Modular articulating seating system for the handicapped

A seating system which can be adapted to the particular body size and required spatial orientation of a disabled person to hold him securely and in an orthopedically correct required position, and which can be fitted to any patient in a manner that minimizes the amount of custom craft work and cost. The seat includes a frame having three shells, including a lower seat back shell that can pivot and shift relative to the seat bottom shell and the upper back shell. A cushion system which includes a group of individual cushions can be rapidly installed on the shells to closely fit the individual. The shells can be independently adjusted to control the general contour of the thighs, back, hips and shoulders. Different cushions can be chosen to closely control the patient's orientation and to snugly but comfortably fit him into the adjusted frame. Close fitting of a patient's trunk and the region above the hips, for a wide variety of body types, is enabled by the use of a three-cushioned lower back arrangement, which includes a lower back cushion that supports only the back, and a pair of side cushions located at either side of the back cushion and projecting forward of it to lie on either side of the patient. The modular side cushions are chosen from a group of such cushions, which provide proper lateral positioning and closely fit the person.

BACKGROUND OF THE INVENTION 
A variety of disabilities necessitates specialized seating for handicapped 
persons wherein the person, and particularly his torso, must be securely 
yet comfortably held in a predetermined position. The general orientation 
of the person varies with different illnesses. For example, persons with 
muscular dystrophy may have to be held in an exaggerated lumbar lordosis 
position, persons with cerebral palsy may have to be held with their 
shoulders and back rounded forward and their head directly over their 
shoulders, while quadriplegic persons may have to be held with their back 
and head extending in a straight line but at an extreme rearward incline. 
Close support of the person's trunk, not only at the front and back but on 
either side, requires that the seat be formed to accommodate persons of 
various widths at different parts of their body. Heretofore, the seats 
available to persons were either of moderate cost with no or poor fitting 
capability, or well-fitting but individually hand shaped and of a very 
high cost. Seats available at moderate prices have utilized primarily flat 
or gently curved surfaces that could accommodate all persons but none of 
them comfortably or closely. Some seats have provided cushions mounted on 
movable supports with many degrees of freedom, but such supports tended to 
loosen, and the cushions could not adequately fit a wide area of persons 
of different shapes. No existing seats allow for the body to be rounded or 
for proper contouring of patients with hip and spinal obliquities 
(non-symmetrical growth). Custom seats were available, which were 
individually cut to fit or were molded to the person by using a hardenable 
molding compound and molding one or a few cushion sections to the person 
such as by casting around him. Such custom seats require considerable time 
of the person and of skilled technicians, resulting in a high cost. Such 
custom molded seats have been especially expensive when utilized for 
children, whose dimensions greatly change perhaps after periods of less 
than a year, as they grow, requiring a new customized seat. 
A seating system which could adjust to and hold a patient in any of a 
variety of general position orientations, and which also could comfortably 
but securely hold a patient in a particular position within that 
orientation, which could be quickly fitted to a patient utilizing 
off-the-shelf parts, and which could be refitted at moderately low cost to 
growing children, would have considerable benefit to handicapped persons. 
SUMMARY OF THE INVENTION 
In accordance with one embodiment of the present invention, a seating 
system is provided for handicapped persons, which can be readily fitted to 
a patient to closely and comfortably support him in an orthopedically 
correct orientation, utilizing a limited number of off-the-shelf parts to 
enable fitting at low cost. The seat includes a shell-like frame having a 
seat bottom and back that can be locked within a range of pivotal 
positions with respect to the seat bottom. A group of cushions can be 
readily installed on the seat frame, and the cushions are orthopedically 
designed for specific disabilities and to closely hold a particular 
individual. The cushions include a lower back cushion that supports only 
the lower back of a patient. Pairs of side cushions, which position the 
patient laterally, are mounted on either side of the lower back cushion 
and extend forward of it to closely support and flex the patient. Side 
cushions of various thicknesses are available, which all can be utilized 
independently with the same lower back cushion, to accommodate lateral 
deformity and variations in patients width. 
The seat back includes an upper shell segment which is pivotally mounted to 
a lower shell segment, to permit choice of the degree of vertical 
curvature to which the back of a patient is held. All shell segments can 
be not only pivotally adjusted, but also can be adjusted to permit limited 
vertical or horizontal sliding, to fit persons of varying back height and 
thigh length. The ability to independently adjust both right and left 
shoulder and hip positions, allows for correct positioning of patients 
with spinal deformity or asymmetrical growth patterns. 
