Abstract:
A patient care system for providing static progressive positioning of body members in pronation or supination, the system includes a positioning assembly that rotatably positions a first body engaging assembly relative to a second body engaging assembly for static progressive positioning of a body joint in pronation or supination.

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
       [0001]    This application claims priority to United States Provisional Application Ser. No. 60/891,981, filed Feb. 28, 2007, and entitled STATIC PROGRESSIVE PRONATION SUPINATION SPLINT, and incorporated by reference herein in its entirety. 
     
    
     FIELD 
       [0002]    This disclosure relates generally to orthopedic treatment devices. More particularly, the disclosure relates to orthosis devices for treating joint stiffness and soft tissue contractures. 
       BACKGROUND 
       [0003]    In the treatment of joint stiffness or contractures which decrease the range of motion of the joint, an orthotic device may be used to urge the joint to a desired pronation or supination orientation and maintain the orientation for a prescribed period of time. For example, to treat a wrist, it may be desirable to urge the wrist towards the limits of its current range of movement. Such treatments are generally referred to as static-progressive treatments and are used to elongate the soft tissue over time. Improvement is desired in the construction of devices for providing static progressive treatment of joints and for moving the wrist from supine to prone positions. 
         [0004]    The disclosure relates to patient care systems, such as orthotic devices, of improved construction. 
       SUMMARY 
       [0005]    The patient care systems described herein are configured for providing static progressive positioning of body members in pronation or supination. The systems are useful for managing contractures due to neurological disorders, muscle hypertonicity or orthopedic conditions affecting the body member. The systems may be utilized to increase the range of motion. The systems are also suitable for post-operative use to limit or prevent rotation and other movements of the body member. 
         [0006]    In one embodiment, the system includes a first body engaging assembly for engaging first body portions of a user adjacent a joint of the body; a second body engaging assembly for engaging second body portions of the user; and a positioning assembly that rotatably positions the first body engaging assembly relative to the second body engaging assembly for static progressive positioning of the joint in pronation or supination. 
         [0007]    The positioning assembly includes a ring member, the first body engaging member being mounted adjacent an interior portion of the ring member, a yoke to which the ring member is movably mounted, and a rotator mounted to the yoke and positioned to rotationally and frictionally engage the ring member to move the ring member for positioning of the joint. 
         [0008]    In another aspect, a patient care system is provided having a rotatable ring member; a rotator operably associated with the ring member to rotate the ring member for positioning of the joint; a first body engaging assembly mounted on the ring member and configured for engaging first body portions of a user adjacent a joint of the body; and a second body engaging assembly remote from the first body engaging member and configured for engaging second body portions of the user. 
         [0009]    Operation of the rotator causes rotation of the ring member to rotatably position the first body engaging assembly relative to the second body engaging assembly for static progressive positioning of the joint in pronation or supination. 
         [0010]    The systems described herein enable the wrist or other joint of a user to be moved through a range of motion. For example, when used with the wrist, the system may be adjusted to position the wrist at any position between pronation and supination, as well as positions beyond. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS  
         [0011]    Further features of the disclosure are apparent by reference to the detailed description when considered in conjunction with the figures, which are not to scale so as to more clearly show the details, wherein like reference numbers indicate like elements throughout the several views, and wherein: 
           [0012]      FIG. 1  is a perspective view of a wrist orthosis in accordance with a preferred embodiment. 
           [0013]      FIG. 2  is a partially exploded perspective view of the wrist orthosis of  FIG. 1 . 
           [0014]      FIG. 3  is an enlarged view of a positioning assembly portion of the orthosis of  FIG. 1 . 
           [0015]      FIG. 4  is an exploded view of components of the positioning assembly portion of  FIG. 3 . 
           [0016]      FIG. 5  is a front end view of the orthosis of  FIG. 1 , with the orthosis adjusted to position the wrist of a user in supination. 
           [0017]      FIG. 6  is a front end view of the orthosis of  FIG. 1 , with the orthosis adjusted to position the wrist of a user in pronation. 
       
    
    
     DETAILED DESCRIPTION  
       [0018]    The disclosure relates to devices for static progressive pronation and supination of a body member. The preferred embodiment is described in connection with a wrist orthosis. In this regard, it will be understood that sizes and fit features of the splint may be modified for use with other body members typically treated using static progressive pronation and supination techniques, such as the knee, elbow and ankle. 
