Patent Publication Number: US-8122545-B2

Title: Inflatable cushioning device with manifold system

Description:
FIELD OF THE INVENTION 
     The present invention relates generally to an inflatable cushioning device for body supports such as a mattress, sofa, or chair cushion. In particular, the present invention relates to a body support for preventing the formation of pressure induced soft tissue damage. 
     BACKGROUND OF THE INVENTION 
     Heretofore, inflatable cushioning devices for use with body supports, such as a mattress, sofa, seat, or the like, typically included a plurality of air cells or bladders that are inflated to support a person. The air cells provide support to the person, and can be inflated to a desired pressure level to provide the person with a predetermined level of comfort and support. 
     In the medical field, cushioning devices including a plurality of air cells are often used to provide different levels of support under various portions of a patient&#39;s body. For example, a mattress may include separate air cells located in the upper, middle, and lower portions of the mattress. These air cells can be inflated to different pressures to support the upper, middle, and lower portions of the patient&#39;s body with different pressures. 
     In hospitals which provide care to patients confined to a bed for extended periods of time, the patients often suffer from the effects of excess pressure transmitted to their bodies. As known in the medical field, continuous pressure applied to a patient&#39;s body can cause soft tissue damage. When the external pressure exerted on the patient&#39;s skin causes blood carrying capillaries to close, soft tissue degeneration may occur. This soft tissue damage may lead to the formation of pressure sores. For example, continuous pressure applied to a patient&#39;s heel can cause a pressure sore to develop on the heel. The multi-cell cushioning devices described above can be used to relieve the pressure applied to a specific portion of a patient&#39;s body. In the case of a patient&#39;s heel, for example, this may be accomplished by inflating the air cell under the patient&#39;s leg so that the heel is lifted from the mattress. Thus, the continuous heel pressure is relieved and the formation of a bed sore on the heel is prevented. 
     Air cushion devices typically require an external pump to inflate the air cells in the device. Alternatively, the air cushion devices are pre-inflated in the manufacturing plant and are shipped to a field location for use. A problem may develop when the atmospheric pressure at the inflation location is different from the atomospheric pressure at the field location where the device is used. For example, if the field location atmospheric pressure is lower than the atmospheric pressure at the inflation location, the air cells in the field will expand and become firmer. 
     Hospitals rate pressure relief support systems as “treatment products” if they sufficiently reduce the pressure upon a patient&#39;s body, reduce tissue trauma, and facilitate the healing of skin ailments, such as burns, pressure sores, etc. Typical pressure relief support systems which qualify as “treatment products” are embodied in beds which contain motors and pumps to vary the shape and pressure within the mattress. Such beds are very expensive and require the operator to undergo extensive training to learn how to use and operate the system. Furthermore, the “treatment products” often require extensive maintenance due to the failure of the numerous moving mechanical parts. Also, these complicated pressure relief support systems cannot be used on typical box spring mattress supports, and require specialized bed frames. The complicated design of these beds makes their repair very difficult, and often requires the complete replacement of the entire system for proper servicing. A further difficulty is that during power outages, these mattresses lose pressure leaving a patient on a hard surface to develop pressure sores if action is not taken. Thus, a need exists to arrive at a body support which adequately addresses these disadvantages. 
     SUMMARY OF THE INVENTION 
     The present invention provides a cushioning device for a mattress, seat, sofa, or the like where support is obtained from a fluid such as atmospheric air. The cushioning device has few moving parts, is user controllable, requires minimal maintenance, and is easily repairable. The cushioning device of the present invention includes a support system apparatus, a sleeve apparatus, a jacket, a topper cushion, and an outer cover. 
     The support system apparatus includes at least one support cell for providing lifting support for a body. Each support cell includes an envelope containing a fluid. Application of an external load on an outer surface of the envelope causes the envelope to deform into a compressed form. The envelope includes a reforming element that is capable of providing a reforming force to the interior surface of the envelope, to return the envelope to its original unloaded form. The reforming element is preferably made from a resilient foam material, however, other resilient means can be used. 
     An intake valve and an exhaust valve are included in each support cell. The exhaust valve in each support cell is connected to an exhaust control system via a lateral conduit which extends directly from the fluid cell. The intake valve in each support cell is connected to an intake control system via a lateral conduit which extends directly from the fluid cell. As shown in the drawings, each conduit is not connected to or in direct fluid commimication with another conduit on the same cell. Thus, the lateral conduit which connects to the exhaust control system and the lateral conduit which connects to the intake control system are not in direct fluid communication with another. Each intake valve includes an intake check valve allowing fluid to flow into the support cell, while preventing fluid from flowing out of the support cell. Each exhaust valve includes an exhaust check valve allowing fluid to flow out of the support cell, while preventing fluid from flowing into the support cell. The intake control system is connected to a fluid supply reservoir. The exhaust control system is connected to a fluid exhaust reservoir. Preferably, the fluid included in the supply and exhaust reservoirs is air, however, any suitable fluid, c.g., water or nitrogen, can be used. The fluid supply and exhaust reservoirs may comprise the same reservoir, and may comprise an ambient source of fluid such as atmospheric air. 
