Patent Publication Number: US-5891065-A

Title: Mobile extremity pumping apparatus

Description:
BACKGROUND OF THE INVENTION 
     The present invention relates to medical devices for reducing edema and increasing circulation in the extremities of people suffering from spinal cord injuries or otherwise confined to ambulatory devices such as wheelchairs. People suffering from injuries such as spinal cord injuries which confine the person to wheelchairs may suffer from edema. Edema is caused by the flow of plasma fluid out of the cardiovascular system through capillary walls in the blood vessels and into the tissue surrounding the blood vessels. Some of the plasma fluid is reabsorbed into the cardiovascular system through an elaborate system of collecting vessels, called the lymphatic system. The plasma fluid which enters the tissue and is reabsorbed into the cardiovascular system is referred to as lymph. The blood and plasma fluid in the cardiovascular system is circulated through the extremities by the pumping action of muscles in a person&#39;s extremities. Proper functioning of the lymphatic system and the muscle pump system ensures that excess lymph will not accumulate in the lower extremities and assures proper blood circulation. 
     An accumulation of excessive lymph leads to edema with side effects of pain, fibrotic tissue changes, dermal ulceration, infection and possibly a loss of a limb. When trauma or paralysis prevents a person from exercising the legs, the natural pumping action of the calf muscles is lost and the result can be lymphedema and tissue fibrosis. 
     People who suffer from spinal cord injuries or are recovering from surgeries are more likely to be sedentary and suffer from lymphedema. Lymphedema can also lead to more serious effects such as venous stasis with secondary deep venous thrombosis (DVT) in turn DVT may lead to life threatening pulmonary embolism. 
     Typically edema may be relieved by raising the lower extremities above the waste level. This elevation of the extremities allows the edema to subside naturally, however, the person must remain in that position for a period of time. Edema is ideally treated upon occurrence. Delayed treatment can cause discomfort, can lead to more lengthy treatment and can lead to further complications. In order to allow people confined to a wheelchair to spend extended periods in the sitting position, a wheelchair having a system for the detection of edema and manipulation of the extremities to reduce excessive lymph in the tissues is needed. Any compression system on the extremities should not be unsightly. 
     The present invention is designed to provide detection and treatment of edema for persons restricted to a vehicle such as a wheelchair for long periods of time without requiring the person being returned to a predetermined location for treatment of the edema. 
     SUMMARY OF THE INVENTION 
     The present invention is a vehicle having a mobile extremity pumping apparatus mounted thereon. The mobile extremity pumping apparatus comprises a control module, a driver module and one or more compression units. An outer shell may be used to surround the compression unit and a soft fabric inner layer may be placed between the compression unit and the person&#39;s extremity. The outer shell may utilize different fabrics which match the user&#39;s apparel. A two-layer bladder assembly is positioned between the inner layer and the outer shell comprising precompression and compression bladder layers. The precompression bladder layer extends longitudinally along the person&#39;s extremity with the individual bladders each wrapping around and arranged sequentially along the extremity. The precompression bladder layer is surrounded by a compression bladder layer mounted between the precompression bladder layer and the outer shell. The individual bladders in each bladder layer have overlapping edges to assure a uniform pressure is placed on the extremity. The bladders in the precompression bladder layer are each connected to a pressure sensor in the driver module. Each bladder in the precompression bladder layer is further connected to a valve in the driver module for controlling the flow of a compression media into each respective bladder. Each bladder in the compression bladder layer is similarly connected to a valve in the driver module and a pressure sensor in the driver module. A pump in the driver module compresses the media, which may be water, air, or similar media, and directs the compressed media to a manifold for distribution to each valve in the driver module. A control processor unit in the control module is connected to each valve in the driver module and further connected to each pressure sensor in the driver module to monitor the pressure in each bladder in the two-bladder layer assembly. The control processor also controls the flow of media into each bladder for maintaining a preset pressure in the precompression bladder layer and monitors pressure changes in the precompression bladder layer caused by the expansion of the extremity due to the onset of edema. The control processor unit may sequentially control each individual bladder in the compression bladder layer to provide a compression wave effect along the extremity of the person to urge the flow of fluids from the distal end of the extremity to the proximal end of the extremity. 
     An advantage of the present invention is that it allows extended sitting in the wheelchair. 
