Abstract:
A back brace is designed to custom fit a wearer in a multitude of different configurations. First, the back brace could have a lumbar support that is split into upper and lower sections that are connected to a flexible joint, allowing the lumbar support to bend towards the spine of the user. The lumbar support is also generally split into left and right sections that are drawn towards one another while the joint bends towards the lumbar curve. This allows the back brace to conform to the lumbar curve of the wearer as a custom fit. Second, the brace could have optional extenders that alter the support length, width, and height of lumbar and lateral supports about the wearer. Third, the brace could have reinforcement support mechanisms that alter the rigidity of various lumbar and lateral supports about the wearer.

Description:
This application is a continuation of U.S. patent application Ser. No. 13/036,340 filed Feb. 28, 2011 which claims priority to U.S. Provisional Patent Application Ser. No. 61/308,728, filed Feb. 26, 2010. All extrinsic materials identified herein are incorporated by reference in their entirety. 
    
    
     FIELD OF THE INVENTION 
     The field of the invention is wearable lumbar supports. 
     BACKGROUND 
     Orthotic devices are typically provided for partial or substantial immobilization of the torso to stabilize the back. Some orthotic devices are back braces that fit around the torso around the lumbar area. When worn properly, a body brace can lend additional support to the abdomen and the spinal column to achieve spinal stability. However, for many users body braces are difficult to appropriately position and fasten. For example, U.S. Pat. No. 4,640,269 to Goins provides a back brace that is tightened around the body by threading a Velcro strap through a loop and pulling the strap backwards towards the user&#39;s posterior. The awkward angle of the strap prevents users from fully tightening the strap themselves and requires a third party to assist in the tightening process. 
     Goins and all other extrinsic materials identified herein are incorporated by reference in their entirety. Where a definition or use of a term in an incorporated reference is inconsistent or contrary to the definition of that term provided herein, the definition of that term provided herein applies and the definition of that term in the reference does not apply. 
     US 2007/0017945 to Willis teaches a body brace that wraps around a user&#39;s lumbar region and has a belt with a strap that pulls forward to fit the brace around the user. Willis&#39; body brace is easier to tighten since the strap tightens by pulling forward, which is a natural body movement. Willis, however, fails to contour to body shapes of different shapes and sizes, for example differently shaped hips and different lordotic curves. 
     U.S. Pat. No. 6,213,968 to Heinz teaches a custom fitted orthotic device with cables with a split lumbar support that is tightened around a lumbar region using pulleys and cords. Heinz, however, provides either rigid support or flexible support, and fails to allow the lumbar support to flex and bend into the lumbar curve while the lateral support remains rigid. These and all other extrinsic materials discussed herein are incorporated by reference in their entirety. Where a definition or use of a term in an incorporated reference is inconsistent or contrary to the definition of that term provided herein, the definition of that term provided herein applies and the definition of that term in the reference does not apply. 
     Unless the context dictates the contrary, all ranges set forth herein should be interpreted as being inclusive of their endpoints, and open-ended ranges should be interpreted to include commercially practical values. Similarly, all lists of values should be considered as inclusive of intermediate values unless the context indicates the contrary. 
     It has yet to be appreciated that stiff lumbar supports could have flexible joints that wrap around a patient&#39;s curvature to provide a stiff support that is custom fit. 
     Thus, there is still a need in the art for a body brace that conforms to body shapes of different shapes and sizes. 
     SUMMARY OF THE INVENTION 
     The present invention provides apparatus, systems, and methods in which one could use a brace to support the lumbar region of a patient by providing a lumbar support having a joint between upper and lower sections of the lumbar support. The upper and lower sections of the lumbar support are generally rigid with respect to the joint such that the joint can move anteriorly relative to the coronal plane of the body such that the joint folds into the curve of the lumbar region and the upper and lower sections “hug” the lumbar region. As used herein, the term “rigid” refers to a material that will not fold in half without permanently deforming the shape of the material, such as by snapping or breaking. A rigid material may bend slightly under pressure and return to its previous form when such pressure is removed, but will not fold in half. Contrast this with a “flexible” material, which could be unfolded to a planar form and could be folded in half with ease, without permanently deforming the shape of the material. 
     The upper and lower sections of the lumbar regions preferably have right and left sections that are coupled together by upper and lower mechanically advantaged systems. Contemplated mechanically advantaged systems include series of pulleys, gears, levers, screws, or combinations thereof that provide force to an adjustment mechanism. Preferably, the advantaged adjustment mechanism is mechanically advantaged more than 2:1, and is more preferably mechanically advantaged at 4:1 or more, additional pulleys or longer levers could easily increase the mechanical advantage ratio of the mechanism. Exemplary mechanically advantaged systems are further described in co-pending U.S. application Ser. Nos. 12/394867, 10/977726, and 10/440525, which are each incorporated herein by reference. 