     In use, the weight of a body of a person, patient, or animal resting on the envelope deforms the envelope. For illustration purposes, a patient will be used as an example of a body resting on a the envelope. The pressure of the fluid within the envelope increases as the volume of the envelope decreases under deformation. As the pressure of the fluid increases, the fluid in the envelope flows out of the envelope through the exhaust valve and into the exhaust control system. Next, the fluid flows from the exhaust control system into the fluid exhaust reservoir. Furthermore, as the envelope deforms to conform to the irregular shape of the patient, the area of the envelope supporting the load increases. Equilibrium is achieved when the forces within the envelope, including the pressure of the fluid within the envelope multiplied by the area of the envelope supporting the load, plus the force provided by the reforming element equal the weight of the load. 
     A controllable pressure relief valve is included in the exhaust control system so that a maximum pressure level of the fluid within the envelope can be set and maintained. Different selected maximum pressure levels of the fluid allow the support cell to accommodate different weights or allow different degrees of conformation between the patient and the envelope surface. Preferably, the maximum pressure level of the fluid is set to ensure that the interface pressure under the entire contact surface of the patient is below the pressure that may cause soft tissue damage such as pressure sores to occur. 
     As the weight of the patient is removed from the support cell, the reforming element exerts an outward force on the interior surface of the envelope. As the envelope expands, a partial vacuum is created in the interior space of the envelope, causing fluid to be drawn back into the interior space of the envelope. The fluid is drawn from the fluid supply reservoir into the intake control system, through the intake valve, and into the interior space of the envelope. The intake valve includes a one way intake check valve that permits fluid to re-enter the interior space of the envelope, while preventing fluid from exiting the interior space of the envelope. 
     The support cells included in the present invention can use atmospheric pressure as the pressure source for inflation. Therefore, when the fluid supply and exhaust reservoirs comprise atmospheric air, non-powered inflation can be accomplished without the need for expensive blowers, pumps or microprocessors as required by previously available “treatment products.” A plurality of support cells can be interconnected via a lateral conduit to the intake control system and via a lateral conduit to the exhaust control system to create a support system apparatus. Interconnecting the support cells allows a constant pressure to be maintained across the fluid cells. The support system apparatus can support a patient by providing self adjusting pressure management to the entire contact surface of the patient. The support system apparatus provides a low interface pressure under the entire surface of the patient being supported. For example, if the patient is lying on the support system apparatus, the support system apparatus ensures that the interface pressure under the entire contact surface of the patient is below the pressure that may cause soft tissue damage to occur. 
     The support system apparatus also has the ability to self-adjust every time a patient moves, or is repositioned on the support system apparatus. When the pressure distribution applied to the support system apparatus changes, the support cells within the support system apparatus automatically inflate or deflate as necessary, to maintain a low interface pressure under the entire patient. 
     Another embodiment of the current invention provides for separately controlled support zones within the support system apparatus. Each support zone comprises at least one support cell. Each support cell includes at least one intake valve and at least one exhaust valve. The intake valve for each support cell in each support zone is connected to a manifold system, including a conduit having a pluraqlity of lateral conduits extending therefrom, included in the intake control system. The exhaust valves from each support cell in a single support zone are connected to a manifold system, including a conduit having a plurality of lateral conduits extending therefrom, including in a single exhaust control system. Each support zone has a separate exhaust control system. The intake control system is connected to the fluid supply reservoir. The exhaust control system for each support zone is connected to the fluid exhaust reservoir. Generally the pressure level in each support zone is et at a different level. For example, if the support system apparatus comprises a mattress in a bed, the upper, middle, and lower zones of the support system apparatus can be set to provide a different level of pressure or firmness for the upper, middle, and lower portions of the patient&#39;s body. 
     The sleeve apparatus includes a cell cover surrounding each support cell. For a plurality of support cells, each cell cover is attached to an adjacent cell cover. The cell cover allows the surface of the envelope of the support cell to slide freely along a first side of the cell cover, without transmitting this sliding movement to a second side of the cell cover. The second side of the cell cover can be the side on which a patient is lying. Therefore, movement of the support cell is not transmitted to the patient, thereby preventing frictional or shear force abrasion damage to the skin of the patient. In the event that repair of a support cell becomes necessary, the sleeve apparatus allows each support cell to be easily removed and replaced. 
