Therapeutic multiple joint exerciser

A cyclical therapeutic joint exerciser is provided; it alternatively imparts a straightening and bending motion to a desired joint of a patient, e.g., a finger, elbow or knee. The device primarily consists of an inflatable pouch to which a spring steel member is removably attached. The spring or springs maintain the body portion in a flexed, non-extended position when the pouch remains uninflated. As the pouch is inflated, the springs mounted on the pouch, which are normally in a bent position, are extended along with the joint. When the pouch is deflated, the inherent biasing action of the springs causes the pouch and springs to bend, which brings the joint back to the flexed position.

BACKGROUND OF THE INVENTION 
1. Field of the Invention 
The present invention generally relates to exercising devices for body 
portions which cannot otherwise be easily and efficiently exercised, and 
more specifically to a new and improved inflatable body part exerciser 
which is capable of exercising a patient's hand, arm, leg or other joint 
by moving it between a first, non-extended position, and a second, 
extended position. 
2. Discussion of Prior Art 
The present invention relates to therapeutic exercise devices for 
incapacitated body portions and is capable of moving the body portions in 
a simple and effective manner in order to exercise them at desired times 
and rates. 
Applicant's own prior patent, U.S. Pat. No. 3,937,215, discloses a cyclic 
therapeutic hand exerciser which is adapted to move the fingers of a user 
in accordance with inflation and deflation of selected bag-like or 
pouch-like portions. This apparatus was designed to pull the fingertips of 
a patient and to curl them inwardly towards the palm of the patient upon 
inflation and deflation of the pouches. Air pressure inflates a splintlike 
upper member to straighten the fingers, and when this splintlike member is 
deflated and a wrist pouch inflated, a flap is tightened to pull the 
fingertips down and to curl the fingers inwardly towards the palm of the 
user. 
This apparatus, however, requires the use of at least two inflatable 
members for moving the hand in either direction. Although it is simpler 
than the other complex systems which have been developed for similar 
purposes, it does require distinct inflatable pouches whose movements can 
be coordinated with one another. 
CLARK et al., U.S. Pat. No. 3,457,912 is a complex system involving a 
pneumatically actuated apparatus for extending and closing the fingers of 
a patient. The apparatus utilizes inflation to extend the fingers but 
depends upon driven cords to pull individual fingers of a glove to close 
the fingers. SHERBOURNE, U.S. Pat. No. 3,581,740, discloses an apparatus 
whose use is limited to straightening the fingers of a patient. No motion 
can be imparted to the fingers to close them or to repeat the exercise 
cycle. KETCHUM, U.S. Pat. No. 3,756,222, discloses a hand splint for 
exercising fingers which includes a plurality of flexible elements for 
manipulating the fingers of a patient. DANIELS et al., U.S. Pat. No. 
3,020,908, discloses a splint which can be attached to the hand of a 
patient to manipulate and exercise the same. None of these devices, 
however, manipulate selected body portions in as efficient, simple, and 
inexpensive a fashion as the present invention. None disclose the use of 
springs to bias a joint into a flexed position and a pneumatic pouch to 
extend the joint. 
SUMMARY OF THE INVENTION 
It is a general object of the present invention to provide a new and 
improved exerciser for automatically exercising the fingers, hands, arms 
or legs of a patient. 
It is a further object of the present invention to provide a simple device 
for exercising a predetermined body part of a user which depends on 
pneumatic pressure only for movement of the body part in one direction, 
and which automatically returns the body part to a non-extended position 
when the pneumatic means are not in operation. 
Still another object of the present invention is to provide an exerciser 
device for preselected body portions which can periodically/intermittently 
extend and retract such body portions. 
The joint flexor device in accordance with the present invention provides 
for cyclic flexure of fingers, elbows and knee joints. Although it is 
specifically disclosed as being directed to exercising such joints, it is 
not necessarily limited to these joints, and the principles described 
throughout this application could be applicable to other movable body 
joints. For the fingers the first embodiment involves the utilization of a 
flexible, inflatable pouch having a substantially cylindrical shape when 
inflated which is capable of flexing only one joint at a time. The 
diameter of the pouch is approximately twice that of a normal finger. The 
pouch extends from slightly beyond the tip of the finger to slightly past 
the wrist. Attached to the wrist end of the pouch is a hose or tube and a 
valve through which air can pass to inflate or deflate the pouch. A piece 
of spring steel, rounded in the middle and curved only slightly on the 
ends, is mounted on the surface of the pouch. The length of the spring, 
when straight, is approximately three quarters that of the pouch. The 
spring steel is mounted on the pouch by means of a pocket into which it is 
inserted. The pocket has a "VELCRO" flap at one end which closes over the 
end of the pocket. 
