wires that are activated by an ohmically heated wire passing through the interior of the braid. 
         [0092]    In a further alternative, the shape-changing element may be a auxetic cable that changes aspect ratio rather than length. With this type of material, the thickness of the cable increases when the cable is activated, which translates into a radial pressure on the limb for a generally inelastic integument. The auxetic cable is actuated by pulling the ends of the cable. A shape memory actuator may be utilized to provide the force to pull the ends of the auxetic cable. It is further contemplated that a micro-solenoid structure may be used to provide the pulling force. In this case, the micro-solenoid can be controlled to provide an oscillating pressure, such as by rapidly pulling and releasing the auxetic cable. 
         [0093]    While the invention has been illustrated and described in detail in the drawings and foregoing description, the same should be considered as illustrative and not restrictive in character. It is understood that only the preferred embodiments have been presented and that all changes, modifications and further applications that come within the spirit of the invention are desired to be protected. 
         [0094]    For instance, while the present disclosure is generally directed to human users, patients or athletes, the compression integuments disclosed herein can be adapted to other animals. For instance, race horses often receive pre- and post-race treatments similar to those received by human athletes. Any of the compression integuments disclosed herein may be sized and configured to encircle any part of the leg of a horse. Similar modifications can be made for treatment of other animals as well. 
         [0095]    Moreover, the SMA wires described herein may be actuated by the application of an electrical current, such as a typical shape memory alloy. The SMA wires will thus generate heat as the current flows through the wires. This heat may be part of the treatment regiment using the compression integuments of the present disclosure. Alternatively, the SMA wires may be thermally isolated to avoid heat transfer to the patient. 
         [0096]    As a further alternative, the compression integuments or devices disclosed herein can be configured to apply focused pressure on a portion of the body without encircling the body. For instance, a device such as the device  400  may include a limited number of ribs, for example the three ribs shown in  FIG. 18 . The ribs may be removably adhered to the skin of a patient, such as across or along the lower back. Actuation of the SMA wires cause the space between ribs to successively reduce and expand as the wires contract and return to their neutral length. This action in effect kneads the skin as the device contract and expands. This approach allows the compression devices disclosed herein to be used as a training aid in which the device is worn by an athlete and is controlled to apply a compression force in response to an improper motion. For instance, the device can be adhered the triceps region of the arm of a golfer to apply a compressive force to the back of the arm in response to the golfer&#39;s elbow not being straight during a swing. Sensors associated with the device can determine the attitude of the golfer&#39;s arm and the relative position of the forearm and upper arm. The slight compressive force applied by the device can cause the golfer to tighten the triceps to thereby straighten the arm. Practice with the compression device generates a muscle memory so that the golfer learns to keep the elbow straight during a swing. The device can be used at any joint of the body to promote proper form for any type of repetitive sports motion, whether kicking a soccer ball, shooting a basketball or executing a butterfly swimming stroke.