     Another embodiment of the present invention provides an additional alternating pressure system for providing alternating supply pressure to a plurality of zones. The alternating pressure system can be used in combination with the support system apparatus. Each zone includes at least one support cell. The alternating pressure system includes a pressurized fluid supply source including a pump, a pressurized fluid tank, etc. Additionally, the alternating pressure system includes a control system for sequentially supplying fluid pressure to the plurality of zones. The raising and lowering of the alternating zones under a patient provides beneficial movement of the skeleton and tissue in the patient. The movement helps stimulate circulation and lymph fluid movement in the patient. When the alternating pressure system is deactivated or fails, the support system apparatus continues to provide self adjusting pressure management to the patient&#39;s body. 
     The jacket houses the support system apparatus, the intake and exhaust control systems, and portions of the alternating pressure system. The jacket can be made from any suitable stretchable material, and is preferably is formed from a stretchable fabric material. 
     The topper cover provides further resilient torso support. The topper cover may be formed from a layered fiber filled material or other suitable material. The topper may include a resilient heel support unit to reduce pressures on the sensitive heel region of a patient. The topper cover may rest above the jacket, and may be covered by the outer cover. Alternatively, the topper cover may rest above the support system apparatus. 
     The outer cover provides a low friction and low shear surface further protecting the patient from frictional tissue damage. Additionally, the outer cover provides a waterproof and stain resistant surface. For medical uses the outer cover can be made from an anti-microbial type material. 
     The cushioning device of the present invention allows a user in the field to adjustably set the maximum pressure level in each support cell. When surrounded by atmospheric air, the support system apparatus is self-inflating, self-adjusting, and does not require expensive pumps and control systems as required by related “treatment product” art. Also, since there are fewer moving parts in the present invention, maintenance and repairs are simple and reasonable in cost compared to the complex related art. 
     The cushioning device of the present invention can be used in combination with any support device where self adjusting dynamic pressure support of the person or patient is required. For example, these support devices can be mattresses, sofas, seats, etc. 
     Generally, the cushioning device of the present invention comprises: 
     a plurality of fluid cells; and 
     a non-powered manifold system, operatively attached to the plurality of fluid cells. 
     The present invention additionally provides a cushioning device comprising: 
     a plurality of self-inflating fluid cells; 
     a manifold system, operatively attached to the plurality of self-inflating fluid cells; and 
     means, operatively attached to the self-inflating fluid cells for adjusting the firmness or softness of all of the fluid cells. 
     The present invention additionally provides a cushioning device comprising: 
     a plurality of self-inflating fluid cells; 
     a manifold system, operatively attached to the plurality of self-inflating fluid cells; and 
     a pressure regulator attached to the manifold system. 
     The present invention additionally provides a cushioning device comprising: 
     a plurality of fluid cells; 
     a pressure regulator; and 
     a manifold system, operatively attached to each of the fluid cells, wherein the fluid cells do not communicate with each other through the manifold and all fluid cells communicate with the pressure regulator. 
     The present invention provides a method for supporting a body comprising: 
     providing a plurality of non-powered self-inflating fluid cells; 
     applying a body weight to the non-powered self-inflating fluid cells; and 
     allowing each of the non-powered self-inflating fluid cells to react to the body weight and adjust to an identical internal pressure. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The features of the present invention will best be understood from a detailed description of the invention and a preferred embodiment thereof selected for the purposes of illustration and shown in the accompanying drawings in which: 
         FIG. 1  illustrates a perspective view of an inflatable cushioning device of the present invention; 
         FIG. 2  illustrates a partial cross-sectional view of a support cell including a reforming element and an intake valve; 
         FIG. 3  illustrates an end view of a support system apparatus; 
         FIG. 4  illustrates a plan view of another embodiment of the support system apparatus including a plurality of controlled support zones; 
         FIG. 5  illustrates a cross-sectional view of the support system apparatus taken along the line  5 — 5  of  FIG. 4 ; 
         FIG. 6  illustrates an example of a pressure distribution in a plurality of zones in the support system apparatus of  FIG. 5 ; 
         FIG. 7  illustrates a plan view of another embodiment of the support system apparatus including an alternating pressure system; 
         FIG. 8  illustrates a cross-sectional view of the support system apparatus taken along the line  8 — 8  of  FIG. 7 ; 
         FIG. 9  illustrates a first pressure distribution pattern provided by the alternating pressure system in the plurality of support cells of  FIG. 8 ; 
         FIG. 10  illustrates a second pressure distribution pattern provided by the alternating pressure system in the plurality of support cells of  FIG. 8 ; 
         FIG. 11  illustrates a cut-away perspective view of a mattress cushioning device; 
         FIG. 12  illustrates a perspective view of the mattress cushioning device with an outer cover; 
         FIG. 13  illustrates a cross-sectional view of a patient lying on a conventional mattress; 
         FIG. 14  illustrates a cross-sectional view of the patient being supported by the cushioning device of the present invention, wherein a low interface pressure is provided under the patient; 
         FIG. 15  illustrates a perspective view of a chair seat cushioning device; 
         FIG. 16  illustrates a plan view of another embodiment of a cushion device with alternating pressure support cells; 
         FIG. 17  illustrates a perspective view of a coiled spring resilient support; and 
         FIG. 18  illustrates a perspective view of a bellows resilient support. 
