Thermal applicator method

A thermal applicator method using a support garment which encloses a human extremity such as an arm or a leg and includes a plurality of pockets adapted to receive thermal elements for retaining such thermal elements adjacent a specified portion of the human extremity and the combination of such a thermal applicator with a pressure applicator. The method comprises applying thermal treatment to a selected portion of the arm or leg and simultaneously applying a plurality of decreasing pressure steps the arm or leg from distal portions to proximal portions thereof.

BACKGROUND OF THE INVENTION 
In the medical arts there are known a wide variety of devices for applying 
thermal environment externally to portions of a human body for the medical 
treatment thereof. For purposes of this application, the term "thermal" is 
intended to denote both hot and cold thermal application, thus, whirlpool 
baths, ice packs, hot water bottles, heating pads, and the like all are 
examples of such technology. Another is a hydrogel material which is sold 
under the trademark Elastogel. 
In general, the placement of discrete thermal environment elements such as 
cold packs and hot water bottles or similar elements, and retention 
thereof with respect to a human extremity has posed significant 
difficulties. Accordingly, in the prior art it has been necessary to 
envelope the entire limb within a hot or cold thermal appliance even 
though the thermal environment was actually required only at a specific 
position or location to treat a corresponding specific portion of the 
limb. The application of thermal environment to an entire limb when only a 
localized portion required it is of course inefficient from the energy 
usage standpoint, but in addition it made for ineffective thermal 
environment therapy because for the typical patient the application of 
thermal environment to an entire limb, especially at temperatures varying 
widely from ambient temperature, quickly becomes very uncomfortable or 
even painful. The patient thus will not tolerate such application of 
thermal environment for long periods of time, and as a result the duration 
of thermal application therapy was necessarily limited. 
There are also known garments in the nature of support stockings, wraps, 
and the like which are adapted to encompass a human extremity such as a 
leg or a portion thereof. Such support garments typically have been made 
from resilient elastic fabric or similar material to provide the requisite 
support function. The above and other expedients have been employed for 
various purposes including the treatment of circulatory deficiencies, 
contusions or bruises, muscle system and skeletal problems such as 
soreness or stiffness, as well as a variety of other conditions. 
The art has further contemplated various sorts of apparatus for circulating 
thermal fluid through sleeves or other limb coverings which are adapted to 
enclose all or a portion of a human limb. Some such apparatus include pads 
or covers that are placed over a human limb and some include fluid 
chambers through which a heat transfer medium is pumped by a suitable pump 
apparatus to establish and maintain a desired temperature. Among the 
patents known to me which pertain generally to such apparatus are U.S. 
Pat. Nos. 4,338,994, 4,149,529, 3,967,627, 3,918,458, 2,415,455, 
2,272,481, 3,186,404 and Italian patent 442,309. 
Another prior art patent of interest regarding the present invention is 
U.S. Pat. No. 4,370,975, which discloses a sheath for receiving a human 
extremity such as an arm or leg, the sheath being divided into 
longitudinally spaced inflatable air cells encircling the limb, and a 
source of air pressure which is operable to inflate the respective cells 
to predetermined pressure magnitudes repeatedly in a timed sequence to 
produce a gradient pressure. The apparatus in this latter patent has been 
used for the treatment of lymph system disorders such as Parkes-Weber 
Syndrome which is characterized by the accumulation of lymphatic fluid in 
a human limb and resultant swelling of the limb to a much greater than 
normal size. 
Notwithstanding the above and other expedients known in the prior art, 
practitioners of the art have continued to seek improved means of 
providing external application of thermal and/or pressure treatment to 
portions of the human body to treat a variety of disorders. Much recent 
activity in this regard has been undertaken in the sports medicine field, 
but medical practice in general is replete with examples of such 
treatments. 
BRIEF SUMMARY OF THE INVENTION 
The present invention contemplates a novel and improved method and 
apparatus for applying thermal treatment or simultaneous thermal treatment 
and pressure treatment to a human limb. In brief, the invention 
contemplates a stocking or similar garment, preferably of a stretch fabric 
or similar construction, for enclosing such a limb, and having a plurality 
of pockets which are adapted to retain thermal environment elements 
adjacent a corresponding selected portion or portions of the limb on which 
the stocking garment is worn. Judicious placement of the pockets or other 
retention means upon the stocking structure permits one or more thermal 
environment elements to be positioned at a location or locations selected 
by the medical practitioner to treat specific, selected portions of the 
limb. 