         [0019]    With reference to the drawings, one embodiment of the disclosure relates to a wrist orthosis  10  preferably having a hand/wrist engaging assembly  12 , an elbow/arm engaging assembly  14 , and a positioning assembly  16  that rotatably positions the hand/wrist engaging assembly  12  relative to the elbow/arm engaging assembly  14  and can be used for static progressive positioning of the wrist joint in pronation or supination or other orientation. As seen in  FIG. 1 , an arm A of a user is shown in phantom, with the wrist thereof in an intermediate orientation between prone (facing down) and supine (facing up). 
         [0020]    The hand/wrist engaging assembly  12  preferably includes a substantially rigid hand/wrist receiving member  18  configured to receive the hand and the wrist of the user. The member  18  includes a substantially V-shaped hand receiver  20  and an aligned and substantially V-shaped wrist receiver  22 . The receivers  20  and  22  are spaced apart from one another by a connector segment  24  of the receiver  18 . Straps  26  and  28  preferably overlie the open upper ends of the receivers  20  and  22 , respectively, and are releasably securable to the receivers  20  and  22  as by use of mating hook and loop material or the like. 
         [0021]    The member  18  may be made of a rigid plastic material, such as a high density polyethylene, or a lightweight aluminum material, encased within a flexible semi-rigid material, such as a polyurethane foam. The segment  24  is configured to include bosses or other structure, accessible via apertures for receiving fasteners such as screws for mounting of the member  18  to the positioning assembly  16 . The straps  26  and  28  are preferably made of a soft flexible fabric or plastic material overmolded with polyurethane foam or the like. It will be understood, however, that the member  18  and the components thereof may be made in various configurations for engaging and retaining the hand/wrist of the user and may be made of a variety of materials. 
         [0022]    The elbow/arm engaging assembly  14  is constructed of similar materials to the assembly  12  and includes a substantially L-shaped open-ended elbow/ann receiver  30  configured for receiving the elbow and portions of the bicep and forearm of the user adjacent the elbow. In this regard, the receiver  30  also preferably includes straps corresponding to the straps  26  and  28  for securing the receiver  30  snugly to the user. A mounting plate  32  is secured to a lower surface of the receiver  30 , as by screws or other fasteners. 
         [0023]    The mounting plate  32  is configured to be adjustably mounted to an extension member  34  which extends from the positioning assembly  16  to enable the position of the assembly  14  to be adjusted relative to the position of the assembly  12  for fitting the orthosis  10  to different arm lengths. For example, the extension member  34  may be a square aluminum tubing and the mounting plate  32  includes a plurality of spaced apart ribs  36  or other receiving structure configured to fittingly receive the member  34 . In this regard, it will be understood that adjustment of the positions of the assemblies  12  and  14  along the aligned longitudinal axes thereof is desired, but that it is desired that the assemblies  12  and  14  remain aligned during use of the orthosis  10 . 
         [0024]    The positioning assembly  16  is configured to rotatably position the hand/wrist engaging assembly  12  relative to the elbow/arm engaging assembly  14  and can be used for static progressive positioning of the wrist joint in pronation or supination or other orientation. The positioning assembly  16  includes a ring member  40 , a yoke  42 , and a rotator  44 . 
         [0025]    The ring member  40  is a partial ring configuration having free ends  46  and  48 . The ring member  40  is substantially rigid and may be of one-piece molded plastic construction if desired. The ring member  40  preferably has a diameter of from about 4 to about 5 inches for use with adults. A portion of the ring member  40  is open such that the spacing between the ends  46  and  48  is sufficient to enable a user&#39;s wrist to fit through the open space, such as from about 2½ to about 3½ inches. The ring member  40  may also be a complete ring. Also, the ring member  40  may have other than a circular cross-section, and may be other shapes, such as oval, U-shaped, D-shaped, and V-shaped, with the term “Ring member” referring to structure having a generally encircling or partially encircling configuration. 
         [0026]    As best seen in  FIGS. 4 and 5 , a support  50  extends across a portion of the interior of the ring member  40  for mounting of the segment  24  of the hand/wrist receiving member  18 . For example, the segment  24  may be secured to the support  50  as by fasteners and the like. 