     A further object of the present invention is a mobile extremity pumping apparatus which may be moved from a wheelchair to an automobile or other ambulatory means for the person. 
     Yet another object of the present invention is a mobile extremity pumping apparatus which may be easily disassembled and reassembled for cleaning or maintenance. 
     A feature of the present invention is an edema sensing and treatment apparatus mounted on a wheelchair. 
     Another feature of the present invention is a plurality of sequentially positioned and supported overlapping bladders surrounding an extremity of the person for treatment of edema. 
     Another feature of the present invention is a fabric-like outer shell which may be removed, cleaned and interchanged with other shells to provide an aesthetically pleasing appearance. 
     Another feature of the present invention is quick disconnects on the individual bladders in the edema treatment apparatus for quick disassembly. 
     Another feature of the present invention is a mid-foot bladder in the bladder assembly for comfortably fitting around a foot on a person&#39;s leg. 
     Another feature of the present invention is a heel bladder in the edema treatment system for comfortably fitting the heel of a person&#39;s foot. 
     Another feature of the present invention is a toe and leg bladder for comfortably fitting the toe portion and the leg of a person. 
     Another feature of the present invention is the power supply may be a battery on the wheelchair or a cigarette lighter plug for using the electrical system in an automobile. 
     Another feature of the present invention is the overlapping edges of adjacent bladders in each layer to guarantee compression of the covered portion of the leg or extremity. 
     Another feature of the present invention is the bladders are supported in the overlapping configuration to continuously engage the extremity along the length of the pumping apparatus and to provide a smooth compressive wave along the extremity. 
     Another feature of the present invention is the system may utilize liquids or air as a compression media. 
     Another feature of the present invention is the profile of the housing is minimized by placing the valves and the pressure sensors in the driver module. 
     Another feature of the present invention is alarm signals may be generated to indicate the apparatus has detected the onset of edema or compression of the bladders may be automatically commenced upon the sensing of edema. 
     Another feature of the present invention is the control module may control the individual pressurization of each bladder in the compression unit to provide sequential compression of the extremity from the distal end to the proximal end. 
     Another feature of the present invention is the control module may be programmed to provide gradient sequential compression of the extremity. 
     An advantage of the present system is the bladder assemblies may be easily removed and replaced from the housing. 
     Another advantage of the present invention is that components in the mobile extremity pumping apparatus are easily cleanable. 
     Another advantage of the present invention is the outer shell may be replaced by other fabric-type materials to match clothes worn by the person. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     FIG. 1 is a perspective view of a person in a wheelchair having the mobile extremity pumping apparatus mounted thereon. 
     FIG. 2 is a detail section view taken at approximately 2--2 of the compression unit illustrated in FIG. 1. 
     FIG. 2A is a detail section view taken at approximately 2--2 of FIG. 1 of an alternative embodiment of the compression unit. 
     FIG. 2B is a detail section view taken at approximately 2--2 of FIG. 1 of an alternative embodiment of the compression unit. 
     FIG. 3 is a perspective view of the driver module. 
     FIG. 4 is a perspective view of the control module. 
     FIG. 5 is a perspective view of the mobile extremity pumping apparatus mounted on a wheelchair. 
     FIG. 6 is a perspective view of the mobile extremity pumping apparatus being used in an automobile. 
     FIG. 7 is a detail view illustrating the quick disconnect nipples. 
     FIG. 8 is a side elevation view illustrating the compression bladder layer attached to the shell of the housing. 
     FIG. 9 is a schematic view of the control module. 
     FIG. 10 is an elevational view of the compression unit illustrated in FIG. 2A. 
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     The present invention comprises a device 11 for supporting a person 22 and detecting and treating edema in the person&#39;s extremity 24 comprising a mobile extremity pumping apparatus 10 on a vehicle 12 on wheels 161. The mobile extremity pumping apparatus 10 may be mounted on a wheelchair 14 and comprise a pumping portion 15 connected to a control portion 18 and a driver portion 20. 