The above characterized stocking may be utilized in conjunction with a 
pressure apparatus such as that disclosed in the above mentioned patent 
4,370,975 by enclosing the human extremity in the novel stocking and then 
enclosing the stocking within the sheath of the pressure apparatus so that 
both thermal treatment and pressure may be applied simultaneously to such 
a human extremity. Specifically regarding the apparatus disclosed by U.S. 
Pat. No. 4,370,975, my invention further contemplates the combination of a 
stocking such as above characterized, and a pressure apparatus for 
applying gradient pressure repeatedly in timed sequence from a distal 
portion to a proximal portion of a human limb. 
The invention thus provides a novel and improved apparatus and method for 
the application of thermal and pressure treatment to a human extremity. 
The advantages of the invention include but are not limited to enhanced 
ease and convenience in the application of thermal treatment, and improved 
patient tolerance of treatment. The invention also offers enhanced 
treatment modes by employing thermal treatment and gradient pressure 
simultaneously, and the same together with the static confining or 
supporting pressure of the stocking garment itself. 
It is therefore one object of the invention to provide a novel and improved 
garment in the nature of a stocking or the like which is adapted to 
receive and retain thermal elements adjacent a predetermined, selected 
portion of a human extremity or limb. 
A further object of the invention is to provide an apparatus and method for 
medical treatment comprised of static or stationary thermal treatment 
applied to a human extremity simultaneously with gradient pressure applied 
repeatedly in timed sequence from a distal portion to a proximal portion 
of the human extremity.

DESCRIPTION OF THE PREFERRED EMBODIMENTS 
There is generally indicated at 10 in FIG. 1 a stocking apparatus according 
to one presently preferred embodiment of the instant invention and 
comprising a generally hollow, tubular, elongated body 12 formed by 
stitching or similar construction from a flexible stretch fabric which 
exhibits the property of resilient elasticity, for example a blend of 54% 
lycra and 46% antron nylon. 
The elongated tubular body 12 includes an open proximal end 14 and a closed 
distal end 16, although of course distal end 16 could alternatively be an 
open end if desired. In such form, the stocking 10 may be slipped endwise 
onto the leg of a user as shown in FIG. 2. Alternatively or in addition, 
stocking 10 may include a longitudinally extending opening 18 which 
extends substantially throughout the length thereof so that stocking 10 
may be applied to the leg of a user by sliding the leg laterally into the 
opening 18 and thereafter securing the stocking by means of suitable 
closure or fastener elements 20, for example strips of interengaging hock 
and loop pile fastener material such as velcaotm brand fixed to stocking 
10 adjacent the opposed sides of opening 18 at spaced intervals along the 
length thereof. 
Along the length of stocking 10 there are disposed pockets which are 
adapted to receive thermal treatment elements such as cold compresses or 
heat retaining packets or pads. As shown, the pocket structure includes a 
plurality of pockets disposed serially from the upper open end 14 of 
stocking 10 and including an upper thigh pocket 22, a mid-thigh pocket 24, 
a knee pocket 26, a mid-calf pocket 28, an ankle pocket 30 and a foot 
pocket 32. A similar array of pockets may be disposed along the opposed 
lateral side of stocking 10, or in an alternative arrangement the pockets 
22 through 32 inclusive may be smaller than as shown and similar arrays of 
smaller pockets may also be disposed along the front and rear of stocking 
10 intermediate the laterally opposed series of side pockets. 
Referring to pocket 24 as exemplary, each of the disclosed pockets includes 
an opening portion 34 through which a thermal treatment element 36 may be 
inserted into any selected one of the pockets 22-30. The thermal element 
36 thus is retained adjacent a selected portion of the wearer's leg 
according to the pocket selected for its insertion, and thereby it 
provides the thermal energy source for hot or cold thermal treatment 
applied directly to a specific, selected portion of the user's leg. 
Referring now to FIG. 2, the stocking 10 is shown enclosing a user's leg 38 
and a pressure sheath 40 encloses the leg 38 and stocking 10. Sheath 40 
includes a serial plurality of inflatable cell portions 42, 44 and 46 
spaced longitudinally thereof from the distal end 48 to the proximal end 
50 of sheath 40. Each cell 42, 44 and 46 is provided with a pressure 
conduit connection 52 for connection of a respective supply/exhaust 
conduit 54 extending from a pressure supply apparatus 56. The sheath 40, 
pressure supply 56 and connecting elements extending therebetween may be 
entirely similar in all salient respects to the apparatus disclosed in 
prior U.S. Pat. No. 4,370,975, especially as regards the operative ability 
of that apparatus to apply declining gradient pressure from the distal to 
the proximal end of a human extremity by repeated sequential inflation of 
the cells 42, 44 and 46 to specified pressure levels as disclosed in the 
cited prior patent. Reference is made hereby to said prior U.S. Pat. No. 