The construction provides a significant advantage as the spring steel is 
thus easily removable. When the spring steel gets fatigued and can no 
longer provide as much force as is necessary to fully exercise the injured 
body part, it can be easily replaced. The spring steel can be removed for 
cleaning, if necessary. An additional advantage is that the spring can be 
removed and replaced by a stronger, or weaker, spring, depending on the 
force needed to bend the user's finger. The force required may change, for 
example depending on whether the user is an adult or child. 
A small strap attaches the injured finger to one end of the pouch while a 
wrist strap attaches the wrist to the other end of the pouch. When the 
pouch is inflated, it straightens until the shape of the pouch matches the 
shape of the injured finger. The pouch is then attached to the finger and 
hand, using the finger and wrist straps. By pumping air in and out of the 
pouch in a controlled manner, the pouch and finger are flexed. 
The second embodiment, or multiple joint finger flexor, involves the 
utilization of a wider pouch, which might be constructed, for example, 
from two or more single joint finger flexors connected to one another, 
side-by-side. The second embodiment operates in a manner identical to the 
first embodiment, differing only in that it can flex the joints of all of 
the fingers simultaneously. The flexor of the second embodiment is 
attached to the hand in a manner similar to that used in the first 
embodiment in that straps are used to attach the pouch to the wrist and to 
the fingers. 
The preferred embodiments for the elbow and knee flexors represent a 
further modification of the first embodiment of the finger flexor. The 
elbow and knee flexors include relatively large pouches to accommodate the 
increased size of the arm and leg as compared with the finger. As with the 
finger, these units are inflated until they match the bend in the elbow or 
knee. They are then attached by straps to the upper and lower portions of 
the arm or leg, respectively, of a patient. The spring steel attached to 
the pouches of the elbow and knee flexors in a manner similar or identical 
to that in which they are attached to the finger flexor. Of necessity, in 
view of the relatively large size of the pouch which must be used, more 
springs are used and they are essentially longer, wider and thicker than 
those used in conjunction with the finger flexor. 
In a first aspect of the present invention, an exerciser for manipulating a 
selected body part of a user is provided. The exerciser comprises a 
flexible, inflatable pouch having a tubular shape and an exterior surface. 
The exerciser also comprises means for attaching the inflatable pouch to 
the body part and means for resiliently biasing the selected body part 
into a first, non-extended position when the pouch is non-inflated. The 
exerciser also includes pneumatic means for inflating the pouch and for 
thereby overcoming the biasing means in order to move the body part into a 
second, extended position when the pouch is inflated, as well as means for 
mounting the biasing means on the exterior surface of the pouch. 
The ends of the pouch are sealed, and the inflatable pouch comprises two 
layers of material bonded to each other. The biasing means comprises at 
least one spring which occupies a natural, bent position when said 
inflatable pouch is not inflated. The mounting means comprises means for 
detachably mounting the biasing means to the exterior surface of the 
pouch. The means for detachably mounting comprises a pocket attached to 
the pouch, the biasing means being inserted into the pocket. The pneumatic 
means comprises a pneumatic fluid supply tube attached to the pouch via a 
valve. 
The pocket includes means for attaching a strip of material to a top 
portion of the exterior surface. The attaching means comprises two rows of 
stitches positioned substantially parallel and spaced apart from one 
another, running lengthwise along opposing edges of the strip, and wherein 
a first end of the strip is unattached to the exterior surface to form an 
open pocket end, and a second end of the strip is stitched to the exterior 
surface to form a closed pocket end. The pocket further comprises a flap 
attached to said exterior surface, the flap being adapted to be folded 
over and attached to the strip to close the pocket. 
Finger strap attachment means is attached to a first end of the pouch for 
connecting the pouch to a selected body part, and wrist strap attachment 
means is attached to a second end of the pouch for connecting the pouch to 
the wrist of a user. 
In a second embodiment of the invention a plurality of springs are 
positioned in a substantially parallel spaced-apart relation to one 
another along the exterior surface of the pouch and a plurality of pocket 
means are attached to the exterior surface of the pouch for mounting the 
plurality of springs. Each spring is adapted to extend across at least two 
fingers and comprises two bent portions adapted to bend two joints on each 
finger. The pouch is attached to the fingers and wrist of the user 
substantially as described above. 