     An exemplary mechanically advantaged system includes pulleys and cords that work to draw the left and right sections of the support region towards one another, towards the front/anterior side of the wearer. Such pulley systems could have 2, 3, 4, 5, or more pulleys, depending on the size and strength needed in such a device. In order to prevent the right and left sections of the lumbar support from pulling too far apart from one another, a limiter is preferably provided that prevents the left and right sections from moving a threshold distance away from one another. For example, a limiter could be a cloth, rope, or other material that couples the right and left sections without stretching. The limiter is preferably made from a compressible material to allow the right and left sections to fold over one another during storage, and also preferably includes a hole along the sagittal midplane of the wearer to allow a doctor to access the lumbar region of the wearer without removing the brace itself. 
     One or more optional extenders could be coupled with the lumbar support to extend the effective length, width, or height of the lumbar support, allowing for greater flexibility in the form and function of the brace. The optional extenders could alter the length, width, or height of the lumbar support by a variety of lengths, for example at least 2 inches, 5 inches, 10, inches, or 15 inches. Multiple extenders could be configured to attach to one another, allowing for a variety of extension configurations for wearers of different sizes and/or needs. Rigid reinforcing supports could also be coupled to the lumbar support, overlapping the joint, to prevent the flexible joint from bending in certain configurations. 
     The body brace preferably also has a rigid lateral support that reinforces the wearer&#39;s oblique muscles. Preferably, the rigid lateral support has a surface area greater than 4, 5, 10, 15, or 20 square inches. In an exemplary embodiment, the rigid lateral support extends anteriorly past a midline of the wearer. The lateral support may have an optional extender that couples to the lateral support to extend an effective length, width, or height of the lateral support, and/or may overlap with sections of the lateral support to reinforce a rigidity of the lateral support. Such optional extenders could alter the length, width, or height of the lumbar support by a variety of lengths, for example at least 2 inches, 5 inches, 10, inches, or 15 inches. Multiple extenders may be attached to one another to extend the lateral support for a plurality of lengths, or to reinforce the lateral support for a plurality of rigidity strengths. 
     The present invention provides apparatus, systems and methods in which a body brace is configured to conform and fit a variety of body shapes of different shapes and sizes. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWING 
         FIG. 1  is a rear plan view of an embodiment of a quick draw brace. 
         FIG. 2  is a front plan view of the quick draw brace of  FIG. 1 . 
         FIG. 3  is a rear plan view of the quick draw brace of  FIG. 1 , with fitting belts attached to the rear side of the lateral support. 
         FIG. 4  is an exploded view of the quick draw brace of  FIG. 3 . 
         FIG. 5  is a plan, rear view of the quick draw brace of  FIG. 1 , with fitting belts attached to the front side of the lateral support. 
         FIG. 6  is an exploded view of the quick draw brace of  FIG. 5 . 
         FIG. 7  is a plan view of the quick draw brace of  FIG. 6 , with the fitting belt folded over. 
         FIG. 8  is a perspective view of the brace of  FIG. 1  with the lumbar support in a bent position. 
         FIG. 9  is a rear plan view of an embodiment of an extender. 
         FIG. 10  is a front plan view of an embodiment of the extender of  FIG. 9 . 
         FIG. 11  is a rear plan view of the quick draw brace of  FIG. 7  juxtaposed with the extender of  FIG. 9 . 
         FIG. 12  is a rear plan view of the quick draw brace of  FIG. 7  with the extender of  FIG. 9  attached to the quick draw brace. 
         FIG. 13  is a rear plan view of a reinforcement panel. 
         FIG. 14  is a front plan view of the reinforcement panel of  FIG. 13 . 
         FIG. 15  is a rear plan view of the extender of  FIG. 9  juxtaposed with the reinforcement panel of  FIG. 13 . 
         FIG. 16  is a rear plan view of the extender and reinforcement panel of  FIG. 15  juxtaposed with the quick draw brace of  FIG. 7 . 
         FIG. 17  is a rear plan view of the extender, reinforcement panel, and quick draw brace of  FIG. 16  coupled with one another. 
         FIG. 18  is an enlarged, exploded view, showing the cord guide parts within the upper left and right sections of the brace of  FIG. 1 . 
         FIG. 19  is a perspective view of the upper left and right sections of  FIG. 18  in the assembled configuration. 
     
    
    
     DETAILED DESCRIPTION 
       FIGS. 1 and 2  show a quick draw brace  100  with a lumbar support  110 , lateral supports  120  and  130 , cords  140  and  150 , and limiter  160 . Lumbar support  110  is split into upper left section  111 , lower left section  112 , upper right section  114 , and lower right section  115 . Upper left section  111  and lower left section  112  are configured to pivot with respect to one another along flexible joint  113 , and likewise upper right section  114  and lower right section  115  are configured to pivot with respect to one another along flexible joint  116 . Upper left section  111 , lower left section  112 , upper right section  114 , and lower right section  115  are all preferably rigid or semi-rigid in order to provide support to the upper lumbar curve and the lower lumbar curve of the wearer. 
