Abstract:
An apparatus for disposition on appendage, such as an arm or leg, is capable of encircling and applying opposing forces selectively thereto. A C-shaped component receives one side of the appendage, a second C-shaped component receives the other side of the appendage, and a tensioning system draws the two components together for selective application of pressure to the appendage. Outriggers and pressure applicators may be used to apply pressure to extended areas of the appendage that otherwise would not be engaged by the C-shaped components. Side-to-side tissue compression thereby is provided for deflection of muscle forces, functional shortening of muscle length, and the maintenance of neurovascular channels. Circumferential forces may be minimized based on semirigid characteristics of the components. Elbow and shoulder braces apply side-to-side tissue compression to arms.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS  
       [0001]     The present application is a continuation of, and claims the benefit of priority under 35 U.S.C. §120 to, U.S. patent application Ser. No. 11/187,590, pending, which &#39;590 application published as US 2006/0020237 and which &#39;590 application is a continuation-in-part patent application of each of U.S. design Pat. application Ser. No. 29/209,971, filed Jul. 22, 2004, now U.S. design Pat. No. 519,637, and U.S. design Pat. application Ser. No. 29/209,987, filed Jul. 22, 2004, now U.S. design Pat. No. 521,644, and which &#39;590 application is a nonprovisional patent application of, and claims the benefit of priority under 35 U.S.C. §119(e) to, each of U.S. provisional patent application Ser. No. 60/590,940, filed Jul. 22, 2004, expired, and U.S. provisional patent application Ser. No. 60/590,947, filed Jul. 22, 2004, expired. Each of these patent applications, patents, and patent application publication is incorporated herein by reference. 
     
    
     COPYRIGHT STATEMENT  
       [0002]     All of the material in this patent document is subject to copyright protection under the copyright laws of the United States and other countries. The copyright owner has no objection to the facsimile reproduction by anyone of the patent document or the patent disclosure, as it appears in official governmental records but, otherwise, all other copyright rights whatsoever are reserved.  
       BACKGROUND OF THE INVENTION  
       [0003]     Life expectancies are rising and diverse athletic activities are becoming increasingly available to people of all ages. Accordingly, the number of people suffering current minor injuries, the number of people living with chronic joint ailments, and the number of people facing the possibilities of sports-related injuries are ever increasing.  
         [0004]     Many braces for disposition on an arm or leg are available to aid such people. However, most available braces and joint-support accessories are complex, unattractive, and uncomfortable There are braces for preventing joint motion or for maintaining a particular joint position. Typical such braces, having hard-shell or rigid beam components, are not typically conveniently adjusted with regard to forces and resulting pressures applied to an arm or leg and with regard to a comfortable fit. There also are braces for use in supporting active joint motion. These braces generally include binding arrangements that tend to apply circumferential forces to an arm or leg and adversely affect blood flow and circulation.  
         [0005]     A demand therefore is growing for one or more braces that improve upon the braces currently available.  
       SUMMARY OF THE INVENTION  
       [0006]     A first aspect of the invention generally relates to an apparatus for disposition on a person&#39;s body, such as an arm or leg. More particularly, the first aspect of the invention relates to an apparatus for circumferential disposition on an arm or leg and for selectively applying thereto forces and resulting pressures. According to this aspect, a first partial collar and second partial collar, together preferably completely encircling an arm or leg, are drawn together by a tensioning system such that opposing forces are thereby applied to the arm or leg.  
         [0007]     In accordance with this and other aspects, the partial collars generally are C-shaped, and each C-shaped partial collar may comprise arcuate segments, polygonal segments, or both. Furthermore, as used herein, “C-shaped” is intended to encompass both “U-shaped” and other variations and equivalents thereof, including the component shapes of the drawings set forth herein.  
         [0008]     In a feature of the first aspect, a tensioning system includes a rotary device and tensioning lines for controllably varying the forces applied to the arm or leg. In one example, rotation of a handle or control knob of the rotary device causes the tensioning lines to retract and the forces of the partial collars engaging the appendage to be increased.  
