Ambulatory therapeutic footwear

A therapeutic fabric boot that warms the calf and foot, permits ambulation and provides for moisture absorption and selective exposure and ventilation of the covered extremity. An internal foam cradle restricts foot movement and reduces pressure at the heel and calf when lying in a supine position. A re-sizable, flat, hinged foam extension piece extends from the cradle and folds to protect the heel, sole and toes. Several fleece and moisture absorbent fabric cover panels selectively fasten about the foot and calf. Numerous hook and loop fasteners are fitted to external surfaces and attach to straps and/or outer cover pieces upon wrapping the straps and panel pieces about the supported lower calf and foot.

BACKGROUND OF THE INVENTION

The present invention relates to medical footwear and, in particular, to an improved ventilated, fabric boot containing a molded foam, calf and heel support with an integrated folding sole and toe piece mounted in an insulated fabric covering and wherein hook and loop fasteners and straps are mounted to selectively expose, ventilate and relieve moisture and contact pressure at a protected extremity.

A variety of leg and footwear appliances have been developed for patient therapy situations. Pre and post-operative footwear are worn to prevent vasoconstriction and promote vasodilation to maintain blood circulation and thereby prevent clotting. That is, by keeping the legs and feet warm, the blood vessels don't constrict and healthy blood flow is maintained. The footwear also physically protects and warms the legs and feet with minimal skin trauma (e.g. ulcerations, cracking and/or abrasions). Fleece-lined, hook and loop fastened boots of the foregoing type manufactured by applicant are disclosed at U.S. Pat. Nos. Des. 326,556 and 6,866,043.

The present improved footwear was developed to provide a therapeutic boot that warms the extremity, permits ambulation and provides moisture absorption. Most significant, the boot selectively permits exposure and ventilation of the covered extremity. The improved boot also supports the calf, heel and sole in a foam cradle having a flat posterior surface and a contoured anterior surface that prevents leg rotation and reduces pressure at the heel and calf when resting in a supine posture. A plantar, hinged foam sole piece extends from the cradle and can be cut to vary the boot size. The foam sole piece is hinged to the foam calf support and folds to protect the heel, sole and toes. The boot interior is faced with insulation and fleece. An alternative boot is faced with sections of smooth, porous, laminated, moisture absorbent fabric in the region of the calf. Numerous hook and loop fastener pieces are fitted to exterior cloth surfaces and attach to straps and/or fabric cover pieces upon wrapping the straps and cover pieces about a supported calf and foot.

SUMMARY OF THE INVENTION

It is accordingly a primary object of the invention to provide thermally insulated medical footwear to stimulate blood circulation.

It is a further object of the invention to provide pre and post-operative footwear comprising a lined, thermally insulated, moisture wicking fabric boot having a number of hook and loop fasteners fitted to boot panel pieces and associated straps to collectively wrap and fasten to configure the boot about the leg and foot.

It is a further object of the invention to provide a fleece and laminated, porous moisture wicking fabric lined boot with a foam insert to define a flat posterior surface and a contoured interior surface that supports the calf and heel to prevent rotation and minimize heel support pressure when resting in a supine posture.

It is a further object of the invention to provide a foam support having a conformal contoured anterior surface that supports the calf and elevates the heel to reduce pressure at the heel when resting in a supine posture.

It is a further object of the invention to provide a foam support having a seamless, hinged plantar extension piece that can be cut to size and that wraps to encase the heel sole and toes.

It is a further object of the invention to provide a boot with fleece and/or porous, moisture wicking liner pieces that overly and contain a foam support(s).

It is a further object of the invention to provide a boot with panel pieces that permit selective exposure of portions of the foot and/or calf to inspection and ventilation without disruption to other panels.

It is a further object of the invention to provide an accessory wedge piece that mounts to the boot to support the foot against rotation.

It is a further object of the invention to provide straps that wrap around the metatarsal heads and attach to the boot to support the toes and prevent “foot drop” and accommodate swelling or bulky bandaging or dressings.

The foregoing objects, advantages and distinctions of the invention are obtained in a presently preferred fabric boot of the invention that is lined with thermal insulation, fleece and/or porous, laminated fabric. The laminated fabric is constructed and located to enhance the wicking of moisture and ventilation of the foot. Several tabs of hook and loop fastener materials are arrayed about several fabric panel pieces that mate with other associated panel pieces and straps. The straps and panel pieces align to define and selectively control the fitting of the boot to the foot. The panel pieces are shaped and located to permit selective exposure of portions of the foot without disrupting adjoining panel pieces that cover other portions of the foot to permit inspection and ventilation.