In a third embodiment of the invention one strap connects one end of the 
pouch to the wrist of a user and another strap connects the pouch to the 
upper arm of the user. In a fourth embodiment of the invention, one strap 
is attached to the ankle of a user and another strap is attached to the 
upper leg of the user. 
According to the invention, there is provided an exerciser for manipulating 
a selected body part which comprises a flexible, inflatable pouch having a 
tubular shape and an exterior surface. The exerciser further comprises 
means for attaching the inflatable pouch to the body part and means for 
resiliently biasing the selected body part into a first, non-extended 
position when the pouch is non-inflated. The exerciser further comprises 
pneumatic means for inflating the pouch and for overcoming the bias of the 
resilient means to move the body part into a second, extended position 
when the pouch is inflated and means for mounting the biasing means on the 
exterior surface of the pouch. The biasing means comprises at least one 
spring which occupies a natural, bent position when the inflatable pouch 
is not inflated. The mounting means comprises means for detachably 
mounting the biasing means to the exterior surface of the pouch. The means 
for detachably mounting comprises a pocket attached to the exterior 
surface of the pouch, the biasing means being inserted into the pocket. 
The pneumatic means comprises a pneumatic fluid supply tub attached to the 
pouch via a valve. 
The above and other objects, advantages and features of the present 
invention will become more fully apparent to those of ordinary skill in 
the art to which this invention pertains upon further review of this 
application.

DETAILED DESCRIPTION OF THE DRAWINGS 
A first embodiment of the present invention is fully illustrated in FIGS. 
1-5. The device is a finger exerciser or flexor which comprises a 
flexible, inflatable pouch. The pouch is shown in its fully deflated 
position in FIG. 1 and in its fully inflated position in FIG. 2. 
The pouch is fabricated from two layers of flexible material, e.g., textile 
layers 2 and 3, as shown in the cutout portion of FIG. 2. Plies 2 and 3 
are laminated together; the double layer of bonded material is overlapped 
and bonded to itself so as to form a substantially cylindrical tubular 
member. The diameter of the tube which forms pouch 1 is approximately 
twice that of a finger. The pouch extends from slightly beyond the tip of 
the finger to slightly past the wrist. The inside edges of both ends of 
the tube are coated with an adhesive and then flattened to seal the tube. 
The flattened ends are coated with adhesive and folded again as shown in 
FIGS. 1-3. The pouch shown in various embodiments of the flexor of the 
present invention will typically be constructed in the manner outlined 
above. 
The sealed pouch is not in fluidic communication with the exterior of the 
pouch except through pressurized fluid supply tube 6, which is attached to 
one end of pouch 1. The pouch is normally in an uninflated condition, but 
can be inflated by directing air through fluid supply tube 6 and valve 7 
via a suitable inflating device (not shown) which is capable of inflating 
and deflating pouch 1 in cyclical fashion. 
The bend in pouch 1, as shown in FIG. 1, is caused by a spring steel 
element 5, shaped generally as shown in FIG. 5. Spring steel element 5 is 
rounded in the middle and curved only slightly on the ends. The length of 
spring 5, when straight, is approximately three quarters the length of 
pouch 1. Although only one spring is shown in the first embodiment, two or 
more could be used. Some of these additional springs could also be mounted 
to the bottom surface of pouch 1, as shown in FIG. 3. 
In the preferred embodiment, spring steel 5 is mounted to pouch 1 using a 
pocket made of a strip of "VELCRO". A narrow strip 8 of soft "VELCRO" is 
attached to top layer 2. Strip 8 is sewn to the top surface of pouch 1, 
using two rows of stitches, positioned on either side of strip 8. The rows 
are spaced far enough apart to permit spring steel 5 and any additional 
springs to be inserted into the opening between material layer 2 and strip 
8. One end of strip 8 is stitched closed and the other end remains open. 
Flap 9 is attached at the open end. Flap 9 is made of hard "VELCRO" 
material and is positioned between strip 8 and pouch 1. Spring steel 5 is 
held in place by flap 9. Flag 9 folds over and attaches to soft "VELCRO" 
strip 8, thereby closing the pocket. 
If a spring is also to be attached to the bottom surface of pouch 1, as 
shown in FIG. 3, it can be secured to pouch 1 in a like manner as 
described above. 