     Referring to FIG. 1, the person 22 is seated on a seat 23 on the wheelchair 14. The person 22 has an extremity 24 which is engaged by the pumping portion 15. Tubes 26 connect the pumping portion 15 to the control portion 18 and the driver portion 20. A quick disconnect connector 28 is used to connect the tubes 26 to the driver portion 20 for easy disassembly of the mobile extremity pumping apparatus 10. As shown in FIG. 1, the pumping portion 15 may be configured as a leg module 16. The pumping portion 15 may have a housing 32 having a removable shell 34 made of a non-stretch material such as nylon fabric or the like. A compression unit 30 (FIG. 2) is contained to bear against the extremity 24 of the person 22. The compression unit 30 extends sequentially along the extremity 24 as illustrated in FIG. 1 from the person&#39;s toe portion 38 to a position below the knee 40. The compression unit 30 is flexible to wrap around and engage the extremity 24 to allow each bladder 51 to wrap around the extremity 24. The compression unit 30 positions the bladders 51 to sequentially extend along the extremity 24. An edema sensor portion 42 may be a separate device (FIG. 2A) engaging the extremity 24 and located on the housing 32. The edema sensing portion 42 may be in communication with the control portion 18 for sensing the onset of edema in the extremity 24. 
     Referring to FIG. 2, a cross-section of the leg module 16 is illustrated showing the compression unit 30 having a pair of inflatable bladder subassemblies 50, each made of a plurality of separately sealed and inflatable bladders 51. The compression unit 30 is flexible and configured to wrap around and engage the extremity 24 to sequentially position each bladder 51 along the extremity 24. The compression unit 30 wraps each bladder 51 lengthwise around the extremity 24 and supports the bladders 51 in an overlapping configuration along the extremity 24. Two bladder subassemblies 50 form a two-bladder layer assembly 52. Each bladder 51 has at least one side portion 54 forming an overlapping edge 56 with an adjacent bladder 51. The overlapping edges 56 may be bonded together to support the overlapping configuration. The two-bladder layer assembly 52 comprises a precompression bladder layer 58 arranged longitudinally and supported along and proximate to the extremity 24 and a compression bladder layer 60 arranged longitudinally and supported between the precompression bladder layer 58 and the shell 34. The two bladder layer subassembly 52 may extend from a distal portion 61 of the extremity 24. 
     Referring to FIG. 2A, the two bladder layer assembly 52 may be longitudinally arranged and supported along the extremity 24 by overlapping compartments 66 having walls 53 extending from the inner layer 44 to the shell 34. The walls 53 are formed in a non-perpendicular angle to the extremity 24 to form the compartments 66 in an overlapping configuration. The bladders 51 are individually inserted into the overlapping compartments 66 to form the two bladder layer assembly 52 comprising a precompression bladder layer 58 proximate to the extremity 24 and a compression bladder layer 60 between the precompression bladder layer 58 and the shell 34. In the configuration shown on FIG. 2A, the bladders 51 have side portions 54 and overlapping edges 56 positioned with respect to adjacent bladders and supported in place by the overlapping compartments 66. A pressure sensor 68 may be connected to one or more of the bladders 51 in the precompression bladder layer 58. Push buttons 70 may be mounted on the housing 32 to allow the person 22 to control the mobile extremity pumping apparatus. 
     Referring to FIGS. 2 and 2A, the precompression bladder layer 58 comprises a precompression toe bladder 62 proximate the distal portion 61 of the extremity 24. The precompression toe bladder 62 engages the extremity proximate to the toe portion 38. The precompression mid-foot bladder 64 is positioned adjacent the precompression toe bladder 62 and longitudinally positioned along the extremity 24 from the precompression toe bladder 62. The precompression heel bladder 65 is longitudinally positioned along the extremity 24 adjacent the precompression mid-foot bladder 64. 
     A first precompression leg bladder 72 is longitudinally positioned along the extremity 24 adjacent the precompression heel bladder 65. A second precompression leg bladder 74 is positioned longitudinally on the extremity 24 adjacent the first precompression leg bladder 72. Additional bladders 51 may be positioned along the extremity 24 such as third precompression leg bladder 76 positioned proximate to the second precompression leg bladder 74. The precompression bladder layer 58 extends to a proximal portion 77 of the extremity 24. 
     Continuing to refer to FIGS. 2 and 2A, the compression bladder layer 60 comprises a compression toe bladder 78 supported in place between the precompression toe bladder 62 and the shell 34. The compression mid-foot bladder 80 is likewise positioned between the shell 34 and the precompression mid-foot bladder 64. The compression heel bladder 82 is positioned and supported in place between the shell 34 and the precompression heel bladder 65. The compression bladder layer 60 also comprises a first, second, and third compression leg bladders 84, 86, 88 respectively, mounted sequentially along the extremity 24 and supported between the shell 34 and the first, second, and third precompression leg bladders 72, 74, 76, respectively. 