4,370,975 for further detailed description, and the entire disclosure of 
said prior U.S. Pat. No. 4,370,975 is incorporated herein and made a part 
hereof by reference. 
In an alternative embodiment of the invention as shown in FIGS. 3 and 4, a 
stocking garment 60 is fabricated from elastic material similar in all 
salient respects to that used for the stocking described hereinabove, and 
is made to generally conform to the shape of a human extremity such as an 
arm or leg, the leg stocking being shown at 60. A top opening 62 is 
provided for insertion of the limb into the stocking 60, and the opposed 
end 64 is enclosed. A wide band of fastener material 66, for example 
Velcrotm brand fastening material as disclosed hereinabove is attached to 
the opposed lateral sides of stocking 60 and extends substantially the 
entire length thereof. 
Two wide flaps 68 are fixed adjacent a rear portion 70 of stocking 60 
alongs a substantial extent of its length. The free edges 72 of the flaps 
68 are provided with longitudinally spaced fasteners 74, for example 
Velcrotm brand fastener. Cooperating mating fastener elements 76 are 
affixed at spaced locations along a frontal portion 78 of stocking 60 
whereby flaps 68 may be drawn over lateral side portions of stocking 60 
and, by securing respective fastener elements 74 and 76, may enclose such 
lateral portions of stocking 60 entirely. 
Thermal packs such as shown at 80 are covered with a lining material 82 
such as antron nylon. A wide strip of fastener material 84 is disposed on 
one side of each pack 80 so as to extend lengthwise thereof intermediate 
its long edges, and is secured to the covering material 82 as by 
stitching, for example. The fastener material 84 is compatible with 
material 66 for securing packs 80 with respect to stocking garment 60 at 
any selected position along the extent of fastener material 66. In 
addition, by orienting the fastener material 66 and 84 generally at right 
angles, the position of the packs 80 also may be adjusted toward the 
frontal or rear portions of stocking 60. This allows for continuously 
adjustable horizontal and vertical placement of the packs 80, depending 
upon the application position needed in the judgement of the medical 
practitioner. 
After positioning the pack or packs 80 as described, flaps 68 are drawn 
over the lateral sides of stocking 60 and the retained packs 80 and 
secured thereabout by fasteners 74, 76. The flaps 68 thus assist in 
retaining packs 80 in the desired position. 
Maintaining packs 80 in the selected position by means of flaps 68, or the 
pockets disclosed hereinabove with reference to FIGS. 1 and 2, is 
important as the thermal environment packs must be retained in the desired 
position upon insertion of the limb with stocking and thermal packs into 
the sheath of a pressure apparatus such as shown in FIG. 2. It will be 
understood that the stocking garment 60 of FIGS. 3 and 4 may be used in 
conjunction with a pressure appliance such as shown in FIG. 2 in entirely 
the same manner as above described with respect to the stocking garment of 
FIG. 1. 
From the above description, the method of my invention will be understood 
to comprise the steps of enclosing a human limb in a thermal treatment 
garment or appliance, retaining a static thermal treatment element 
adjacent a specific selected portion of the limb and applying the thermal 
effect of the thermal treatment element to the respective portion of the 
limb. The method of my invention further contemplates the above steps in 
combination with the simultaneous application of pressure to the limb, 
preferably in a pressure application mode which includes a declining or 
decreasing gradient pressure applied from a distal portion to a proximal 
portion of the limb with the gradient pressure steps being applied in 
timed sequence beginning with the larger magnitude pressure steps and 
ending with the lower magnitude pressure steps of the pressure gradient. 
From the above description it will be seen that I have invented a novel and 
improved apparatus and method for medical treatment of a human extremity. 
Of course, I have contemplated various alternative and modified 
embodiments of the invention and such would certainly also occur to others 
versed in the art once apprised of my invention. Accordingly, it is 
intended that the invention should be construed broadly in accordance with 
the scope of the claims appended hereto.