     
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     Although certain preferred embodiments of the present invention will be shown and described in detail, it should be understood that various changes and modifications may be made without departing from the scope of the appended claims. The scope of the present invention will in no way be limited to the number of constituting components, the materials thereof, the shapes thereof, the relative arrangement thereof, etc., and are disclosed simply as an example of the preferred embodiment. The features and advantages of the present invention are illustrated in detail in the accompanying drawings, wherein like reference numerals refer to like elements throughout the drawings. Although the drawings are intended to illustrate the present invention, the drawings are not necessarily drawn to scale. 
     Referring to  FIG. 1 , there is illustrated a perspective view of a cushioning device  10  in accordance with a preferred embodiment of the present invention. The cushioning device  10  can be used in combination with any support device where self-adjusting dynamic pressure support of a person or patient  56  ( FIG. 14 ) is required. For example, the support device may include a mattress, sofa, seat, etc. The cushioning device  10  includes a support system apparatus  12  comprising at least one support cell  14 , a sleeve apparatus  16  ( FIG. 5 ), a jacket  18  ( FIG. 5 ), and a topper cushion  20 . 
     The support system apparatus  12  includes at least one support cell  14  for providing lifting support for a patient  56 . An intake valve  40  and an exhaust valve  42  are included in each support cell  14 . As illustrated in  FIG. 1 , the cushion device  10  also includes two end walls  24 ,  26 , and two side walls  28 ,  30 . The end walls  24 ,  26 , and the side walls  28 ,  30  can be formed from a resilient material such as foam or rubber. The topper cushion  20  rests on top of the jacket  18  and provides further cushioning to a body. The topper cushion  20  can be composed of any resilient material, for example, foam, down feathers, an inflatable air cushion, etc. 
       FIG. 2  illustrates a partial cross-sectional view of the support cell  14 A including an envelope  34 A and a reforming element  32 A. The envelope  34 A contains a fluid  36 . The application of an external load on the envelope  34 A causes the envelope  34 A to deform into a compressed form. The reforming element  32 A provides a reforming force to the interior surface  38 A of the envelope  34 A. The reforming force causes the envelope  34 A to return to its original form when the external load is removed from the envelope  34 A. The reforming element  32 A is preferably a resilient foam material, however, other resilient means can be used such as a coiled spring  500  ( FIG. 17 ) or a bellows  520  ( FIG. 18 ). The coiled spring  500  is surrounded by a resilient material  502 . The bellows  520  may be formed from a pliable resilient material such as plastic and filled with a fluid such as air. 
     An example of a support system apparatus  12  for a mattress includes a plurality of support cells  14 A,  14 B,  14 C, and  14 D is illustrated in  FIGS. 1 and 3 . An example of interior cells,  14 A and  14 D, and end cells,  14 B and  14 C, are depicted in  FIGS. 1 and 3 . Intake valves  40 A,  40 B,  40 C,  40 D, and exhaust valves  42 A,  42 B,  42 C and  42 D are also illustrated in  FIG. 3 . Each intake valve  40  includes an intake check valve  48  allowing fluid  36  to flow into the support cell  14 , while preventing fluid  36  from flowing out of the support cell  14 . Each exhaust valve  42  includes an exhaust check valve  50  allowing fluid  36  to flow out of the support cell  14 , while preventing fluid  36  from flowing back into the support cell  14 . Each exhaust valve  42  is connected to an exhaust conduit via T-intersection  60 A,  60 B,  60 C, and  60 D in a manifold  60  included in an exhaust control system  46 . Each intake valve  40  is preferably connected to an intake conduit via T-intersection  58 A,  58 B,  58 C, and  58 D in a manifold  58  included in an intake control system  44 . 
     The intake control system  44  is connected to a fluid supply reservoir  52 . The exhaust control system  46  is connected to a fluid exhaust reservoir  54 . Generally, the fluid  36  included in the fluid supply reservoir  52  and the fluid exhaust reservoir  54  is air, however, any suitable fluid  36  (e.g. water or nitrogen) can be used. The fluid supply reservoir  52  and the fluid exhaust reservoir  54  may comprise the same reservoir, and may comprise an ambient source of fluid  36  such as atmospheric air. 