     Lateral supports  120  and  130  are preferably made of a semi-rigid or rigid material to provide lateral support to a user. While the current embodiment shows lateral support  120  being wholly contiguous with left lumbar support sections  111  and  112 , the lateral support could be made separately from the lumbar supports without departing from the scope of the current invention. It is preferred that the lateral support is a semi-rigid material that is greater than 4 or 5 inches so that the lateral support would pass the midline of the wearer. 
     In the current embodiment, flexible joints  113  and  116  are created by creating a thin peninsula of a substantially rigid plastic polymer separate from the lateral supports  120  and  130 . Since the peninsula is so thin (approximately 1.5 centimeters across), the upper and lower sections are able to bend along the joint, whereas they would not be able to if the peninsula was much wider. As shown in  FIG. 8 , as the upper and lower sections bend inward, the lateral section does not also bow inward because of the shape of the peninsula. In reality, lateral section  130  bows outward slightly, which is largely contained when cord  150  is pulled against lateral section  130 . One skilled in the art would understand that other flexible joints could be used, for example by using a cloth lumbar support or by adding a hinge or series of hinges to a more rigid peninsula. 
     Cords  140  and  150  are attached to pulleys (shown in  FIGS. 18 and 19 ) in the upper and lower sections in a similar manner to the pulleys described in US2009/0192425 and U.S. Pat. No. 7,001,348. This creates a mechanically advantaged system such that when a wearer pulls cords  140  and  150 , these sections could then fold anteriority until the flexible joint engages the lordotic curve of the wearer&#39;s posterior side, allowing for a tighter fit. Since the lateral supports  120  and  130  are coupled to the lumbar support  110  via thin, semi-rigid peninsulas, the lateral supports do not bend when the cords are pulled. Preferably, the pulley system comprises an elastic band or spring that will automatically retract the cord when a force ceases to be applied to the cord. 
     Cords  140  and  150  terminate in handles  142  and  152 , which each have hook and loop attachments that could be attached to left and right adjustment mechanisms  310  and  320  shown in  FIGS. 3-8 . Left adjustment mechanism  310  and right adjustment mechanism  320  preferably both have loop material along a majority of their lengths along the front side, to allow cord handles  142  and  152  to be attached to any portion of the adjustment mechanism. Right adjustment mechanism  320  also has hook attachments along its tip to allow it to mate with the front side of left adjustment mechanism  310  when wrapped around a wearer. 
     Limiter  160  is an underlying cloth that lumbar support  110  is attached to. Since limiter  160  is made of a substantially inelastic material, limiter  160  prevents cords  140  and  150  from being pulled too far towards the holes, effectively controlling the minimum distance that the cords can be retracted. As used herein, a 5 inches (12.7 cm) of a “substantially inelastic material” does not stretch more than 3 mm without tearing. Limiter  160  also has hole  162 , which allows access to the lumbar region of the wearer for emergencies, and also prevents direct force from being applied to the lumbar region in case of severe injury. 
     Right adjustment mechanism  320  attaches to lateral support  130  via holes  132 . As shown in  FIG. 6 , hole  132  comprises two opposing bolt recesses  133  and  134 . This allows right adjustment mechanism to attach to a front side of a hole as shown in  FIG. 4 , or attach to the rear side of a hole as shown in  FIG. 6 . Allowing right adjustment mechanism  320  to attach to either the front or a rear side of a hole doubles the adjustment length as compared to an adjustment mechanism that merely attaches to one side of the lateral support. It is contemplated that other methods of attaching adjustment mechanisms  310  and  320  to the lateral supports could be used, for example buttons, claps, hooks, or even more hook and loop attachments. 
     As shown in  FIGS. 5 and 6 , when right adjustment mechanism  320  attaches to the rear side of a hole, the adjustment mechanism needs to thread through loophole  136  in order to be orientated correctly for wearing. Loophole  136  is shown as a hole in lateral support  130 , but could be a recess (or an open hole) without departing from the scope of the invention. Since right adjustment mechanism could attach to either a front side or a rear side of the lateral support, the length of right adjustment mechanism could be altered considerably. Additionally, shorter or longer adjustment mechanisms could be provided to allow an even greater variability in sizes. The holes could also be used to attach other lateral supports to accommodate larger wearers and extend the length even further. 