     Continuing to refer to FIG. 2, the bladders 51 are connected to the driver portion 20 by tubes 26 connected to a nipple 90 on each bladder 51. The nipples 90 may have a quick disconnect connector 92 on the outside of each bladder 51. Each bladder 51 is made of a substantially inelastic sheet material 94 (FIG. 7) such as a twelve (12) gauge frosty clear. The nipple 90 extends through the sheet material 94 to provide fluid communication between the driver portion 20 and the interior of each bladder 51. 
     Continuing to refer to FIG. 2, the tubes 26 connecting each bladder 51 in the two-bladder layer assembly 52 to the driver portion 20 comprise a first precompression tube 98 connected to the precompression toe bladder 62, a second precompression tube 100 connected to the precompression mid-foot bladder 64 and a third precompression tube 102 connected to the precompression heel bladder 65. A fourth, fifth, and sixth precompression tubes 104, 106, 108 respectively, connect to the first, second, and third precompression leg bladders 72, 74, 76 respectively. 
     Continuing to refer to FIG. 2, a first compression tube 110 connects the compression toe bladder 78 to the driver portion 20. Likewise, the second compression tube 112 connects to the compression mid-foot bladders 80 and the third compression tube 114 connects to the compression heel bladder 82. Similarly, a fourth, fifth, and sixth compression tubes 116, 118, 120 connect to the first, second, and third compression leg bladders 84, 86, 88 respectively. The tubes 26 may be fabricated from plastic tubing such as the TYGON® brand, manufactured by Norton Performance Plastics Corporation, P.O. Box 3660, Akron, Ohio 44309-3660. Each tube 26 connects between the quick disconnect connector 92 on each individual nipple 90 and the quick disconnect connector 28 on the driver portion 20. 
     Referring to FIG. 2B, the compression unit 30 is illustrated as a single layer comprising a bladder subassembly 50. As illustrated in FIG. 2B, the bladders 51 in the bladder subassembly 50 may have side portions 54 which are not overlapping with a side portion 54 of an adjacent bladder 51. 
     Referring to FIG. 3, a detail of the driver portion 20 is illustrated comprising a pump 130 connected to a plurality of valves 132 by a supply manifold 134. The pump 130 is suitable for pumping a compression media such as air or water to the bladders 51 as described below. The valves 132 are electrically activated by a signal from the control portion 18. The valves 132 may be a three-way valve 132 for filling, holding and draining the compression media to and from the bladders 51 such as Model No. D311 from SIRAI Elettromeccanica at Strada Per Cernusco, 19-20060 Bussero-Milano, Italy. The valves 132 may comprise an individual valve 132 a-f in fluid communication with first precompression tube 98, second precompression tube 100, third precompression tube 102, fourth precompression tube 104, fifth precompression tube 106, and sixth precompression tube 108 respectively to control the flow of the compression media to each bladder 51 in the precompression bladder layer 58. described above. Likewise, the valves 132 may further comprise valves 133 a-e in communication with each bladder 51 in the compression bladder layer 60 by first compression tube 100, second compression tube 112, third compression tube 114, fourth compression tube 116, fifth compression tube 118, and sixth compression tube 120 respectively. It should be understood, the valves 132 may have a one to one configuration with the bladders in the two-bladder layer assembly 52 or the bladders 51 may be interconnected into a group of bladders 51 connected to a single valve 132 depending the preference of an individual. 
     Pressure sensors 138 are mounted in communication with one or more bladders 51 in the two-bladder layer assembly 52 to monitor the pressure of the compression media in the connected bladder 51. A pressure sensor 138 may be mounted in fluid communication with each valve 132 to monitor the pressure in each individual or interconnected group of bladders 51. The pressure sensors 138 are connected by input electrical cables 140 to the control portion 18 and are configured to send a signal to the control portion 18 proportional to the sensed pressure. Each valve 132 and the pump 130 are connected to the control portion by output electrical cables 142. 