The construction described for attaching spring steel 5 to pouch 1 in the 
preferred embodiment allows the spring to be removed very easily. Thus, it 
can be easily replaced when it is fatigued and can no longer provide as 
much force as is necessary to fully exercise the injured body part. 
As shown in FIG. 1, there are two flaps 10 and 11, of hard "VELCRO" which 
extend beyond the sides of pouch 1 at the bottom surface of the pouch 
positioned on the same end of the pouch as tube 6. These flaps can be 
formed by attaching one continuous piece of hard "VELCRO" to the bottom 
surface. Alternatively, they may be formed by attaching two pieces of hard 
"VELCRO" to the bottom surface. Flaps 10 and 11 are used to secure wrist 
strap 12 to pouch 1. Wrist strap 12 is made of a rectangular piece of soft 
"VELCRO". 
There are two strips, 13 and 14, of hard "VELCRO" attached to each side of 
pouch 1. Strips 13 and 14 are positioned on the opposite end of pouch 1 
from that on which flaps 10 and 11 are found, best illustrated in FIGS. 
1-3. The strips 13 and 14 are used to secure finger strap 15 (FIG. 4) to 
pouch 1, as shown in FIG. 3. Finger strap 15 comprises a rectangular piece 
of soft "VELCRO" which is formed into a V-shaped strap. Although one 
finger strap is shown, any number of straps may be used in accordance with 
the need to securely strap the hand of the patient to the upper portion of 
pouch 1. 
FIG. 3 illustrates the use of the finger flexor of the present invention. 
Pouch 1 can be used on any injured joint of any finger. For illustration 
purposes, the first joint of the index finger has been arbitrarily chosen. 
It is assumed that this joint remains somewhat bent as shown, and can be 
moved only with considerable pain. To accommodate flexure, pouch 1 is 
inflated until the shape of the extended pouch matches the bend in the 
injured joint. At this point, pouch 1 is placed under the hand and injured 
finger, so that the bend in pouch 1 lines up with the bend in the injured 
finger. Finger strap 15 is placed over the end of the finger and secured 
to pouch 1 by hard "VELCRO" strips 13 and 14. With the wrist and hand now 
resting on pouch 1, as shown in FIG. 3, wrist strap 12 is attached to 
either of the hard "VELCRO" flaps 10 and 11 (see FIG. 2). Wrist strap 12 
is then brought across the wrist and attached to the remaining one of 
flaps 10 or 11. The wrist is thus secured to pouch 1. 
With the wrist and finger properly secured to pouch 1, a small amount of 
additional air is now added to inflate pouch 1. The air is pumped into 
pouch 1 by using a suitable inflating device or pumping unit. Pouch 1 
inflates, forcing the finger to extend slightly. Next, a small amount of 
air is removed from pouch 1 by the same pumping unit. Pouch 1 deflates 
slightly, which causes the finger to bend. This process is repeated in a 
cyclic manner until the degree of pain subsides. At this point, the 
process of increasing the degree of flexure, as described above, is 
repeated as often as necessary. 
FIG. 5 illustrates spring steel element 5 used in the first embodiment of 
FIG. 1. Spring steel element 5 is made of a piece of spring steel, rounded 
in the middle and curved only slightly on the ends. The length of spring 
5, when straight, is approximately three quarters the length of the pouch. 
A second embodiment of the finger flexor of the present invention is fully 
illustrated in FIGS. 6-10. As shown in FIG. 6A, two layers of material 17 
and 18 are laminated together. Then the bonded material is folded over and 
the edge sealed, to form a single loop. The ends of the single loop are 
sealed and folded over, as described with respect to FIG. 1. A row of 
stitches is sewn parallel to the bonded edge and located in the center of 
the large loop so as to form two small loops from the single large loop. 
Alternatively, as shown in the cross-sectional view of FIG. 6B, pouch 16 
can be fabricated from a rectangular piece of material 17. The two edges 
on one side of material 17 are overlapped slightly and then bonded 
together. 
The ends of the single loop thus formed are sealed and folded over, as 
described with respect to FIG. 1. The single loop thus formed is laid flat 
and a row of stitches is sewn parallel to the bonded edge and located in 
the center of the large loop so as to form two small loops from the single 
large loop. The stitches are sealed with adhesive. Another layer 18 of 
material is then bonded to the first layer, as described for the first 
embodiment. 
Two pieces of hard "VELCRO" patches 19 and 20 are attached to sides of 
pouch 16 at the end on which inflating tube 31 is attached. Patches 19 and 
20 are used to secure soft "VELCRO" wrist strap 30 to pouch 16. 