A contoured foam calf and heel support mounts within the boot. Ventilation apertures can be formed in the foam support. A posterior surface of the support exhibits a flat surface portion that prevents leg rotation. A longitudinal interior surface of the support is contoured to conform to the calf, elevate the heel and distribute leg weight to prevent pressure points, especially at the heel. The calf support is contained between the external fabric cover and an internal liner.

A foam plantar extension piece is fastened and hinged to the calf/heel support at a recessed pocket. A closed cell portion of the extension piece is covered with an open cell foam piece and fleece and/or fabric materials. Lateral flaps or wings project from the sides of the covered extension piece to overlap the foot. The wings are secured to permit selective exposure and/or ventilation of the foot without disrupting other, separately fastened panel pieces. The extension piece folds to protect the heel, sole and toes and along with the associated wing panel pieces can be trimmed and re-sized.

Hook and loop fasteners are secured to external and internal panel surfaces and are aligned to overlap and secure the boot to the foot. An accessory wedge piece fastens to the external cover to prevent leg and/or foot rotation. Other accessory and extension straps mount to the external cover to prevent foot drop and accommodate swelling and/or bulky bandaging or dressings.

Still other objects, advantages, distinctions and constructions of the invention will become more apparent from the following description with respect to the appended drawings. Similar components and assemblies are referred to in the various drawings with similar alphanumeric reference characters. The description should not be literally construed in limitation of the invention. Rather, the invention should be interpreted within the broad scope of the further appended claims.

Similar structure throughout the drawings is referred to with the same alphanumeric reference numerals and/or characters.

DESCRIPTION OF THE PREFERRED EMBODIMENT

Referring toFIGS. 1-5several perspective views are shown to external surfaces of the improved therapeutic boot2of the invention. The boot2is constructed of an air permeable, fabric cover4. The cover4is presently sewn from a durable velour cloth. Other materials such as a heavyweight cotton fabric, CORDURA® or other fabrics or fabric combinations might also be used.

A thermal insulation material6(shown in cutaway) is fitted between the cover4and a separate interior lining8. The insulation material6can comprise THINSULATE® or any of a variety of other suitable thermal insulation materials. The insulation material6provides a thermal barrier to maintain the temperature of the calf and foot to promote dilation of the blood vessels and blood flow through the covered extremity.

With additional attention toFIGS. 6,7and9, the lining8is constructed and organized to provide a soft, smooth/comfortable surface to contact the skin without any abrading seams or surface portions that can cause ulcerations or skin trauma. The lining8is also constructed to provide a soft interface with the calf and foot to wick moisture away and ventilate the covered calf and foot. Seams between sections of fleece10and/or fabric, moisture wicking materials12are located and configured to minimize contact with the skin. Seams can be sewn or adhesively fixed.

Seams in the region of the heel are especially avoided or hidden in the boot2. Presently, an adhesively bound seam between calf and extension liner pieces at the heel is located in or immediately adjacent a recess32of a foam support cradle28. The recess32shelters overlapping or butted, adhesively bound liner pieces. The recess32also shelters the proximal end of a foam, plantar extension piece30that extend from the support cradle28. regions of sustained contact between the skin and the lining8.

For the boot2ofFIG. 6, the fleece material10comprises the entire liner8and is located to surround the calf and foot. As with the boot2ofFIG. 7, the insulation6is generally included beneath all regions of the lining8to surround the entire calf and foot, although could be selectively positioned about the boot2. Collectively, the insulation6and fleece material10traps warm air and wicks away moisture.

The interior lining8of the boot2ofFIG. 7otherwise is constructed of several sections of fleece material10and/or moisture wicking materials12. The moisture wicking material12used in the boot ofFIG. 7presently comprises a material having a porous, center substrate piece and to the opposite surfaces of which micro-fleece materials are laminated. The side facing the interior of the boot2is covered with an open-weave and/or porous polyester facing piece (e.g. such as used in sports clothing). The facing piece is smooth and apertures in the material ventilate the material and foot against and any absorbed moisture. A variety of other soft, moisture absorbent, air permeable open weave or porous materials can be used.

The wicking material12is located to absorb moisture and ventilate the foot. Moisture typically develops at regions of sustained contact between the skin and the lining8. The moisture wicking material12is preferably located at the primary points of contact with the calf and foot, for example, at the posterior surfaces of the calf, at the heel, sole and around the foot.