     Referring to FIG. 4, the control portion 18 is illustrated as a separate control module 147 having an enclosure 148 and a control processor unit 150. The control processor unit 150 comprises precompression outputs 152 connected to output electrical cables 142. Each individual precompression output 152 is connected to a single valve 132 between the pump 130 and the precompression bladder layer 58. A plurality of compression outputs 154 are on the control processor unit 150 and individually electrically connected to each valve 132 in communication with a bladder 51 in the compression bladder layer 60. It should be understood, the precompression outputs 152 and the compression outputs 154 each have an individual connection through the output electrical cable 142 to their respective valve 132. The control processor unit 150 also comprises a plurality of pressure sensor inputs 156 individually electrically connected to the pressure sensors 138 for monitoring the pressures in the two-bladder layer assembly 52. The push buttons 70 are electrically connected to the push button inputs 158 by input electrical cables 140. A power supply 164 supplies power to the control processor unit 150 to control actuation of each individual valve 132 and power for the pressure sensors 138 for generating a signal proportional to the pressure detected in a respective connected bladder 51. 
     Referring to FIG. 5, the mobile extremity pumping apparatus 10 is shown comprising a support structure 160 on the wheelchair 14 having a plurality of wheels 161 rotatably mounted thereon. The wheels 161 engage and roll along the ground to allow the wheelchair 14 to support and move the person 22. The control portion 18 and driver portion 20 are contained in a rack 162 mounted to the support structure 160 of the wheelchair 14. A reservoir 163 may be attached to the support structure 160 if the compression media is a fluid such as water. The power supply 164 may comprise a battery 164.1 mounted in the rack 162. The power supply 164 may further comprise a solar panel 165 connected to the battery 164.1 for recharging the battery 164.1. 
     Referring to FIG. 6, the mobile extremity pumping apparatus 10 may comprise a vehicle 12 such as an automobile having a car seat 166 supporting the control portion 18 and the driver portion 20. In this embodiment, the power supply 164 is configured to have a cigarette lighter connection 168 for connecting to the electrical system of the automobile. The person 22 may ride in or operate the automobile having a compression unit 30 removably mounted on one or more extremity 24. 
     Referring to FIG. 7, the nipple 90 is illustrated having quick disconnect connector 92 extending into a bladder 51. The quick disconnect connector 92 may comprise a ridge 170 on the nipple 90 and a press-on connector 172 on the tube 26 illustrated connected to a bladder 51 in the precompression bladder layer 58. The quick disconnect connector 92 may alternatively comprise other configurations and apparatus well known in the art of quick disconnect fluid communication connectors such as quarter-turn connectors. 
     Referring to FIG. 8, a bladder subassembly 50 is illustrated attached to the shell 34 on the housing 32. The compression bladder layer 60 is illustrated to show an overlapping configuration having bonded side portions 54 with overlapping edges 56 forming the overlapping configuration between bladders 51. The overlap portion 178 comprises a bond 180 of an adhesive or a heat formed bond for attaching the side portions 54 of adjacent bladders 51 together. Support straps 182 may be used to support the bladder subassembly 50 in place. A second bladder subassembly 50 may be placed on top of the bladder subassembly 50 illustrated, to form a two-bladder layer subassembly 52 (FIG. 2). A releasable wrapping strap 183 may be positioned at several locations along the shell 34 for releasably wrapping the shell 34 about the extremity 24. The releasable wrapping strap 183 and the support straps 182 further comprise a releasable fastener 184 such as a hook material 184a and a complimentary loop material 184b for releasably fastening. It should be understood, the fastener 184 may be alternative releasable fasteners such as snaps, hooks, buttons, or other releasable fasteners known in the art of fastening. 
     Referring to FIG. 9, a schematic layout of the control portion 18 is illustrated showing the connections between the control processor unit 150 and the valves 132, the pressure sensors 138, the pump 130, and the control push buttons 70. The control processor unit 150 comprises a memory portion 188 connected to a circuitry portion 190 which is connected to and controlling an output portion 185 and an input portion 186. The circuitry 190 is configured to monitor the inputs coming into the input portion 186 from the control push buttons 70 and the pressure sensors 138 and control the pump 130 and valves 132 by output portion 186 to direct the compression media from the pump 130 to the valves 132 and into each the bladders 51 in the two-bladder layer assembly 52. The circuitry and components of the control processor unit are conventional such as was disclosed in U.S. Pat. No. 5,437,610 which is incorporated herein by reference. 