Hard "VELCRO" patch 21 is attached to the bottom surface of the pouch 16 at 
the opposite end from patches 19 and 20. Patch 21 is used to secure finger 
strap 22 to pouch 16. Finger strap 22 consists of a rectangular piece of 
plexiglass or other appropriate material. This plexiglass is covered with 
material piece 24, similar to the material used for layers 17 and 18. 
Attached to the end of members 23 and 24 are two straps 25 and 26, 
fabricated from soft "VELCRO". 
Pockets or housings 27 and 28 are attached to the top surface of pouch 16 
to removably mount the spring steel 29 used in this embodiment. A typical 
spring 29 is shown in FIG. 7, in its natural bent position, as it would 
appear if removed from its housing. Spring 29 is shown as having two 
circular sections, in contrast to the one pictured in FIG. 5. The two 
bends in spring 29 allow the flexor to bend two joints on each finger, 
rather than only one. 
The second embodiment allows not only more than one joint to be exercised 
(FIGS. 7 and 9), it also allows more than one finger to be exercised at 
once, as most clearly shown in FIG. 10. When pouch 16 is inflated to match 
the shape of the fingers, the fingers are secured to pouch 16 using finger 
strap 22, as illustrated in FIG. 10. As can be seen, finger strap 22 is 
placed over the fingers, and soft "VELCRO" straps 25 and 26 are secured to 
hard "VELCRO" patch 21. Soft "VELCRO" wrist strap 30 is placed over the 
wrist and secured to hard "VELCRO" patches 19 and 20 (FIGS. 6 and 9). 
The preferred embodiment for the elbow flexor is fully illustrated in FIGS. 
11-15. As can be seen, the elbow flexor is similar in appearance and 
construction to the second embodiment of the finger flexor. The only 
significant difference involves the utilization of pouch 39 which is 
longer and wider than pouch 16. This accommodates the greater length and 
width of the arm (as compared to the fingers) of a user. The elbow flexor 
contains springs (four are shown for illustration purposes) similar to 
that shown in FIG. 12. The springs are removably mounted to pouch 39 using 
pockets 38 in a manner identical to that used for the finger flexors. 
FIG. 11 illustrates pouch 39 of the elbow flexor in its fully deflated 
position. FIG. 13 illustrates pouch 39 in its fully inflated position. 
To use the elbow flexor, pouch 39 is inflated, partially or fully, to match 
the bend in the arm of the user. Pouch 39 is then placed under the arm, as 
shown in FIG. 14, so that the elbow rests in the middle of pouch 39. This 
location is well defined by the characteristic dip caused by the springs 
(see FIG. 13). This dip will occur even when the pouch is fully inflated. 
Next, a soft piece of "VELCRO" strap 36 is attached to one of the two hard 
"VELCRO" flaps 32 and 33, each of which is attached to one end of pouch 
39, as shown in FIG. 14. Strap 36 is then brought across the upper arm and 
attached to the remaining flap 32 or 33. In a like manner, the wrist is 
secured to pouch 39 using soft "VELCRO" strap 37 and hard "VELCRO" flaps 
34 and 35. 
With the arm properly secured to pouch 39, a pumping unit, similar to that 
used with the finger flexor, is used to pump air into and out of pouch 39. 
Thus the pouch 39 is alternatively straightened and bent, causing the 
flexing and exercise of the elbow. FIG. 14 illustrates the elbow flexor 
fully inflated, including the straight arm of the patient, while FIG. 15 
illustrates the elbow flexor fully deflated, including the flexed arm of 
the patient. 
The preferred embodiment for the knee flexor is illustrated by FIG. 16. The 
construction is very similar to that of the elbow flexor. The knee flexor 
is wider and longer than the elbow flexor. It may also contain additional 
springs. 
It is possible that both the elbow and knee flexor may require additional 
straps similar to straps 36 and 37 of FIG. 14, in order to maintain the 
arm or leg in a proper position relative to the pouch as the joints are 
being flexed. It is also possible that an identical flexor could be used 
for both the elbow and the knee exerciser. As illustrated in FIG. 15, the 
patient is placed on his back when flexing his elbow joint and on his 
stomach (see FIG. 16) when flexing a knee joint. 
It is to be understood that the forms of the invention as disclosed are 
merely preferred embodiments. Various changes and modifications can be 
made in shape, size or arrangement of the parts and equivalent means can 
be substituted for those illustrated and described without departing from 
the spirit and scope of the present invention.