Abstract:
An orthotic for mounting on a user&#39;s arm comprises an upper cuff that is removeably attachable to the user&#39;s arm at a point above the elbow joint. A lower cuff is removeably attachable to the user&#39;s arm at a point below the elbow joint, and is rotationally fixed to the forearm. At least one flexible elongated member having a first end that is releasably coupled to the upper cuff and an opposite second end that is releasably coupled to the lower cuff. The upper cuff and the lower cuff are configured to move in more than one plane with respect to one another.

Description:
CLAIM OF PRIORITY 
       [0001]    This application claims priority to U.S. provisional application Ser. No. 60/992,370, filed Dec. 5, 2007, the entire disclosure of which is incorporated by reference herein. 
     
    
     BACKGROUND OF THE INVENTION 
       [0002]    The present invention generally relates to orthotic devices and, in particular, an orthotic device that is designed to span the elbow and that are secured to an arm both above and below the elbow. 
         [0003]    Following a neurological injury, a patient often experiences upper limb involvement (hemiparesis). Often times the elbow presents with hypertonia or hypotonia. Hypertonia is when the elbow tends to, stay in the flexed position, and hypotonia is when the elbow is week and hangs down at the side. Hypotonia is often also referred to as flaccid. 
         [0004]    Orthotic devices that address the hemiparetic elbow conventionally include an upper component that attaches to the arm above the elbow and a lower component that attaches to the arm below the elbow. Furthermore, the upper component and the lower component are hinged together in pivotable disposition in the area of the elbow, and a biasing member typically biases the upper and lower components toward a particular orientation relative to one another and thereby urges the arm into flexion or extension, as the case may be. An example of such an orthotic device  100  is shown in  FIGS. 1-3 . In particular,  FIG. 1  is an overall perspective view of a conventional elbow orthotic  100 ;  FIG. 2  is a partial perspective view of the orthotic  100  in a flexed position; and  FIG. 3  is a partial perspective view of the orthotic  100  in a flexed position. As will be appreciated from review of  FIGS. 1-3 , upper and lower arm components  102 , 104  of the orthotic  100  have overlapping portions that are hinged together at an axis  106 . 
         [0005]    A drawback to such conventional orthotic devices is that they tend to inhibit or otherwise interfere with movement of the forearm between pronation and supination. In this respect, it is important to note that the elbow flexes and extends; however, below the elbow the forearm pronates and supinates, which is to say that the forearm turns the hand palm down and palm up, respectively. This is anatomically done by the physical make up of two bones of the forearm, i.e., the Radius and the Ulna. Another drawback with conventional elbow orthotic devices is that they do not incorporate the hand functionally for grasp and release activities. 
         [0006]    An orthotic device in accordance with one or more preferred embodiments of the present invention addresses such drawback. 
       SUMMARY OF THE INVENTION 
       [0007]    The present invention includes many aspects and features. 
         [0008]    In an aspect of the invention, an orthotic includes: (a) an upper component configured to be attached to an arm above the elbow; (b) a lower component configured to be attached to an arm below the elbow; and (c) one or more elongate intermediate components connecting the upper component and the lower component together, wherein the one or more intermediate component are elastic and wherein only the one or more intermediate components connect the upper and lower components together. 
         [0009]    In another aspect of the invention, an orthotic includes: (a) an upper component configured to be attached to an arm above the elbow; (b) a lower component configured to be attached to an arm below the elbow; and (c) one or more elongate intermediate components connecting the upper component and the lower component together, wherein the one or more intermediate component are elastic and wherein the upper and lower components are not hinged together. 
         [0010]    In a feature of one or more of these aspects, the orthotic is an elbow orthotic and is configured to urge the arm into flexion. 
         [0011]    In a feature of one or more of these aspects, the orthotic is an elbow orthotic and is configured to urge the arm into extension. 
         [0012]    In a feature of one or more of these aspects, the one or more intermediate components is an elastic cord. 
         [0013]    In a feature of one or more of these aspects, the one or more intermediate components is a flexible rod. 
         [0014]    In a feature of one or more of these aspects, the orthotic further includes a component that is attached to and extends from the upper component and that defines a point of tensional redirection in one of the intermediate components. 
         [0015]    Another aspect of the invention is a method of treating a hemiparetic elbow using an orthotic of any of the preceding aspects and features. 
         [0016]    Another aspect of the invention is a method of making/assembling the orthotic of any of the preceding aspects and features. 
         [0017]    In still yet another aspect, an upper arm component configured to be secured to an upper arm above the elbow and a component attached thereto and extending therefrom and configured to guide a line of tension from the upper arm component to a point of tensional redirection located below the elbow. 