The boot2ofFIG. 7only surrounds the calf with the foregoing laminated moisture wicking materials12. Fleece12otherwise covers the foot and a layer of insulation6is provided below both materials10and12. WhileFIGS. 6 and 7depict two presently preferred configurations of the liner8, the locations of the fleece10and moisture wicking material12can be varied as desired.

With additional attention toFIGS. 6 through 9, details are shown to the construction of the boot2and the relative arrangement of several fabric panels that are or can be lined with the fleece10and/or moisture wicking material12.FIGS. 6 through 8depict the interior and exterior construction of the boot2with the panels folded open.FIGS. 9 and 10depict the foam support cradle28that mounts inside the boot2beneath the liner8.FIGS. 11 and 12depict the several boot panels as they are sequentially folded and fitted to the calf and foot to ultimately form the wrapped configurations shown atFIGS. 1 through 5.

Apparent fromFIGS. 6 through 8are respective internal and external folded open views of the boot2. The boot2opens full-length along its front or anterior surface at right and left, fleece covered calf panels20and22and right and left foot panels24and26.

The calf panels20and22overly and contain the foam support cradle28shown in detail atFIGS. 9 and 10. The cradle28is preferably constructed of a relatively dense elastic material that flexes or compresses slightly to provide a resilient interface with the calf. The cradle28can for example be constructed of a variety of materials including elastomers, polyurethane foam, and/or other open and/or closed cell foams or combinations thereof. The durometer and resilience of the material preferably compresses slightly to support the calf and foot without undue compression, yet springs back to shape upon relieving any pressure, particularly at the anterior surface of the calf.

The cradle28provides a longitudinal channel27that receives the calf. The cradle28mounts in a pocket or space formed beneath and between the calf panels20and22. The cradle28can provide through apertures29to aerate the calf. The foot panels24and26overly and contain a separate flat, foam plantar extension piece30. A base portion31of the extension piece30is constructed of a closed cell foam, approximately ⅛-inch thick. A proximal end is bonded to a recess32(shown in dashed line) formed into the flat posterior surface of the support cradle28adjacent an inverted U-shaped cutout35adjacent the peripheral edge of the anterior surface of the cradle28. The cutout35is formed to shelter the suspended heel as described in more detail below. Peripheral edges of the cutout35arcuately depend to contact the extension piece30, referenceFIG. 10.

Any seam between the cradle28and extension piece30is thereby removed and/or shielded by the recess32and cutout35from contact with the heel. The plantar extension piece30extends from the region adjacent the heel and wraps over the sole and toes. An interior surface of the extension piece30is typically covered with a separate panel of open celled foam33approximately ½-inch thick. The plantar extension piece30and portions of the overlapping panels24and26are also fabricated to be sheared to size when the boot2is first fit to a user and the details to which fitting are discussed below. The extension piece30includes vent apertures29in the region of the heel.

With attention also toFIGS. 9 and 10, the support cradle28, when viewed from a longitudinal end, generally exhibits a U-shape. A posterior surface34of the cradle28is constructed to be flat and from which side walls36project and extend along the longitudinal sides of the calf. The flat surface34stabilizes the cradle28and calf against rotation when the user rests in a supine position and the boot2is supported on a bed.

The anterior surface38of the cradle along the channel27is contoured and exhibits a compound arcuate shape to support the calf, referenceFIG. 10. A raised surface portion40in the region of the Achilles tendon is shaped to elevate and support the heel in the cutout region35with minimal pressure and contact with the boot and away from any support structure, such as a bed, foot stool etc.

The contoured surfaces38and40are particularly formed to distribute and equalize support pressures on the calf and prevent pressure points that might induce skin ulceration or abrasion.FIG. 16depicts a pressure map to a prior boot of applicant that exhibited an average pressure distribution of 16 mmHg and two relatively significant pressure points37and39on the order of 62 mmHg.FIG. 17in contrast depicts a pressure map to the improved boot2of the subject invention which uses the cradle28and plantar extension piece30and wherefrom a reduction of pressure points and even distribution of pressure on the order of 14 mmHg average and a minor peak pressure point41of 28 mmHg is apparent. The latter pressures are well below the nominal pressure of 32 mmHg where capillary closure and reduced blood perfusion and flow is observed with consequent risks of skin ulceration

Returning attention toFIGS. 6 through 8and when folded closed, the calf panels20,22and foot panels24,26respectively wrap and overlap each other to form the boot2shown atFIGS. 1-5. The overlapped panels20-26are fastened together with mating strips of hook42and loop44type fastener material aligned along the peripheral edges of the panels20-26. Hook and loop fasteners42and44are preferred although other fastenings might be adapted to the boot2.