         [0009]     In an exemplary construction related to the first aspect of the invention, end portions of one partial collar are disposed between end portion of the other partial collar and the arm or leg. Optionally within that construction, one of the partial collars has conduits or channels for receiving end portions of the other partial collar.  
         [0010]     Partial collars optionally apply pressure to selective areas of an arm or leg in conjunction with, or by way of, pressure applicators. In some variations, pressure applicators generally apply pressure within margins of the partial collars. In other variations, pressure applicators are attached to outriggers that extend beyond margins of the partial collars.  
         [0011]     Another aspect of the invention relates to a brace for disposition on an arm or leg. More particularly, an inventive brace includes a first clamping component and a second clamping component that, together, preferably circumferentially surround the arm or leg when the brace worn. Tensional forces draw the clamping components toward one another and thereby apply directionally opposing forces to the arm or leg.  
         [0012]     A third aspect of the invention relates to an apparatus for disposition on an arm or leg. More particularly, an inventive apparatus according to this aspect of the invention includes a collar for encircling an appendage. The apparatus further includes a rotary device having a housing, a rotatable control knob, and a line depending from the housing. When the rotatable control knob is rotated, the line is partially drawn into the housing, whereby a force applied to the arm or leg encircled by the apparatus is increased.  
         [0013]     Additional aspects of the present invention relate to methods associated with the aforementioned aspects.  
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0014]     These and other aspects of the invention, as well as one or more embodiments of the present invention, are disclosed with reference to the accompanying drawings which are briefly described below, wherein the same elements are referred to with the same reference numerals, and wherein various elements are not necessarily shown in conformance to any particular absolute or relative scale.  
         [0015]      FIG. 1  is a perspective view of a first embodiment of the invention.  
         [0016]      FIG. 2  is front elevational view of the embodiment of  FIG. 1 .  
         [0017]      FIG. 3  is a plan view of the embodiment of  FIG. 1 .  
         [0018]      FIG. 4  is side elevational view of the embodiment of  FIG. 1 .  
         [0019]      FIG. 5  is an exploded perspective view of the embodiment of  FIG. 1 .  
         [0020]      FIG. 6  is a perspective view of a second embodiment of the invention.  
         [0021]      FIG. 7  is front elevational view of the embodiment of  FIG. 6 .  
         [0022]      FIG. 8  is a plan view of the embodiment of  FIG. 6 .  
         [0023]      FIG. 9  is side elevational view of the embodiment of  FIG. 6 .  
         [0024]      FIG. 10  is an exploded perspective view of the embodiment of  FIG. 6 .  
         [0025]      FIG. 11  is an environmental perspective view showing the embodiment of  FIG. 1  disposed as an elbow brace on an arm, and the embodiment of  FIG. 6  disposed as a shoulder brace on the arm. 
     
    
     DETAILED DESCRIPTION  
       [0026]     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.  
         [0027]     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.  
         [0028]     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.  
         [0029]     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.  
         [0030]     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.” 
         [0031]     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.” 
         [0032]     Turning now to the figures, a first embodiment of the invention is shown in  FIGS. 1-5 . An apparatus  10  for circumferential disposition on an appendage such as an arm or leg comprises a first partial collar  12 , a second partial collar  14 , and a tensioning system  16  ( FIG. 5 ). The first partial collar  12  and second partial collar  14  are each adapted for partially encircling an appendage such that together they completely encircle an appendage when the apparatus  10  is disposed on the appendage. Though other embodiments of the invention are adapted for disposition on other areas of other appendages, the first embodiment of the invention, namely the apparatus  10 , is particularly adapted for disposition on an arm. For example, in  FIG. 11  the apparatus  10  is disposed on an arm beyond the elbow. In this disposition, the apparatus  10  is nominally referred to as an elbow brace.  