     As illustrated in  FIG. 14 , the weight of a body such as a patient  56  resting on the cushion device  10  deforms the envelope  34  in each support cell  14 . The pressure of the fluid  36  within each envelope  34  increases as the volume of the envelope  34  decreases under deformation. As the pressure of the fluid  36  increases, the fluid  36  in each envelope  34  flows out of the envelope  34  through a corresponding exhaust valve  42  and into the exhaust control system  46  ( FIGS. 1 and 3 ). Next, the fluid  36  flows from the exhaust control system  46  into the fluid exhaust reservoir  54 . Furthermore, as each envelope  34  deforms to conform to the irregular shape of the patient  56 , the area of the envelope  34  supporting the load increases. Equilibrium is achieved when the forces within the envelope  34 , including the pressure of the fluid.  54  within the envelope  34  multiplied by the area of the envelope  34  supporting the load, plus the force provided by the reforming element  32 , equal the weight of the load. 
     As illustrated in  FIG. 3  a controllable pressure relief valve  62  is included in the exhaust control system  46  and is attached to an end  64  of the exhaust conduit  60 . The outlet  66  of the controllable pressure relief valve  62  is attached to the fluid exhaust reservoir  54 . The controllable pressure relief valve  62  controls the maximum pressure level of the fluid  36  in the exhaust conduit  60  and in each envelope  34  in each support cell  14 . A rotatable knob  68  or other adjusting mechanism on the controllable pressure relief valve  62  allows a user to adjust the regulated maximum pressure level. Different selected maximum allowable pressures in the support cells  14 A,  14 B,  14 C, and  14 D allow the support system apparatus  12  to accommodate patients  56  of different weights. Also, the setting of different maximum allowable pressures in the support cells  14 A,  14 B,  14 C, and  14 D allows different degrees of conformation between the patient  56  and the surface of each envelope  34 . The maximum pressure is preferably set to ensure that the interface pressure under the entire contact surface of the patient  56  is below the pressure that may cause tissue damage. The cushioning device  10  of the present invention allows a user in the field to adjustably set the maximum pressure level in each support cell  14 . The maximum pressure is preferably above about 6 inches of water but is optimally in the range of about 8 to 12 inches of water. Other ranges may also be used, depending on operational requirements, user preferences, etc. 
       FIG. 13  illustrates the patient  56  resting on a conventional mattress  72 . High pressure regions on the patient  56  are indicated by the force arrows PA, PB, PC, PD, and PE.  FIG. 14  illustrates the patient  56  resting on a cushion device  10  of the present invention. As shown, the cushion device  10  provides a low uniform interface pressure PX that supports the entire contact surface of the patient  56 . This interface pressure is below the pressure that may cause tissue damage, thereby preventing the formation of pressure sores and other injuries. 
     As the weight of the patient  56  is removed from each support cell  14 , the reforming element  32  ( FIG. 2 ) in each envelope  34  exerts a reforming force on the interior surface  38  of each envelope  34 . As each envelope  34  expands, a partial vacuum is created in the interior space  70  of each envelope  34 . The vacuum draws the fluid  36  from the fluid supply reservoir  52  into the intake control system  44 . Next, the fluid  36  is drawn from the intake control system  44  through a corresponding intake valve  40  into the interior space  70  of each envelope  34 . When the fluid supply reservoir  52  and the fluid exhaust reservoir  54  comprise atmospheric air, inflation can be accomplished without the need for expensive blowers, pumps or microprocessors as required by previously available “treatment products.” The support system apparatus  12  of the present invention also has the ability to self-adjust every time a patient  56  moves, or is repositioned on, the support system apparatus  12 . When the pressure distribution applied to the support system apparatus  12  changes, the support cells  14  within the support system apparatus  12  automatically inflate or deflate to restore the low interface pressure PX under the entire patient ( FIG. 14 ). 
     Another embodiment of the present invention is illustrated in  FIG. 4  and provides for separately controlled support zones “A,” “B,” and “C” within a support system apparatus  80 . Each support zone “A,” “B,” and “C” includes at least one support cell  14 . Each support cell  14  includes at least one intake valve  40  and at least one exhaust valve  42 . As illustrated in  FIG. 4 , each intake valve  40 A- 40 H is connected to the intake control system  44 . The exhaust valves  42 A and  42 B in zone “C” are connected to an exhaust control system  82 . The exhaust valves  42 C,  42 D,  42 E and  42 F in zone “B” are connected to an exhaust control system  84 . The exhaust valves  42 G and  42 H in zone “A” are connected to an exhaust control system  86 . Each intake valve  40 A- 40 H allows fluid  36  to flow into each support cell  14 A- 14 H, respectively, while preventing fluid  36  from flowing back out of each support cell  14 A- 14 H, respectively. Each exhaust valve  42 A- 42 H allows fluid  36  to flow out of each support cell  14 A- 14 H, respectively, while preventing fluid  36  from flowing back into each support cell  14 A- 14 H, respectively. The intake control system  44  is connected to the fluid supply reservoir  52 . The exhaust control systems  82 ,  84 , and  86  are connected to the fluid exhaust reservoir  54 . Generally, the fluid  36  included in the fluid supply reservoir  52  and the fluid exhaust reservoir  54  is atmospheric air, however, other fluids  36  can be used. 