     Referring to FIG. 10, the housing 32 of the configuration illustrated in FIG. 2A is shown having a plurality of overlapping compartments 66. The tubing 26 extends from the housing 32 for connection to the driver portion 20. The releasable wrapping strap 183 is illustrated as a flap extending along the edge of the housing 32. The fastener 184 on the wrapping strap 183 for releasably wrapping the housing 32 around the extremity 24 is illustrated further comprising a zipper 184.1 between the housing 32 and the fastener 184 for easy tightening or loosening of the housing 32 by a small amount. The overlapping compartments 66 are illustrated as a toe compartment 192, a mid-foot compartment 193, a heel compartment 194, and a first, second, and third leg compartment 195, 196, 197 respectively. Each compartment is separated from adjacent compartments by a wall 53 formed at a non-perpendicular angle to the shell 34 to hold the bladders in an overlapping configuration. 
     Referring to FIGS. 1, 2, 3 and 4 in operation, the compression unit 31 is releasably wrapped about the extremity 24. The tubing 26 is used to connect the driver portion 20 to each bladder 51 in the pumping portion 15. The edema sensor portion 42 is configured to detect a swelling of the extremity 24 indicating the onset of edema. The edema sensor portion 42 may comprise a separate device or alternately comprise one or more pressure sensors connected to the precompression bladder layer and the circuitry 190 in the control processor unit 150 configured to detect swelling in the extremity indicating the onset of edema by monitoring the pressure sensors 138 in communication with the precompression bladder layer 58. The zipper 154.1 (FIG. 10) may be opened allowing the housing 32 to be wrapped about the extremity 24 and releasably attached with the fastener 184. The zipper 184.1 may be zipped to a closed position to snugly fit the housing 32 about the extremity 34. 
     Continuing to refer to FIGS. 1, 2, 3 and 4, the power supply 164 is connected to the control portion 18. The mobile extremity pumping apparatus 10 may be automatically activated or manually activated by the person 22 engaging a button 70 to initiate control of the pumping portion 15. The circuitry 190 and the control processor unit 150 is configured to energize the pump 130 causing the compression media to be pumped from the pump 130 through the supply manifold 134 to the valves 132. The circuitry 190 in the control processor unit 150 is further configured to control the valves 132 a-e connected to the bladders 51 in the precompression unit 58 to fill each bladder 51 in the precompression bladder layer 58 to a predetermined pressure level for compressing the extremity 24. When the bladders 51 and the precompression bladder layer 58 have reached a specified pressure as measured by the pressure sensors 138, each valve 132 is closed to sustain the pressure in the precompression bladder layer 58. 
     Continuing to refer to FIGS. 1, 2, 3 and 4, the pressure sensors 138 and the means for sensing edema comprising the edema sensor portion 42 are monitored by the control portion 18 to detect an increase in pressure in the extremity 24 indicating the existence of edema. Edema causes an increase in diameter in the extremity 24 thus compressing outward the surrounding bladders 51 in the precompression bladder layer 58 causing an increase in the pressure level in one or more of the bladders 51. Upon sensing of a specified increase in pressure, a pressurization sequence is commenced. The control processor unit 150 operates to sequentially open the valves 132 connected to the compression bladder layer 60 to direct the compression media from the pump 130 to each bladder 51 in the compression bladder layer 60. The bladders 51 in the compression bladder layer 60 are inflated and expand to compress the extremity 24 by bearing against the precompression bladder layer 58 and directing the pressure of the inflatable bladders 51 inwardly onto the portion of the extremity 24 adjacent each individual bladder 51. 
     Continuing to refer to FIGS. 1, 2, 3 and 4, the control processor unit 150 begins with the valve 132 connected to the bladder 51 in the compression bladder layer 60 proximate to the most distal portion 61 of the extremity 24, specifically as illustrated herein, the valve 133a connected to the compression toe bladder 78. The valve 133a remains open until the pump 130 has pumped a compression media into the compression toe bladder 78 to create a predetermined pressure on the toe portion 38 as measured by a pressure sensor 138 in communication with the first compression tube 110. The valve 133a is then closed to hold the pressure in the compression toe bladder 78. The circuitry 190 in the control processor unit 150 then sequentially controls the valve 133b connected to the compression mid-foot bladder 80 to likewise fill the bladder to a predetermined compressive pressure as measured by the pressure sensor 138 in communication with the second compression tube 112. 