         [0033]     The tensioning system  16  ( FIG. 5 ) draws together the first partial collar  12  and second partial collar  14 . When the apparatus  10  is disposed on an appendage as shown in  FIG. 11 , the first partial collar  12  and second partial collar  14  are drawn together by the tensioning system ( FIG. 5 ) and respective forces are thereby applied to the appendage by the partial collars. In particular, the first partial collar  12  is capable of applying a first force  18  ( FIG. 3 ) to a first side of and appendage and the second partial collar  14  is capable of applying a second force  20  to a second side of the appendage, wherein the first force  18  and second force  20 , when applied, generally oppose one another.  
         [0034]     The partial collars  12  and  14  are each generally rigid, or at least semirigid. Exemplary materials for their construction include, but are not limited to: plastics, particularly moldable and injection-moldable plastics; Nylon 66; fiberglass; carbon and carbon composites; polycarbonate; polyoxymethylene; polymethylmethacrylate (PMMA); polyacetal; urea-formaldehyde; polystyrene; and vinyl polymers.  
         [0035]     Together, particularly when drawn together by the tensioning system  16 , the partial collars  12 ,  14  define a collar clamp that closes upon an appendage and applies the directionally opposing forces  18 ,  20 . Thus, opposing forces are applied to opposing sides of an appendage and can be so applied, if desired, without any substantial circumferential forces being applied about the appendage as a function of the rigidity of the partial collars and/or use of pressure applicators. Whereas circumferential forces such as those of a tourniquet tend to interfere with blood circulation, the opposing forces  18 ,  20  applied by the apparatus  10  allow blood flow through an appendage encircled by the apparatus while still effecting side-to-side tissue compression of the appendage. Thus, the inventive coapting apparatus  10  provides, among other things, benefits that include: deflection of muscle forces; functional shortening of muscle length; and the maintenance of neurovascular channels.  
         [0036]     The tensioning system  16  ( FIG. 5 ) comprises a device  22  for controllably varying the forces applied to an appendage encircled by the apparatus  10 . In particular, a rotatable control knob  24  depends from the device  22  for grasping and rotation thereof by a wearer or user of the apparatus  10 . Upon rotation of the rotatable control knob  24  in a first rotational direction  26  ( FIGS. 1-2 ), the directionally opposing forces  18 ,  20  ( FIG. 3 ) applied to an appendage encircled by the apparatus  10  are increased. In particular, the forces are increased by the drawing together of the first and second partial collars  12 ,  14  upon rotation of the rotatable control knob  24  in the first rotational direction  26 . It should be understood that, while the first rotational direction  26  is illustrated as clockwise in  FIGS. 1-2 , the descriptions herein similarly may relate to counterclockwise rotations as well.  
         [0037]     Furthermore, by pressing of the rotatable control knob  24 , the directionally opposing forces  18 ,  20  applied to an appendage are decreased or are entirely terminated. Thus, in the first embodiment of the invention, the apparatus  10  closes upon rotation of the rotatable control knob and tends to spring back open upon pressing of the control knob. The apparatus  10  closes in that the second partial collar  14  moves relative to the first partial collar  12  in a first direction  30 , thereby, increasing the forces  18 ,  20  ( FIG. 3 ) when the apparatus is clamped in engagement with an appendage. The apparatus opens in that the second partial collar  14  moves relative to the first partial collar  12  in a second direction  32 , thereby decreasing the forces  18 ,  20  when the apparatus is tightly clamped in engagement with an appendage.  
         [0038]     In another embodiment of the invention, not illustrated, a coapting shell encircling an appendage closes upon rotation of a rotatable control knob in one rotational direction and opens upon rotation of the rotatable control knob in an opposite rotational direction.  
         [0039]     In yet another embodiment of the invention, not illustrated, a coapting brace for encircling an appendage and applying forces thereto applies increasing forces upon rotation of a control knob and releases the forces upon pulling of the knob outwardly from the brace. It should be apparent that the present invention has many embodiments and the descriptions herein of particular tensioning systems and control devices are provided as examples and are not to be construed as limitations of the invention.  