         [0018]    In addition to the aforementioned aspects and features of the present invention, the present invention further encompasses the various possible combinations of such aspects and features. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0019]    One or more preferred embodiments of the present invention now will be described in detail with reference to the accompanying drawings, wherein the same elements are referred to with the same reference numerals, and wherein: 
           [0020]      FIG. 1  is an overall perspective view of the conventional elbow orthotic. 
           [0021]      FIG. 2  is a partial perspective view of the orthotic of  FIG. 1  in an extended position. 
           [0022]      FIG. 3  is a partial perspective view of the orthotic of  FIG. 1  in a flexed position 
           [0023]      FIG. 4  is a perspective view of an elbow orthotic in accordance with a preferred embodiment of the present invention, wherein the arm is in a partially extended position. 
           [0024]      FIG. 5  is a perspective view of the elbow orthotic of  FIG. 4 , wherein the arm is in a flexed position. 
           [0025]      FIG. 6  is a perspective view of an elbow orthotic in accordance with another preferred embodiment of the present invention. 
           [0026]      FIGS. 7-11  are different perspective views of an orthotic in accordance with another preferred embodiment of the invention. 
           [0027]      FIGS. 12-13  are different perspective views of another orthotic in accordance with a preferred embodiment of the invention. 
           [0028]      FIG. 14  illustrates an upper arm component in accordance with a preferred embodiment of the invention. 
           [0029]      FIG. 15  illustrates an upper arm component in accordance with another preferred embodiment of the invention. 
           [0030]      FIG. 16  illustrates an upper arm component in accordance with still another preferred embodiment of the invention. 
       
    
    
     DETAILED DESCRIPTION 
       [0031]    As a preliminary matter, it will readily be understood by one having ordinary skill in the relevant art (“Ordinary Artisan”) that the present invention has broad utility and application. Furthermore, any embodiment discussed and identified as being “preferred” is considered to be part of a best mode contemplated for carrying out the present invention. Other embodiments also may be discussed for additional illustrative purposes in providing a full and enabling disclosure of the present invention. Moreover, many embodiments, such as adaptations, variations, modifications, and equivalent arrangements, will be implicitly disclosed by the embodiments described herein and fall within the scope of the present invention. 
         [0032]    Accordingly, while the present invention is described herein in detail in relation to one or more embodiments, it is to be understood that this disclosure is illustrative and exemplary of the present invention, and is made merely for the purposes of providing a full and enabling disclosure of the present invention. The detailed disclosure herein of one or more embodiments is not intended, nor is to be construed, to limit the scope of patent protection afforded the present invention, which scope is to be defined by the claims and the equivalents thereof. It is not intended that the scope of patent protection afforded the present invention be defined by reading into any claim a limitation found herein that does not explicitly appear in the claim itself. 
         [0033]    Thus, for example, any sequence(s) and/or temporal order of steps of various processes or methods that are described herein are illustrative and not restrictive. Accordingly, it should be understood that, although steps of various processes or methods may be shown and described as being in a sequence or temporal order, the steps of any such processes or methods are not limited to being carried out in any particular sequence or order, absent an indication otherwise. Indeed, the steps in such processes or methods generally may be carried out in various different sequences and orders while still falling within the scope of the present invention. Accordingly, it is intended that the scope of patent protection afforded the present invention is to be defined by the appended claims rather than the description set forth herein. 
         [0034]    Additionally, it is important to note that each term used herein refers to that which the Ordinary Artisan would understand such term to mean based on the contextual use of such term herein. To the extent that the meaning of a term used herein—as understood by the Ordinary Artisan based on the contextual use of such term—differs in any way from any particular dictionary definition of such term, it is intended that the meaning of the term as understood by the Ordinary Artisan should prevail. 
         [0035]    Furthermore, it is important to note that, as used herein, “a” and “an” each generally denotes “at least one,” but does not exclude a plurality unless the contextual use dictates otherwise. Thus, reference to “a picnic basket having an apple” describes “a picnic basket having at least one apple” as well as “a picnic basket having apples.” In contrast, reference to “a picnic basket having a single apple” describes “a picnic basket having only one apple.” 
         [0036]    When used herein to join a list of items, “or” denotes “at least one of the items,” but does not exclude a plurality of items of the list. Thus, reference to “a picnic basket having cheese or crackers” describes “a picnic basket having cheese without crackers”, “a picnic basket having crackers without cheese”, and “a picnic basket having both cheese and crackers.” Finally, when used herein to join a list of items, “and” denotes “all of the items of the list.” Thus, reference to “a picnic basket having cheese and crackers” describes “a picnic basket having cheese, wherein the picnic basket further has crackers,” as well as describes “a picnic basket having crackers, wherein the picnic basket further has cheese.” 
         [0037]    Referring now to the drawings and, in particular,  FIGS. 4-6 , one or more preferred embodiments of the present invention are next described. The following description of one or more preferred embodiments is merely exemplary in nature and is in no way intended to limit the invention, its implementations, or uses. 