In the region of the foot, several parallel strips of hook fastener material42are sewn to extend in displaced, transverse relation along the edge of the panel24to overlap and mate with several transverse strips of loop fastener material44located along the edge of the panel26. The overlapped panels24and26cover a toe panel46defined by a distal end of the extension panel30that folds to cover the toes.

The calf panel20separately contains spaced, transverse strips of loop material44along the edge of the panel22that overlap and mate with a longitudinal strip of hook fastener material44that extends along the longitudinal edge of the panel20. When the panels20and22are wrapped around the calf and overlapped in the manner ofFIG. 12, the strips of fasteners42and44bind the upper portion of the boot2to the calf at a desired, adjustable pressure.

Also apparent fromFIGS. 6 through 8are right and left heel panels50and52. The panels50and52include tabs of hook material42that mate with the lower end of longitudinal strips of loop material that longitudinally extend along the approximate center of the panels20and22. The heel panels50and52hinge the foot panels24and26to the calf panels20and22. The heel panels50and52also advantageously facilitate a selective exposure of the heel during treatment. That is, the heel panels50and52can be detached independent of the foot and calf panels20-26, either for inspection or for ventilation without disrupting the foot panels20-26to expose the heel area. This additional flexibility is very desirable to facilitate healing and ventilate and aerate the lining8to evaporate moisture.FIGS. 11 and 12depict the hinge panels50and52secured to the cradle panels20and22.

The boot2can also be re-sized to fit users with smaller feet. In this regard and fromFIGS. 6 through 8, a number of seams of stitching60and62are respectively provided at the foot panels24and26and the toe panel46. The stitching60and62permit a care giver to size the boot2to best fit the user. For patients with smaller feet, the distal portions of the toe and foot panels46and24,26can be cut away or trimmed from the boot2to accommodate the smaller foot. The stitching60and62also prevents fraying at the remaining associated panel portions.

Where the flat posterior cradle surface34prevents foot rotation, a strap64shown atFIG. 12is provided that can be secured to the longitudinal lengths of loop fastener material42at the cradle panels24and26and wrapped below the foot to prevent “foot drop”, referenceFIGS. 1-5and15. The interior surface of the strap64is covered with several tabs of hook material44. The strap64attaches beneath the foot panels24and26to strips of looped fastener42that longitudinally extend along the sides of a traction pad70that is formed from non-slip material and sewn to the surface of the cover4in the region of the sole.

The pad70facilitates safe ambulation over smooth tile or wood floors. The pad70can be constructed of a variety of non-slip materials. The pad70is shaped to essentially align with and underlie the plantar extension piece30. Upon wrapping the panels20-26and46over the foot, the strap64overlaps mating loop material and establishes the angle of the foot to the calf.

The foot can be further supported with the benefit of an accessory wedge-shaped support80shown atFIG. 13. The support also prevents foot rotation. The support80is constructed of a right triangular piece of foam that is covered with the cover material4. A tab of hook material44is secured to at least one of the exposed orthogonal surfaces and can fasten to the strips of loop material42that extend along the sidewalls of the calf panels20and22.

A strap piece82and fastener tab44extend from the support80and can be trained beneath the calf panels20and22and fasten to strips of fastener42such as in the fashion shown atFIG. 14. The support80might also be fitted to axially align with the pad70and heel.

For users with relatively large feet, swelling or having bulky bandaging or dressings such that the foot panels24and26cannot overlap, an extension strap of suitable length and constructed similar to strap64can also be secured between the foot panels24and26.

From the foregoing, it is to be appreciated the boot2advantageously protects and thermally insulates the foot and lower leg. The construction of the boot2provides numerous advantages and improvements over known therapeutic footwear. The subject footwear particularly protects the heel and foot, permits ambulation, warms and ventilates the foot and calf.

While the invention has been described with respect to a number of preferred constructions and considered improvements or alternatives thereto, still other constructions may be suggested to those skilled in the art. It is to be appreciated that selected ones of the foregoing features can also be used singularly or be arranged in different combinations to provide a variety of improved therapeutic footwear. The foregoing description should therefore be construed to include all those embodiments within the spirit and scope of the following claims.