         [0040]     Nonetheless, in order to provide detailed descriptions of one or more particular embodiments, the tensioning system  16 , as shown in the exploded view of  FIG. 5 , comprises the rotary device  22 , a first line portion  28  depending from the rotary device, and a second line portion  30  depending from the rotary device. Upon rotation of the rotatable control knob  24  in the first rotational direction  26  ( FIG. 1 ), the tensioning lines are retracted and the line portions  28 ,  30  are retracted and shorten. The first and second partial collars are thereby drawn together, thereby closing the apparatus  10  ( FIG. 3 ) and increasing forces applied to an appendage. Upon pressing of the rotatable control knob  24 , the tensioning lines are mechanically released and the line portions  28 ,  30  tend to lengthen. The apparatus  10  ( FIG. 3 ) is thereby opened and forces applied to an appendage are thereby decreased.  
         [0041]     An exemplary releasable and adjustable rotary device comprises a housing within which are incrementally drawn multiple lines upon selective rotation of a control knob. Such an exemplary rotary device is disclosed, for example, in U.S. Pat. No. 5,042,177 to Schoch, titled “Rotary Closure for a Sports Shoe, Especially a Ski Shoe,” which patent is hereby incorporated herein by reference.  
         [0042]     As shown in  FIGS. 1, 2 , and  5 , the first line portion and second line portion depend from the rotary device  22  and extend, in opposite directions, partially circumferentially about the first partial collar  12 . Guide channels  32  ( FIG. 5 ) and  34  ( FIG. 1 ) are defined by the first partial collar  12  for receiving and guiding respective line portions  28 ,  30  and maintaining the courses of the lines within margins of the apparatus. Each line portion  28 ,  30  is furthermore attached at a terminus thereof to the second partial collar. As the line portions  28 ,  30  are drawn partially into the housing of the rotary device  22  upon rotation of the rotatable control knob  24 , the first and second partial collars are thereby drawn together.  
         [0043]     In another embodiment of the invention (not illustrated), first and second line portions that depend from a rotary device are opposing ends of a single line. The rotary device and single line completely encircle an apparatus that comprises two coapting partial collars. When the apparatus is circumferentially disposed on an appendage, the rotary device and continuous line completely encircle the appendage.  
         [0044]     In the first embodiment of the invention each line portion  28 ,  30  comprises a flexible and inextensible line. The line portions  28 ,  30  are illustrated in  FIGS. 1-5  as monofilament lines though these descriptions relate as well to multifilament lines and many types of elongate flexible lines having various constructions and formed of various materials having respective tensile and flexible properties. Exemplary constructions include, but are not limited to: monofilament lines, multifilament lines, wound lines, woven lines, braided lines, layered lines, strings, ropes, cords, threads, twines, intertwined strands, chains, tethers, belts, bands, straps, and combinations thereof. Exemplary materials include, but are not limited to: natural fibers including hemp, cotton, linen, hide, gut, and sinew; synthetic and plastic fibers such as nylon, polyethylene, and fluorocarbon; lines formed of metals such as wires and cables, in particular wound steel cables; and, combinations thereof.  
         [0045]     As shown in  FIG. 5 , each partial collar  12 ,  14  comprises an open, arcuate C-shape. The first partial collar  12  comprises opposing end portions  12   a ,  12   b . Similarly, the second partial collar  14  comprises opposing end portions  14   a ,  14   b . When the apparatus is assembled as shown in  FIG. 3 , opposing end portions  14   a ,  14   b  of the second partial collar are disposed in the interior of the open C-shape of the first partial collar  12 . Consequentially, when the apparatus  10  is circumferentially disposed on an appendage, the opposing end portions  14   a ,  14   b  of the second partial collar  14  are disposed between the appendage and respective opposing end portions  12   a ,  12   b  of the first partial collar  12 . For example, as shown in  FIG. 11 , when the apparatus  10  is circumferentially disposed on an appendage, the end portion  14   b  of the second partial collar  14  is disposed between the appendage and the end portion  12   b  of the first partial collar  12 .  