         [0038]    In this regard,  FIG. 4  is a perspective view of an elbow orthotic  400  in accordance with a preferred embodiment of the present invention, wherein the arm is in an extended position; and  FIG. 5  is a perspective view of the elbow orthotic  400  wherein the arm is in a flexed position. Additionally,  FIG. 6  is a perspective view of an elbow orthotic  600  in accordance with another preferred embodiment of the present invention that is similar in construction and design to orthotic  400 , but that further includes a padding component  602  as part of the orthotic  600 . 
         [0039]    In general, an orthotic of the present invention preferably comprises: an upper arm component that is configured to be secured to the upper arm above the elbow; and a lower arm component that is configured to be secured to the lower arm below the elbow. In particular, the lower arm section is secured to the wrist; to the wrist and hand; or to the wrist, hand, and fingers, as shown in  FIG. 4 . 
         [0040]    In the orthotics  400 , 600 , the upper arm section preferably is in the form of a cuff  402  that is approximately 4 to 6 inches in length. As shown in  FIGS. 4 and 7 , upper cuff  402  may have either a anterior or lateral opening in order to secure the cuff to the user&#39;s upper arm. The cuff is secured to the arm with one or more attachments such as straps, clasps, buckles, or the like. The lower arm component itself comprises forearm-wrist-hand orthotics  404  substantially as shown and described in U.S. Pat. No. 7,001,352, which is hereby incorporated herein by reference; however, other designs of the lower arm component are certainly with the scope of the present invention, and the invention is not limited to use only of orthotics  404  of this patent. 
         [0041]    In accordance with the present invention, upper arm component  402  and lower arm component  404  are connected by one or more elongate members  406 . In contrast to conventional elbow orthotics, the upper and lower arm components are not hinged together. 
         [0042]    In the illustrated embodiments of  FIGS. 4-6 , the elongate members comprise elastic cords  406  each of which provides a line of tension in the orthotic that tends to bias the upper and lower arm components toward a particular orientation relative to one another. In particular, elastic cord  406  is attached both to upper arm component  402  and to lower arm component  404 . The attachments of elastic cord  406  can be accomplished, for example, using hooks, cleats, cams, clips, and the like. In the embodiment shown in  FIG. 4 , cleats  407  and  409  are used. 
         [0043]    Furthermore, an outrigger  408  is attached to the posterior and/or lateral aspects of cuff  402  and can be adjustably mounted in the proximal and/or distal directions via additional attachment openings in the cuff. Outrigger  408  serves to guide each elastic cord  406  from cuff  402  to a point located below the apex of the elbow, from which elastic cord  406  extends and is attached to lower arm component  404 . This arrangement assists with pulling the elbow into an extension position. Outrigger  408  thus defines a point of tensional redirection that is located below the elbow. In a variation not shown, but which will be apparent to the ordinary artisan over the drawings disclosed and described herein, another attachment to the cuff may be provided that locates the point of tensional redirection above the apex of the elbow in order to assist the elbow into a flexed position. The tensional redirection of an elastic cord is achieved in the preferred embodiment by means of a pulley  410 , i.e., a freely rotatable wheel mounted at the distal end of the outrigger.  FIGS. 7-16  shows another embodiment where redirection is achieved by a fixed end of outrigger  408 . 
         [0044]    When using elastic/shock cords to facilitate elbow extension, it is preferred that the cord or cords attach to outrigger  408  on upper component  402 , with a cord (or more cords if using more than one cord) passing down outrigger  408 , passing behind and being redirected below the apex of the elbow, and extending and attaching to lower component  404 . The adjustable force generated in various flexed positions will help pull the elbow back into an extension position. In this case, the tension/force mimics the non-functioning muscle (triceps) that moves the elbow into extension. It also provides resistance to the weakened non-functioning muscle (biceps) that moves the elbow into flexion, thus assisting with strengthening. 
         [0045]    When using elastic/shock cords to facilitate elbow flexion, it is preferred that the cord or cords attach to a site on the posterior or lateral aspect of upper arm component  402 , with a cord (or more cords if using more than one cord) passing above and being redirected above the apex of the elbow, and extending to attach to lower arm component  404 . The adjustable force then generated will help pull the elbow into a flexed position. In this case, the tension/force mimics the non-functioning muscle (biceps) that moves the elbow into flexion. It also provides resistance to the weakened non-functioning muscle (triceps) that moves the elbow into extension, thus assisting with strengthening. 
         [0046]    The attachment sites on the lower component may also allow for force/tension adjustments, such as when cleats/cams  407  are used in conjunction with elastic/shock cords (e.g. when pulling the elastic cord further through the cleat thus increasing the tension/force). 