         [0027]    The yoke  42  movably mounts the ring member  40  so that the ring member  40  may be positioned as desired using the positioning assembly  16 . For example, the yoke  42  may include spaced apart and mutually facing uprights  52  and  54  having opposed receivers on their interior surfaces, such as open-ended channels, ribs, or the like, for slidably receiving edge portions  40   a  and  40   b  of the ring member  40 . If desired, ribs may project from the edges  40   a  and  40   b  to engage corresponding structure on the uprights or other portion of the yoke  42 . 
         [0028]    Alternatively, the edge portions  40   a  and  40   b  may define grooves for being slidingly received by projections located on the uprights  52  and  54  or other opposed portions of the yoke  42  to movably guide the ring member  40  for positioning of the wrist as described herein. The yoke  42  may include a mount  56  configured for mounting of the extension  34 . The mount  56  may be co-molded with the yoke  42  and having a surface shaped to receive a free end of the extension  34 . The extension  34  may be secured to the mount  56  as by friction, mechanical fasteners, adhesives, and the like. 
         [0029]    The rotator  44  rotationally and frictionally engages the ring member  40  to move the ring member  40  for positioning of the wrist as described herein. The rotator  44  may be rotatably mounted to the yoke  42  and positioned to engage the ring member  40 . For example, the rotator may include a shaft  60  that extends though aligned bores of the uprights  52  and  54  so as to be rotatable relative to the yoke  42 . A portion of the shaft  60  that extends between the uprights  52  and  54  may include an outer surface, such as a rubber cylinder  62 , a coating having a relatively high coefficient of friction, or like structure, for frictionally contacting a contact surface, such as the outer periphery  40   c  of the ring member  40 . In this regard, it will be understood that the outer periphery  40   c  corresponds to the general encircling or partially encircling shape of the ring member  40 . 
         [0030]    In this regard, the shaft  60  is located so that the outer surface of the shaft  60 , such as the rubber cylinder  62 , bears against the contact surface of the ring member  40 , such as the outer periphery  40   c.  When the shaft  60  is rotated, it will be understood that such rotation is transferred, preferably directly, to the ring member  40 . In this regard, the distal end of the shaft  60  is rotatably mounted relative to the yoke  42  and the opposite free end of the shaft  60  preferably includes a knob  64  or the like to facilitate manual rotation of the shaft  60 . 
         [0031]    A stop  66 , such as a set screw threadably received by the yoke  42 , or the like may be provided to positively engage the shaft  60  or portions thereof, such as the cylinder  62 , to positively lock the shaft  60  from rotation. This may be desired, for example, once the ring member  40  has been rotated to desirably position the wrist of a user for treatment and it is desired to retain the wrist in the set orientation for a period of time. 
         [0032]    With reference to  FIGS. 4-5 , it will be seen that the positioning assembly  16  advantageously enables the wrist of a user to be moved through a range of motion. For example, in  FIG. 4 , the orthosis is adjusted to position the wrist of a user in supination. In  FIG. 5 , the orthosis is adjusted to position the wrist of a user in pronation. 
         [0033]    As will be appreciated, the orthosis may be adjusted to position the wrist at any position between pronation and supination, as well as positions beyond, as permitted by the size and configuration of the ring member  40 , as well as the mobility of the user&#39;s wrist. 
         [0034]    For example, assuming suitable wrist mobility, the ring member  40  may be rotated by the positioning system  16  from a position corresponding to the position of the free end  46  of the ring member  40  adjacent the cylinder  62  to a position corresponding to the position of the free end  48  of the ring member  40  adjacent the cylinder  62 . The locations of the free ends  46  and  48  are thus preferably selected to limit the rotation so as to not permit a wrist to be over pronated or supinated beyond the physical limits of wrists. 
         [0035]    As mentioned previously, the ring member  40  may also be a complete ring (no free ends). However, in such case it is preferred to have stops, such as projections or the like extending from the periphery  40   c  at locations corresponding to the locations of the free ends  46  and  48 , to limit the extent of rotation. 
         [0036]    The foregoing description of preferred embodiments for this disclosure has been presented for purposes of illustration and description. It is not intended to be exhaustive or to limit the disclosure to the precise form disclosed. Obvious modifications or variations are possible in light of the above teachings. The embodiments are chosen and described in an effort to provide the best illustrations of the principles of the disclosure and its practical application, and to thereby enable one of ordinary skill in the art to utilize the disclosure in various embodiments and with various modifications as are suited to the particular use contemplated. All such modifications and variations are within the scope of the disclosure as determined by the appended claims when interpreted in accordance with the breadth to which they are fairly, legally, and equitably entitled.