         [0046]     As shown in  FIG. 3 , the second partial collar  14  comprises a pair of channels or conduits  40 ,  42  for receiving respective end portions  12   a ,  12   b  of the first partial collar  12 . The conduits  40 ,  42  assist in maintaining a coapting engagement of the first partial collar  12  and second partial collar  14 . The conduits  40 ,  42  furthermore maintain the relative orientations of the partial collars. The opposing end portions  12   a ,  12   b  pass freely within the respective conduits  40 ,  42  allowing relative movement of the partial collars in closing and opening of the apparatus  10 . For example, the end portion  12   a  of the first partial collar passes freely into the conduit  40  as the apparatus  10  closes by movement of the second partial collar  14  relative to the first partial collar  12  in the first direction  30 .  
         [0047]     As further shown in  FIG. 3 , the apparatus  10  comprises a pressure applicator  46  attached to the first partial collar  12 . When the apparatus is circumferentially disposed about an appendage, the pressure applicator  46  applies pressure to a discrete area of the appendage according to the disposition of the apparatus. The pressure applicator, optionally somewhat flexible to allow mild deflection of the applicator while applying pressure to an appendage, is constructed of a material capable of bearing a load and optionally allowing mild deflection. Exemplary materials include, but are not limited to: plastic; fiberglass; carbon and carbon composites; and spring steel. In the first embodiment of the invention, the pressure applicator  46  comprises a leaf spring  48  attached to the first partial collar. The pressure applicator  46  is optionally padded to provide for comfort as it applies pressure to a discrete area of an appendage. The pressure applicator  46  is optionally removable from the apparatus  10 .  
         [0048]     The first and second partial collars are each optionally padded for comfort of the wearer of the apparatus  10 . For example, a collar pad  50  ( FIG. 5 ) is adapted to nestle within the second partial collar  14  as shown in  FIG. 1  for disposition between the second partial collar  14  and an appendage when the apparatus  10  is disposed on the appendage as shown in  FIG. 11 . The collar pad  50  preferably comprises soft, breathable, and washable materials. Exemplary materials include, but are not limited to, natural and synthetic fabrics, pliable foams, elastic fabrics, neoprene, spandex, felt, natural and synthetic chamois, and various stretchable and pliable materials.  
         [0049]     In the first embodiment of the invention, each partial collar defines a respective arcuate receiving area. For example, the second partial collar  14  of the apparatus  10  defines an arcuate, cylindrically-concave receiving area  14   c  ( FIG. 5 ) for receiving a side of an appendage. The apparatus  10  is particularly illustrated for use as an elbow brace in  FIG. 11 . The arcuate receiving area of the second partial collar comfortably receives, for example, the volar side of a forearm proximal an elbow as shown in  FIG. 11 .  
         [0050]     Turning now to a second embodiment shown in various views in  FIGS. 6-10 , an apparatus  110  for circumferential disposition on an appendage such as an arm or leg comprises a first partial collar  112 , a second partial collar  114 , and a tensioning system  116  ( FIG. 10 ). The first partial collar  112  and second partial collar  114  are each adapted for partially encircling an appendage such that together they completely encircle an appendage when the apparatus  110  is disposed on the appendage. For example, in  FIG. 11  the apparatus  110  is disposed on an arm proximal a shoulder. In this disposition, the apparatus  110  is nominally referred to as a shoulder brace.  
         [0051]     The tensioning system  116  ( FIG. 10 ) draws together the first partial collar  112  and second partial collar  114 . When the apparatus  110  is disposed on an appendage as shown in  FIG. 11 , the first partial collar  112  and second partial collar  114  are drawn together by the tensioning system  116  ( FIG. 10 ). Respective forces are thereby applied to the appendage by the partial collars. In particular, the first partial collar  112  is capable of applying a first force  118  ( FIG. 8 ) to a first side of an appendage and the second partial collar  114  is capable of applying a second force  120  to a second side of the appendage. As the second side of the appendage is opposite the first side of the appendage, the first force  118  and second force  120 , when applied, generally oppose each other.  