         [0047]    As an alternative to elastic-cord  406  and -pulley  410 , an elongate energy storing material like spring steel or a flex rod may be used as the elongate member for connecting and biasing the upper and lower arm sections toward a particular orientation relative to one another. Various energy storing materials may be used, and different forces will be generated depending on the respective physical properties of such materials (e.g. a ⅛ of an inch diameter elastic/shock cord will offer less force than a 3/16 of an inch diameter elastic/shock cord). 
         [0048]    Outrigger  408  may also incorporate a padding component  602  at the posterior aspect of the elbow, as shown in  FIG. 6 . Padding component  602  helps maintain the position of upper cuff  402  and lower cuff  404  is moved. 
         [0049]    Still yet,  FIG. 7-11  are different perspective views of an orthotic  700  in accordance with another preferred embodiment of the invention. This orthotic  700  is similar to orthotic  400  in that it has an upper cuff  702 , lower arm component  704  that attaches to the forearm and hand and further spans the wrist. An outrigger  708  is releasably coupled to upper cuff  702  similar to that in the embodiments shown in  FIGS. 4-6 . Elastic cord  706  coupled upper cuff  702  to lower cuff  704 . In contrast,  FIGS. 12-13  are different perspective views of another orthotic  1200  in accordance with a preferred embodiment of the invention, wherein lower arm component  704  attaches only to the forearm. In this embodiment, upper cuff  1202  has two outriggers  1208  that redirect elastic cords  1206 . Cords  1206  connect to lower cuff  1204  by cleats  1207  (only one is shown in the figure). A pad  1210  is coupled to outrigger  1208  to provide additional upper arm support. As shown in  FIG. 13 , pad  1210  is secured to outrigger  1208  by an adjustable spring clamp  1212 . 
         [0050]      FIGS. 14-16  illustrate variations of the upper arm component. In  FIG. 14 , upper arm component  1400  has conduit guides  1402  that are attached to cuff  1404  by adjustable spring plates  1408  and  1414  and that receive therethrough the elastic cords (not shown for clarity). Moreover, the elastic cords are guided by bent or curved sections outrigger end sections  1406  located proximate to the end of the conduit guides as shown in  FIG. 14 . For reference, upper arm component  1400  of  FIG. 14  is utilized in the orthotic  700  of  FIGS. 7-11 . 
         [0051]    In contrast,  FIG. 15  is intended to illustrate an upper arm component  1500  having telescoping conduit guides, in that the bent or curved sections  1506  located at the end of the conduit guides  1502  actually extend within the conduit guides  1502  in frictional fit therewith and may pulled out to lengthen the protraction of the curved sections  1506  from cuff  1504 , whereby the point of tensional redirection can be adjusted and positioned as desired along the direction of the axes of the conduit guides. 
         [0052]    In the structural design of the upper arm component  1400 , 1500  of  FIGS. 14 and 15 , the conduit guides are removably attached to the cuff by spring plate  1408 , which includes curved sides  1410  that receive and retain the conduit guides against the cuff but that may be raised so as to release and remove the conduit guides from the cuff. Furthermore, as shown, a padding component  1412  is adjustably attached to the conduit guides via a second spring plate  1414 . 
         [0053]      FIG. 16  illustrates another upper arm component  1600  in accordance with another preferred embodiment thereof. In this embodiment, outriggers  1602  are provided with pulleys  1604  attached at their distal ends. Proximal ends of the outriggers (i.e., the opposite ends thereof) include retention members  1606  for receiving and retaining ends of the elastic cords (not shown for clarity) that are used to connect the upper and lower components together in an orthotic, which elastic cords are engaged and redirected by the pulleys. Outriggers  1602  is secured to the cuff by a mounting member  1608  and the outrigger preferably is adjustable along the axis thereof by sliding frictional engagement through bores formed in mounting member  1608 . A padding component  1610  also is releasably mounted to outriggers  1602  using a spring plate  1612  and, in  FIG. 16 , spring plate  1612  and padding component  1610  are actually shown in a disengaged state with padding component  1610  disposed below outriggers  1602 . Padding component  1610  is secured to spring plate  1612  using conventional fasteners, such as screws. 
         [0054]    Based on the foregoing description, it will be readily understood by those persons skilled in the art that the present invention is susceptible of broad utility and application. Many embodiments and adaptations of the present invention other than those specifically described herein, as well as many variations, modifications, and equivalent arrangements, will be apparent from or reasonably suggested by the present invention and the foregoing descriptions thereof, without departing from the substance or scope of the present invention. Accordingly, while the present invention has been described herein in detail in relation to one or more preferred embodiments, it is to be understood that this disclosure is only illustrative and exemplary of the present invention and is made merely for the purpose of providing a full and enabling disclosure of the invention. The foregoing disclosure is not intended to be construed to limit the present invention or otherwise exclude any such other embodiments, adaptations, variations, modifications or equivalent arrangements, the present invention being limited only by the claims appended hereto and the equivalents thereof.