     Continuing to refer to FIGS. 1, 2, 3 and 4, the control processor unit 150 follows this procedure sequentially for the compression heel bladder 82, the first compression leg bladder 84, the second compression leg bladder 86, and the third compression leg bladder 88 positioned proximate to the most proximal portion 77 of the extremity 24. This sequential compressing of bladders 51 from the most distal toe bladder 78 to the most proximal leg bladder 88 in the compression bladder layer 60 creates a compressive wave that sequentially compresses the extremity 24 from the most distal portion 61 to the most proximal portion 77. After a specified delay, the circuitry 190 in the control processor unit 150 may stop the pump 130 and command the valves 132 connected to preselected bladders 51 in the compression bladder layer 60 to release the pressure in the bladders 51 in the compression bladder layer 60. The pressure may be released in a preselected sequence of bladders 51 by activating the valves 132 to drain the compression media from the bladder 51. After a second specified delay, the sequence may be repeated to form another sequential, compressive wave along the extremity 24. 
     Referring to FIGS. 2 and 4, after each sequential, compressive wave, the pressure sensors 138 may indicate an increase or reduction in the edema. The pressure sensors 138 monitor the edema intermediate each compression sequence. As should be understood, if the precompression bladder layer 58 is compressed at a specified precompression level, the pressure in the individual bladders 51 in the precompression bladder layer 58 should return to the specified precompression level after the pressure in the compression bladder layer 60 is released. If the pressure in the precompression bladder layer 58 is elevated after release of the pressure in the compression bladder layer 60, swelling of the extremity 24 is detected and the sequential compression wave may be repeated by the control processor unit 150. The overlapping edges 56 of the adjacent bladders 51 provide continuous pressure against the extremity 24 by the precompression bladder layer 58 and minimize gaps between individual bladders 51. 
     Referring to FIGS. 2 and 4, the control processor unit 150 may be programmed to provide a pressure gradient on the extremity 24 where each bladder 51 in the precompression bladder layer 58 has a pressure slightly different than an adjacent bladder 51. Preferably, the bladders 51 closer to the distal portion 61 of the extremity 24 will have a greater pressure than an adjacent, more proximal bladder 51. This gradient can be provided during the compression sequence and/or during the period the compression sequence is not occurring. 
     Referring to FIGS. 2 and 9, the memory portion 188 of the control processor unit may accept programming to offer extreme flexibility and detection of desired pressure increases for detecting edema and in pressurizing the bladders 51 to specified pressure profiles along the extremity 24. Additionally, flexibility provided in the timing of the compression sequences allowing predetermined delays to be specified for each step in the sequence of the precompression of the extremity 24 and the generation of a sequential compressive wave. The compression unit 30 may be adapted for attachment and compression of upper extremities as 24.1 well as a lower extremity 24.3. Furthermore, the housing 32 may be adapted to engage an extremity 24 having a distal portion 61 extending from the housing 32. The outer shell 34 may be used to restrict the outward expansion of the compression unit 30 or may alternatively be decorative to cover the compression unit 30. 
     Referring to FIGS. 2B and 3, the invention may also be practiced with a one-bladder layer assembly 50 having overlapping edges 56 with an initial pressurization sequence to mold the bladder layer assembly 50 about the extremities 24 and a second sequential pressurization sequence wherein each bladder 51 of the bladder assembly 50 is further pressurized in a selected sequence, preferably from the most distal portion 61 to the most proximal portion 77 to form a sequential compressive wave on the extremity 24. Pressure sensors 138 may be connected to each bladder 51 in such a configuration. 
     Furthermore, the individual bladders 51 in the precompression bladder layer 58 may be connected together and controlled by a single valve 132 for creating a uniform precompression pressure on the extremity 24. The single pressure sensor 138 connected to the precompression bladder layer 58 could be used in this configuration for detecting a swelling of the extremity 24 indicating edema. Furthermore, as illustrated in FIG. 4, an alarm 200 may be connected to the control processor unit 150 for audio indication of status in the control processor unit. For example, the alarm 200 may indicate a signal when edema is detected, an alternate signal indicating the compression sequence, and further alarm signals as desired by an individual. 
     The present invention may be embodied in other specific forms without departing from the spirit or essential attributes thereof, and it is therefore desired that the present embodiment be considered in all respects as illustrative and not restrictive, reference being made to the appended claims rather than to the foregoing description to indicate the scope of the invention.