         [0052]     The partial collars  112  and  114  are each generally rigid, or at least semirigid. Together, particularly when drawn together by the tensioning system  116  ( FIG. 10 ), the partial collars  112  and  114  define a collar clamp that closes upon an appendage and applies the directionally opposing forces  118 ,  120  ( FIG. 8 ). Thus, opposing forces are applied to opposing sides of an appendage and can be so applied, if desired, without any considerable circumferential forces being applied about the appendage as a function of the rigidity of the partial collars and/or use of pressure applicators. Generally applying only opposing forces  118 ,  120  by the apparatus  110  allows blood flow through the appendage even though it is surrounded by the apparatus and even though side-to-side tissue compression is applied to the appendage. Thus the inventive apparatus  110  provides, among other things, benefits that include: deflection of muscle forces; functional shortening of muscle length; and the maintenance of neurovascular channels.  
         [0053]     The apparatus  110  of  FIGS. 6-10  bears many similarities to the apparatus  10  of  FIG. 1-5 . Therefore, many of the descriptions herein relate to both apparatus  10  and apparatus  110 . However, in the interest of providing descriptions of the present invention that has many embodiments, and in the interest of minimizing duplicative descriptions, the descriptions below relate particularly to features and benefits of the apparatus  110  that are generally not merely duplicative to those of the apparatus  10 .  
         [0054]     For example, as shown in  FIG. 8 , the second partial collar  114  defines a polygonal concave receiving area  114   c  for receiving a side of an appendage. The apparatus  110  is particularly illustrated for use as a shoulder brace in  FIG. 11 . The polygonal concave receiving area  114   c  ( FIG. 8 ) of the second partial collar  114  comfortably receives, for example, the volar side of an upper arm just below the shoulder. An arterial pressure point resides proximal this area of the arm. The rigid partial collar  114 , having planar facets defining the polygonal concave receiving area  114   c , is capable of applying the force  120  ( FIG. 8 ) while minimizing the restriction of blood flow in the arm, and is furthermore capable of allowing comfortable swinging movement of the arm relative to the nearby rib-cage of the torso.  
         [0055]     For further example, while the pressure applicator  46  of  FIGS. 1-5  does not generally extend significantly beyond margins of the partial collar  12 , other embodiments of pressure applicators contact areas of appendages beyond margins of the partial collars. For example, an outrigger  146  for contacting multiple areas of an appendage is shown in  FIGS. 6-10 . When attached to the first partial collar  112  as illustrated in  FIGS. 6-9 , the outrigger  146  contacts and applies pressure to multiple areas of an appendage ( FIG. 11 ) on which the apparatus  110  is circumferentially disposed. As shown in  FIG. 10 , the outrigger  146  comprises a base  54 , multiple members  56  attached to the base, and pressure applicators  58  respectively attached to the members  56 .  
         [0056]     The outrigger  146  optionally comprises a rigid unitary construction formed, for example, of hard plastic. Alternatively, the members  56  of the outrigger  146  are optionally spring loaded or are articulated by cables. The members  56  may be rigid and fixed, or may be formable. The members may be positionable like jointed fingers. Furthermore, the members may be removable from the base  54  such that they may be replaced or such that a variable number of members depends from the base.  
         [0057]     With regard to each of the pressure applicators described herein, for example pressure applicator  46  of  FIGS. 1-5  and pressure applicators  146  of  FIGS. 6-10 , a pressure applicator according to the present invention optionally comprises an active cell (not illustrated). An “active cell” as used herein relates to an electrical, mechanical, or electromechanical device that, in conjunction with pressure applied by a pressure applicator, applies stimulus or treatment. For example, one embodiment of an active cell applies vibratory waves for massaging or otherwise stimulating tissue and vessels. In another example, an active cell applies acoustic waves. In another example, an active cell applies electrical stimulation or conveys electrical current. In yet another example, an active cell applies heating, cooling, or thermal-cycling therapy.