The novel features of the invention are set forth with particularity in the 
appended claims. The invention will be best understood from the following 
description when read in conjunction with the accompanying drawings.

DESCRIPTION OF THE PREFERRED EMBODIMENTS 
FIG. 1 illustrates a seat 10 designed to hold a handicapped person very 
securely and comfortably in a predetermined upright position. The seat 
includes a shell-like frame 12 and a group of cushions 14 mounted on the 
frame and closely fitted to the person. A harness 15 extends in front of 
the person's trunk to hold him in place. The frame 12 includes a seat 
bottom frame member or shell 16 and a seat back which includes a lower 
seat back frame member or shell 18 and an upper seat back frame member or 
shell 20, all of which are adjustably positioned with respect to one 
another to determine the general configuraiton of the seat. A mounting 
base 22 fitted to the bottom of the seat frame bottom 16, enables the seat 
to be mounted on a variety of devices such as the wheelchair base 
indicated at 24, on a special car seat holder, or merely positioned on a 
car seat with the seat held in place with straps. 
The cushion arrangement 14 includes several orthopedically contoured 
cushions that can be easily mounted and removed to fit the seat to a 
particular individual at a particular desired orientation for that 
individual. The cushion system includes a seat bottom cushion 30 that 
supports most of the weight of the person, an abductor or thigh cushion 32 
for holding the thighs of a person, a lower seat back cushion 34 for 
supporting the lower back, a pair of waist level side cushions 36, 38 
lying on either side of the lower seat back cushion to closely support 
opposite sides of the trunk of the person at his waist, a shoulder cushion 
40 designed to support the shoulder portion of the person, and a head 
cushion 42 designed to closely support the head of the person. The 
cushions are held in place by hook and loop type fastener pads, such as 
the type sold under the Velcro trademark, or interfitting post-type 
fasteners such as the Headlock fastener sold by the 3M Company, to enable 
the cushions to be easily fastened in place at any chosen position on the 
frame. 
As shown in FIG. 2, the three frame members 16, 18 and 20 can be 
constructed of reinforced plastic plates formed to the illustrated shape. 
The seat bottom member 16 is of a U-shaped form, with a base 44 lying in a 
largely horizontal plane and a pair of upstanding plate-like legs 46, 48 
lying in largely vertical planes at opposite side of the base. It may be 
noted that the base 44 is typically utilized by tilting it backwardly (by 
an angle A shown in FIG. 7) by an amount such as 15.degree., to more 
securely hold the person in the seat. The frame lower back member 18 is 
also of a substantially U-shaped configuration, with a lower back base 50 
lying above the rear of the seat bottom base 44, and having a pair of 
outstanding legs 52, 54 extending largely forwardly on either side of the 
lower back base and lying in largely horizontal planes. Each of the legs 
52, 54 of the lower seat member has a downwardly-extending flange 56 which 
is connected by a joint 58, 60 to a corresponding one of the seat bottom 
legs 46, 48. As will be described below, the joints 58, 60 permit pivoting 
of the lower seat back with respect to the seat bottom, and also permits a 
degree of shifting in any direction such as up and down to increase or 
decrease the height of the lower seat back. The upper seat back frame 
member 20 is also of a largely U-shaped configuration, with a base 62 
lying over the lower seat base 50, and with a pair of largely 
forwardly-extending legs 64, 66. The legs 64, 66 have downwardly-extending 
flanges 68 that are pivotally connected at joints 70, 72 to the lower seat 
back legs 52, 54. A considerable gap is left between the lower and upper 
bases 50, 62 to permit ventilation and to enable pivoting without 
interference. Thus, the frame has a seat bottom formed by the bottom 
member base 44, a seat back formed by the back member bases 50, 62, and 
side walls formed in part by the legs 46, 48, 52, and 54. 
The frame 12 includes a group of hook-and-loop type fastener pads 74 
positioned to receive the various cushions. A thigh cushion mounting 
bracket 76 is mounted at the middle of the seat bottom 16, and can be 
adjusted forwardly or rearwardly to hold the thigh cushion in a selected 
position. A pair of upper harness fittings 78 and a pair of lower harness 
fittings 80, enable the mounting of the harness on the seat. As shown in 
FIG. 4, the harness 15 includes a pair of upper straps 82 that can fit 
through the upper harness fittings, and a pair of lower straps 84 that can 
fit through the lower harness fittings to hold a patient snugly against 
cushions on the frame. 