     Each exhaust control system  82 ,  84 , and  86  includes a pressure relief valve  88 ,  90 , and  92 , respectively, that maintains the pressure of the fluid  36  in zones “A,” “B,” and “C” below a selected level. A rotatable knob  68  or other adjusting system included in each pressure relief valve  88 ,  90 , and  92  allows a user to set the maximum pressure level of the fluid  36  in each zone “A,” “B,” and “C.” 
       FIG. 5  illustrates a cross-sectional view of the support system apparatus  80  and zones “A,” “B,” and “C” taken along line  5 — 5  of  FIG. 4 . When atomospheric air is supplied to the fluid supply reservoir  52 , there is no need for blowers or pumps to supply the pressurized fluid  36 . Each support cell  14 A- 14 H self-inflates when the weight of the patient  56  is removed as described above for the support system apparatus  12 . Each exhaust control system  82 ,  84  and  86  allows the maximum pressure level of the fluid  36  in each zone “A,” “B,” and “C” to be individually set.  FIG. 6  illustrates an example of different pressure levels set in zones “A,” “B,” and “C.” For example, if the support system apparatus  80  is included in a mattress in a bed (not shown), a different level of pressure or firmness can be provided for the upper, middle, and lower portions of the patient&#39;s body  56 . 
     As shown in  FIG. 5 , the sleeve apparatus  16  includes a cell cover  96  surrounding each support cell  14 . Each support cell  14 . Each cell cover  96 A,  96 B,  96 C,  96 D,  96 E,  96 F,  96 G, and  96 H, is attached to each adjacent cell cover  96  by connections  98 A,  98 B,  98 C,  98 D,  98 E,  98 F, and  98 G. For example, the connections  98 A- 98 G can be formed by a glued, heat sealed or sewn connection. Each cell cover  96  allows the exterior surface  100  of a corresponding envelope  34  to slide freely along an interior surface  102  of the cell cover  96 , without transmitting this movement to an exterior surface  104  of the cell cover  96 . For example as illustrated in  FIG. 5 , the support cell  14 A includes the envelope  34 A, which is surrounded by the cell cover  96 A. The exterior surface  100 A of the envelope  34 A is free to slide along the interior surface  102 A of the cell cover  96 A. This sliding movement is not transmitted to the stationary exterior surface  104 A of the cell cover  96 A. The stationary exterior surface  104 A is located on the side of the outer cover  22  ( FIG. 11 ) on which the patient  56  is lying, so that the sliding movement of the envelope  34 A is not transmitted to the patient. Therefore, the cell covers  96  of the sleeve apparatus  16  prevent frictional shear force abrasion damage to the skin of the patient  56 . 
     Another embodiment of a support system apparatus  106 , provides an additional alternating pressure system  130  for providing alternating supply pressure to a plurality of zones “E” and “F” as illustrated in  FIG. 7 . The alternating pressure system  130  can include any means for supplying the fluid  36  under pressure including a pump, compressor, etc. Also, included in the alternating pressure system  130  is any means such as a valve (not shown) for periodically switching the pressurized fluid  36  between conduit  132  and  134 . Each support zone “E” and “F,” comprises at least one support cell  14 . Each support cell  14  includes at least one intake valve  40  located directly on the fluid cell and at least one port  43  located directly on the fluid cell, such that the intake check valve is positioned adjacent to and is not in direct fluid communication with at least one port on the support cell. Each intake valve  40  includes a check valve (not shown) allowing fluid  36  to flow into the support cell  14 , while preventing fluid  36  from flowing out of the support cell  14 . Each port  43  allows unimpeded fluid  36  flow into or out of the support cell  14 . As illustrated in  FIG. 7 , each intake valve  40 J- 40 Q is connected to the intake control system  44 . Also shown in FIG. 7 ,each port is not in direct fluid communication with any other port on the same fluid cell. 
     The ports  43 Q,  430 ,  43 M, and  43 K in zone “B” are connected to a manifold system, including a conduit  108  having a plurality of lateral conduits extending therefrom and inlerconnecting the fluid cells. The ports  43 J,  43 L,  43 N, and  43 P in zone “F” are connected to a manifold system, including a conduit  110  having a plurality of lateral conduits extending therefrom and interconnecting the fluid cells. A first end  112  of conduit  108  is connected to a check valve  114 , and a second end  118  of conduit  108  is connected to a shut off valve  120 . A first end  122  of conduit  110  is connected to a check valve  124 , and a second end  126  of the conduit  110  is connected to a shut off valve  128 . Conduit  132  connects the shut off valve  120  with the alternating pressure system  130 . Conduit  134  connects the shut off valve  128  with the alternating pressure system  130 . Conduits  136  and  138  connect the check valve  114  and the check valve  124  with the exhaust control system  140 . 