     The effective height and width of lumbar support  110  could be extended using extender  1000  with optional rigid support  1010  and padding  1020 , shown in  FIGS. 10 and 11 . Rigid support  1010  preferably overlaps with some of the surface of lumbar support  110  to reinforce the rigidity of lumbar support  110 . While the drawing illustrates that padding  1020  covers hole  1030 , it is preferred that padding  1020  has a hole that matches hole  1030 , preventing any padding from touching the delicate spinal column along the lumbar region, and providing access to the lumbar region. When lumbar support  110  is attached to extender  1000  as shown in  FIGS. 12 and 13 , the effective height of the lumbar support and the effective lengths of the lateral supports could be lengthened considerably. 
     Preferably, the effective height of the lumbar support is lengthened so that the lumbar support provides support from the sacrococcygeal junction to the 9th thoracic vertebra. This effective height is generally greater than 9 inches in an average adult, and may extend more than 10, 11, 12, 13, or 14 inches, depending on the size of the user. In another embodiment, the effective height of the lumbar support could be adjusted by attaching or detaching other extendable support structures. 
     Unless the context dictates the contrary, all ranges set forth herein should be interpreted as being inclusive of their endpoints and open-ended ranges should be interpreted to include only commercially practical values, all lists of values should be considered as inclusive of intermediate values unless the context indicates the contrary. 
     The effective length that is added by extender  1000  could be further altered by removing lateral extenders  1012  and  1014 , or by replacing the lateral extenders with longer or differently shaped extenders. As shown in  FIG. 9 , lateral extenders  1012  and  1014  mate with bolt holes  1022  and  1024 , respectively, and overlap with a portion of the rigid support  1010  to reinforce the strength of a portion of the rigid support  1010 . The rigid support  1010  shown as being constructed from three separate panels—a mid-panel, a left lateral extender  1012 , and a right lateral extender  1014 —the rigid support could be made from more or less portions as needed. Preferably, the rigid support  1010  is made from the same material as lateral supports  120  and  130 , but could be made from different material if needed. 
       FIGS. 15 and 16  show the front and back portions of detachable small back panel  1600 . Small back panel  1600  is preferably made from a rigid material covered in padding to protect the regions close to the spine. As shown in  FIGS. 13-17 , the small back panel could be wrapped around lumbar support  110  to prevent lumbar support  110  from bending into the lumbar curve of the wearer and to add a more rigid support structure to the lumbar region. 
       FIGS. 18 and 19  show the configuration of a mechanically advantaged system  1800  represented as upper left section  111  and upper right section  114 , which are pulled together using cord  150 . The lower left and lower right sections are constructed in the same manner. The upper left section  111  has an upper left cord guide base  38 , which has three pulleys, shown in the figure as cord guide lobes  40 ,  42 , and  44  thereon. In addition, the base  38  has posts  46  and  47  which snap into matching detents (not shown) in cap  56 . The cord guide lobes  40 ,  42 , and  44  are half round and are undercut on their half circumference. The under cut is circular in profile and is at least as large as the diameter of the cord. The under cuts are preferably smooth so that cord  150  can be engaged therearound and smoothly moved around the lobes. For smooth movement, it is preferably that the upper left section  111  and upper right section  114  be made of a low friction polymer, such as nylon or Teflon. The upper right section  114  is similar to upper left section  111 , and also has three cord guide lobes  50 ,  52 , and  54  on its base  37 , which act as pulleys for cord  150 . The cord  150  has an eye thereon engaged over post  49  on cord guide  114 . The cord  150  engages around love  40 , lobe  52 , and thence lobe  44  to extend out over the base  37 . When the cord  150  is pulled, the upper left section  111  and upper right section  114  are pulled together with a 4-to-1 mechanical advantage (neglecting friction) The cord  150  is preferably a strong cord with low friction characteristics with respect to the cord guide lobes, such as nylon. 
     In order to hold a cord in place on the lobes, caps  56  and  58  could be used to cover the bases  38  and  37 , respectively. The caps have half round recesses  60  that engage over the lobes. The recess  60  engages over lobe  44  to hold the cord in the undercut below the top of lobe  44 , and hold the cord loop on the post  49 . The caps can be attached in any other suitable way, for example by using adhesives or mating buttons. Other pulley mechanisms are contemplated, for example pulleys mounted on wheels. 
     Thus, specific compositions and methods of providing aback brace have been disclosed, it should be apparent, however, to those skilled in the art that many more modifications besides those already described are possible without departing from the inventive concepts herein. The inventive subject matter, therefore, is not to be restricted except in the spirit of the disclosure. Moreover, in interpreting the disclosure all terms should be interpreted in the broadest possible manner consistent with the context. In particular the terms “comprises” and “comprising” should be interpreted as referring to the elements, components, or steps in a non-exclusive manner, indicating that the referenced elements, components, or steps can be present, or utilized, or combined with other elements, components, or steps that are not expressly referenced.