FIG. 3 illustrates the group of cushions 14 that are utilized on the seat 
frame to hold a patient snugly in position. One of the most important 
considerations in designing the cushions for a handicapped seating 
arrangement, is to provide close support for the trunk of the person near 
waist level. This can be accomplished by utilizing cushions that fit 
closely against opposite sides of the person's waist region, but the great 
variability in the width of persons' waists has heretofore made this 
fitting difficult. To accomplish such fitting, a three cushion arrangement 
is provided, which includes a lower back cushion 34 that is designed only 
to support the back of a person, and two separate side waist cushions 36, 
38 that engage only the side of the person near his waist. 
The cushions 34, 36 and 38 are formed, as shown in FIGS. 3 and 8, so that 
the width 34w of the back cushion and the widths 36w and 38w of the 
rearward side cushion portions fit snugly in the U-shaped lower back frame 
member 18, to stabilize the positions of these cushions. The forward 
portion 36f, 38f of the side cushions can be constructed to any width 
within a wide range to closely confine the sides of the person. A young 
and thin person can be seated by the use of side cushions which have wide 
forward portions 36f, 38f. As that child becomes older and wider at the 
waist, the side cushions can be replaced by others of a somewhat smaller 
width at their forward portion, such as side cushion 36A, to closely fit 
the person. For a person with narrow hips and chest, a relatively straight 
cushion may be utilized, while for a person with a narrower waist but 
wider hips and chest, a more curved side cushion may be utilized. For 
persons with lordosis, a thicker lower back cushion 34 may be utilized, 
while for persons who have a form of sclerosis which requires a sideward 
tilting of the trunk, one side cushion may be thicker than the other. The 
side cushions 36, 38 extend forwardly so as to engage the sides of the 
person at his waist, but not so far as to interfere with the person's arms 
extending down in front of the side cushions and with his forearms lying 
on the side portions of the bottom cushion. Alternate head and shoulder 
cushions of different counters also are available. 
The bottom cushion 30 shown in FIG. 3 is a single-trough-shaped number with 
a bottom 30b and upstanding sides 30s. However, a separate bottom and 
separate side cushions can be utilized to facilitate fitting to a wider 
range of persons, or a different combined bottom cushion 30A can be 
provided. It may be noted that the bottom cushion has a slot 90 which 
receives a mounting bar 92 on the thigh cushion 32 to facilitate the 
mounting of the thigh cushion on the mounting bracket 76 of the frame. The 
uppermost or head cushion 42 is formed with a deep recess 42R to closely 
surround the head of a person, to help keep it in a centered position. The 
shoulder cushion 40 normally can be constructed with a shallower recess. 
Cushion 135 is an optional cushion to accommodate growth asymmetries. 
In fitting a seat to a handicapped person, a technician can first adjust 
the relative positions of the three frame members 16, 18, and 20 (FIG. 5). 
Each of the joints such as 60 and 72 permit pivoting of the frame members 
to choose a variety of general seat configurations. For example, in 
cerebral palsy, it is generally desirable to round the back of the person, 
which can be accomplished by pivoting the upper back member 20 from the 
orientation along a straight back line 100 to a forward-tilted arc 102. In 
a typical seating arrangement for cerebral palsied individuals, an upright 
trunk orientation may be desirable, in which case the upper frame back 
portion 20 may be oriented upright along the line 100. The joint such as 
72 which connects the upper and lower back frame portion, is a pivot joint 
that can be locked in a desired orientation. 
The lower back frame member 18 is designed not only to be pivoted with 
respect to the seat bottom 16 and upper back frame member 20 to adjust the 
angular orientation of the person, but also to enable some adjustment for 
variation in the height of persons as well as other variations. This is 
important, for example, in enabling the same frame to be utilized with a 
child over a period of a few years while he is growing in height and 
therefore the distance between his waist and seat bottom is increasing. To 
this end, the joints 58, 60, 70 and 72 are each constructed as shown in 
FIGS. 8 and 8A, to permit sliding as well as pivoting. 