     The shut off valve  120  can be a “quick disconnect” type that allows fluid  36  to flow through the shut off valve  120  when the conduit  132  is connected, and prevents any flow of the fluid  36  flow when the conduit  132  is disconnected. The shut off valve  128  can also be a “quick disconnect” type that allows fluid  36  to flow through the shut off valve  128  when the conduit  134  is connected, and prevents any flow of the fluid  36  when the conduit  134  is disconnected. Check valve  114  allows fluid  36  to flow from conduit  108  into conduit  136 , and prevents fluid  36  from flowing from conduits  136  and  138  into conduit  108 . Check valve  124  allows fluid  36  to flow from conduit  110  into conduit  138 , and prevents fluid  36  from flowing from conduits  138  and  136  into conduit  110 . The exhaust control system  140  includes a pressure relief valve  142  similar to the pressure relief valves described above. 
     When shut off valves  120  and  128  are closed, the pressure relief valve  142  maintains the pressure of the fluid  36  below a selected level in the conduits  108  and  110 . Each intake valve  40 J- 40 Q allows fluid  36  to flow into each support cell  14 J- 14 Q, respectively, while preventing fluid  36  from flowing out of each support cell  14 J- 14 Q, respectively, ( FIG. 7 ). Each intake valve  40 J- 40 Q is connected to the intake control system  44 , which is connected to the fluid supply reservoir  52 . Generally, the fluid  36  included in the fluid supply reservoir  52  is atmospheric air, however, any other suitable fluids can be used. Conduits  108  and  110  are connected through ports  43 J- 43 Q to the zones “ 13 ” and “F.” Therefore, the pressure relief valve  142  maintains the pressure of the fluid  36  below a selected level in zones “E” and “F.” A rotatable knob  144 , or pressure regulator, or other adjusting system included in the pressure relief valve  142  allows a user to set, or pre-set the maximum pressure of the fluid  36  in the zones “E” and “F,” such that the release pressure in all the fluid cells is set at arr identical level and the pressure of fluid in all the fluid cells self-adjusts to below an identical pre-selected level. The pressure relief valve  142  is connected to the fluid exhaust reservoir  54 . When non-powered, thus, using atmospheric air, and with the shut off valves  120  and  128  closed, the support system apparatus  106  is self-inflating and self-adjusting. 
     The alternating pressure system  130  supplies alternating high and low pressure fluid  36  to conduits  108  and  110 . When conduit  132  is connected to shut off valve  120 , and conduit  134  is connected to shut off valve  128 , the alternating pressure is supplied to conduits  108  and  110 . The conduits  108  and  110  supply the alternating fluid  36  pressure to zones “E” and “F.” 
     For example, a high pressure fluid  36  may be supplied to the conduit  108  from the alternating pressure system  130 , and a low pressure fluid  36  may be supplied to conduit  110 , creating a high fluid  36  pressure in zone “E” and a low fluid  36  pressure in zone “F.” The fluid  36  flows through check valve  114  to conduit  136  and  138 , but is prevented by check valve  124  from flowing into conduit  110 . The fluid  36  flow provided by the alternating pressure system  130  is much higher than the flow passing out through the pressure relief valve  142 , so that the high pressure fluid  36  fills the zone “E” support cells  14 K,  14 M,  14 O, and  14 Q as illustrated in  FIG. 8 .  FIG. 9  illustrates the pressure levels in the support cells in zones “E” and “F”. For this condition, the support cells  14  in zone “E” rise under the patient  56  and the support cells  14  in zone “F” lower under the patient  56 . 
     Next, a high fluid  36  pressure is supplied to conduit  110  and a low fluid  36  pressure is supplied to conduit  108 , forcing a high pressure fluid  36  into zone “F” and a low pressure fluid  36  into zone “E”. The fluid  36  flows through check valve  124  to conduit  138  and  136 , but is prevented by check valve  114  from flowing back into the conduit  108 . The fluid  36  flow provided by the alternating pressure system  130  is much higher than the flow passing out through the pressure relief valve  142 , so that the high pressure fluid  36  fills the zone “F” support cells  14 J,  14 L,  14 N, and  14 P.  FIG. 10  illustrates the pressure levels in the support cells  14  in zones “E” and “F.” For this condition, the zone “F” support cells  14  rise under the patient  56  and the zone “E” support cells  14  lower under the patient  56 . 
     The alternating rising and lowering of the support cells  14  in the zones “E” and “F” under the patient  56 , provides beneficial movement of the skeleton and tissue in the patient  56 . The movement helps stimulate circulation and lymph fluid movement in the patient  56 . 
     The alternating pressure system  130  includes a computerized control system  131  that is programmed to supply alternating pressures to a plurality of support cells  14  in any sequence that is desired by the user. 