As shown in FIGS. 8 and 8A, the joint 60 includes a special washer device 
104 which has a projection 106 that closely fits in a hole 108 formed in 
the leg 48 of the seat bottom member. The washer device 104 includes a 
steel ring member and a pair of rubber washers 110, 112 on opposite sides 
thereof. A locking bolt device 114 includes a large flange 116 that lies 
against the inner side of the seat bottom leg 48, and a bolt 118 that 
passes through a large hole 120 in the washer device 104 and threadably 
engages a nut 122. The nut 122 is of specialized construction, to closely 
fit in a sleeve 124 when fully threaded into position, so that the sleeve 
124 can prevent unauthorized turning of the nut 122 by a person without a 
specialized tool that fits into a pair of holes in the nut. When the nut 
122 is loosened slightly, it not only permits the flange 56 of the lower 
back frame member to pivot, but also permits it to shift up or down, by 
shifting of the bolt 118 within the hole 120. Such shifting permits some 
lengthening or shortening of the frame, to accommodate growing of a child 
or to obtain a somewhat better fit to a person. The joint also allows 
forward and rearward shifting of the lower back member 18 with respect to 
the seat bottom and upper back member. In certain disabilities, such as 
obliquity of the spine, a person trunk may have to be held in a slightly 
rotated position, which can be accomplished by moving one joint such as 58 
forward, and the opposite joint 60 rearwardly. 
FIG. 9 shows the manner in which the thigh cushion 32 can be installed by 
its rod 92 fitting into the mounting bracket 76. The mounting bracket 76 
is mounted by a pair of bolts 130 that fit through holes in the seat 
bottom member and through a slot 132 in the bracket. The bracket 76 can be 
slide forward or rearwardly, and a pair of nuts 134 tightened on the bolts 
130 to fix the position of the bracket. 
FIGS. 11-13 show the seat in additional positions that are appropriate for 
various conditions. FIG. 11 shows the lower seat back shell 18 tilted to 
one side at the hip joints 58, 60, and the upper seat back shell 20 also 
tilted to one side at the shoulder joints 70, 72, to meet a patient's 
lateral assymetric deformity. In that case, an auxiliary bottom cushion 
(shown at 135 in FIG. 3) may be utilized. FIG. 12 shows the lower and 
upper shells 18, 20 twisted about a vertical axis, by lateral shifting of 
the joints 58, 60, 70 and 72, to meet a patient's hip and spine rotational 
misalignment. FIG. 13 shows a range of positions of pivoting and sliding 
of the shell portions, to accommodate a variety of lengths and contours of 
patients. 
The seat 10 with a mounting base 22 thereon, facilitates multiple uses of 
the seat. Disabled persons normally are transferred to an automobile by 
removing them from a wheelchair and carrying them into the auto. By 
utilizing the seat 10 as the seat portion of both a wheelchair and a seat 
portion of an automobile, and by providing a transference conveyer, the 
handicapped person can remain in the same seat 10 during both wheelchair 
and automobile travel. Such transference of seat is useful both in aiding 
a handicapped driver to move himself into or out of the driver's seat of 
an auto, and in aiding the transference of a large child or adult to the 
passenger seat. FIG. 10 shows a conveyor adapter 130' held on the mounting 
base 22, and slideable along a pair of rods 132' extending from an 
automobile 134'. The adapter 130' has been disengaged from a wheelchair 
base 136 and has received the rods 132', to begin the transference into 
the automobile. 
Thus, the invention provides a seating system for the handicapped, which 
enables close support of a person, particularly at the trunk, in a custom 
designed manner, but without the large cost and time normally required for 
custom fitting. This can be accomplished by the use of a frame that 
permits adjustment of the general configuration of the seat, such as the 
relative angular positions of the seat bottom to the lower seat back, the 
lower and upper seat backs, and the limited adjustment of the height of 
the seat back over the seat bottom. In addition, separate easily installed 
cushions are provided that permit close fitting of the seat to a 
particular patient. The trunk of the patient, particularly at the waist, 
can be closely and comfortably encircled by a lower back cushion at the 
rear, a harness at the front, and a pair of side cushions at either side. 
Close fitting to the patient is achieved by choosing side cushions of 
proper thickness for that particular patient, and if the patient's waist 
increases as in the case of a growing child, the side cushions can be 
replaced by somewhat narrower ones to maintain the close support. By the 
use of a relatively limited number of different frame and cushion sizes, 
handicapped persons of a wide variety of sizes and required positions can 
be closely fitted at a relatively low cost. A technician fitting a 
particular person has to spend some time to choose the proper orientations 
of the frame members and to choose the proper cushions and install them, 
but the time is much less than has been required heretofore in custom 
fitting. 
Although particular embodiments of the invention have been described and 
illustrated herein, it is recognized that modifications and variations may 
readily occur to those skilled in the art and consequently, it is intended 
that the claims be interpreted to cover such modifications and 
equivalents.