     Another embodiment of a support system apparatus  180  with a plurality of support cells  14  is illustrated in  FIG. 16 . This embodiment shows another example of the shape of support cells  14 AA- 14 SS. The support cells  14  can be inter-connected in a manner similar to the support system apparatus  12  and the support system apparatus  106  to provide the support system apparatus  180  with self-inflating, self-adjusting, zoned pressure control, and alternating pressure support and movement to a person lying on the support system apparatus  180 . The computerized control system  131  included in the alternating pressure system  130  may be programmed to supply alternating pressures to the plurality of the support cells  14 AA- 14 SS in any sequence that is desired by the user. 
       FIG. 11  illustrates a cut-away perspective view of a mattress cushioning device  200 . The mattress cushioning device  200  includes a torso support system  220 , a heel support system  240 , and a sleeve apparatus  260 , the jacket  18 , the topper cushion  20 , and the outer cover  22 . The torso support system apparatus  220  includes a plurality of support cells  14 , the side wall  28 , the end wall  26 , and the side wall  30 . The side walls  28  and  30  and the end wall  26  are formed from a resilient material. The sleeve apparatus  260  includes cell covers  96 . Each cell cover  96  surrounds a support cell  14  to prevent sliding and frictional motion to be transmitted to the patient  56 . The support cells  14  provide self-inflating and self-adjusting pressure support to the torso region of a patient  56  resting on the support system apparatus  220 . The support cells  14  extend in a longitudinal direction of the mattress cushioning device  200 . Also, alternating pressure can be applied to the individual support cells  14  under the patient  56  to provide therapeutic movement to the body of the patient  56 . 
     The heel support system apparatus  240  includes a plurality of support cells  14 , the end wall  29 , a side wall  242 , and a side wall  244 . The heel support system  240  provides support for the heel area of a patient  56 . The support cells  14  extend in a transverse direction on the mattress cushioning device  200 . 
     The jacket  18  surrounds the torso support system apparatus  220  and the heel support system apparatus  240 . The topper cushion  20  lies on top of the jacket  18  and provides further cushioning and comfort to the patient  56 . The topper cushion  20  can be composed of any resilient material, for example, foam, down feathers, an inflatable air cushion, etc. 
     The outer cover  22  is illustrated in  FIGS. 11 and 12 . The outer cover  22  of the mattress cushioning device  200  provides a low friction and low shear surface further protecting the patient  56  from frictional tissue damage. Additionally, the outer cover  22  provides a waterproof and stain resistant surface. For medical uses the outer cover  22  can be made from an anti-microbial type material. The outer cover  22  includes end walls  202  and  204 , side walls  206  and  208 , a top wall  210  and a bottom wall  212 . A closure  214  joins an upper portion  216  to a lower portion  218  of the outer cover  22 . The closure  214  may comprise, for example, a zipper, snaps, hook and eye fasteners, etc. The side walls  206  and  208  can include stretchable panels  222  and  224  that allows the outer cover  22  to expand and contract as the support cells  14  rise and fall within the outer cover  22 . The displacement of the support cells  14  is accommodated by the stretchable panels  222  and  224  so that stretching of the top wall  210  is prevented. Thus, the top wall does not transmit shear forces to the patient  56  resting on the top wall  210 . Flexible handles  226  can be attached to the outer cover  22  to allow a user to grasp and move the mattress cushioning device  200 . 
     An embodiment of a seat cushioning device  260  in accordance with the present invention is illustrated in  FIG. 15 . The seat cushioning device  260  includes three supporting sections  262 ,  264 , and  266 . Each section  262 ,  264 , and  266  includes at least one support cell  14 . The support cells  14  can be inter-connected in a manner similar to the support system apparatus  12 , the support system apparatus  180 , and the support system apparatus  106  to provide the seat cushioning device  260  with self-inflating, self-adjusting, zoned pressure control, and alternating pressure support and movement to a person sitting on the seat cushioning device  260 . For example, the supporting sections  262 ,  264 , and  266  may each include an intake valve  263  and an exhaust valve  265 . The exhaust valves  265  are interconnected by an exhaust control system  267  having a controllable pressure relief valve  269 . As in previous embodiments of the present invention, the pressure relief valve  269  is provided to control the maximum pressure level of the fluid in each of the supporting sections  262 ,  264 , and  266 . 
     The foregoing description of the present invention has been presented for purposes of illustration and description. It is not intended to be exhaustive or to limit the invention to the precise form disclosed, and many modifications and variations are possible in light of the above teaching. For example, the cushioning device of the present invention is suitable for providing self-inflating, self-adjusting, zoned pressure control, and alternating pressure support to any supported body. Also, the cushioning device of the present invention is suitable for any application where low interface pressure is required between the cushioning device and the surface of the body being supported. Such modifications and variations that may be apparent to a person skilled in the art are intended to be included within the scope of this invention as defined by the accompanying claims.