Patent Publication Number: US-9839568-B2

Title: Swing walker

Description:
RELATED APPLICATION DATA 
     This application is a continuation of U.S. patent application Ser. No. 13/800,767, now allowed, filed Mar. 13, 2013; which claims priority to U.S. application Ser. No. 61/707,304, filed on Sep. 28, 2012, the entireties of which are incorporated herein by reference. 
    
    
     FIELD OF THE INVENTION 
     This invention relates to the field of swing or suspension walkers and more particularly to a device and method that decreases the impact forces to which a patient&#39;s foot is subjected if walking in a cast or boot after surgery or other injury. 
     BACKGROUND OF THE INVENTION 
     Walking and running can be defined as methods of locomotion involving the use of the two legs, alternatively, to provide both support and propulsion, with at least one foot being in contact with the ground at all times. While the terms gait and walking are often used interchangeably, the word gait refers to the manner or style of walking, rather than the actual walking process. The gait cycle is the time interval between the exact same repetitive events of walking. 
     The defined cycle can start at any moment, but it typically begins when one foot contacts the ground and ends when that foot contacts the ground again. If it starts with the right foot contacting the ground, then the cycle ends when the right foot makes contact again. Thus, each cycle begins at initial contact with a stance phase and proceeds through a swing phase until the cycle ends with the limb&#39;s next initial contact. Stance phase accounts for approximately 60 percent, and swing phase for approximately 40 percent, of a single gait cycle. 
     However following injury or surgery to the foot, a patient may be fitted with a walker to assist in locomotion. Various devices that allow a patient to continue the normal gait cycle are known, for example casts, braces, cuffs, splints, soft boots, hard boots and the like, which are designed to protect and stabilize the foot following injury or surgery. However, most of these devices are constructed such that the patient&#39;s foot is still subjected to all the impact force when it hits the ground. Hard surfaces in modern human environments have changed the forces encountered by the human musculoskeletal system during the gait cycle as compared to the forces which it evolved to sustain. Impact energies from such surfaces enter the body through boney and dense tissues and through soft and fatty tissues. When a patient is trying to recover from injury or surgery, such impact energy frequently exacerbates the injury. 
     Other causes of injury to the foot relate to underlying pathological disease states, such as by way of example, diabetes. Diabetes is a chronic disease that affects up to six percent of the population in the U.S. and is associated with progressive disease of the microvasculature. Complications from diabetes include not only heart disease, stroke, high blood pressure, diabetic retinopathy but also in particular diabetic neuropathic foot disease. 
     Diabetic neuropathic foot disease typically results in the formation of ulcers which commonly result from a break in the barrier between the dermis of the skin and the subcutaneous fat that cushions the foot during ambulation. This rupture may lead to increase pressure on the dermis. In order for the ulcer to heal, the patient must either stay off their feet altogether or use a pressure relieving orthotic or brace. 
     While there are devices and methods that purport to prevent planar ulcer formation in a diabetic patient there are no devices on the market that treat the ulcer with dynamic offloading of the weight bearing limb. 
     Therefore, what is needed is a system and method that can be used to mitigate excessive impact forces on an injured foot during locomotion or off-load an injured, weight bearing limb during locomotion while allowing a patient to maintain normal gait function. 
     BRIEF SUMMARY OF THE INVENTION 
     The aforementioned problems are addressed by the weighted and unweighted systems and method in accordance with the invention. In one aspect of the present invention, the system broadly includes a sole plate having a rocker bottom, a yoke portion and an extension leg attached to the yoke portion. A boot received by a patient&#39;s foot is operably coupled to the yoke portion by a first fastener and to an upper portion of the extension leg by a second fastener. 
     In another aspect of the invention, the extension leg may be operably coupled at a hinge axis to an upper hinged portion. The hinge axis is aligned with the knee. A below the knee collar operably and securely couples the boot to the extension leg and the yoke portion. An above the knee collar operably secures the upper hinged portion to the patient&#39;s thigh. 
     In another aspect of the invention a patellar suspension may operably couple the boot to the extension leg and the patient&#39;s leg. 
     The foregoing elements work together as a system to off-load an injured, weight bearing limb during locomotion and mitigate excessive ground forces while allowing a patient to maintain normal gait function. The system may also be adapted to address a variety of orthopedic remedial and therapeutic issues. These are other embodiments of the system and method in accordance with the invention will be described in detail herein below. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       For a better understanding of the invention, and to show how the same may be carried into effect, reference will now be made, by way of example, to the accompanying drawings. Those of skill in the art will appreciate that the FIGS. are not drawn to scales and various elements may be shorter or longer than as depicted or positioned higher or lower than as depicted. 
         FIG. 1  is a side elevational view of an aspect of the invention shown on the lower extremity in a weight-bearing position; 
         FIG. 2  is a side elevational view of an aspect of an unweighting invention shown functionally attached to the thigh with a an above-the-knee collar; 
         FIG. 3  is a side elevational view of an aspect of an unweighting invention similar to  FIG. 2  except including a patellar suspension system; 
         FIG. 4  is a side elevational view of a further aspect of an unweighting invention and a variation of the embodiment shown in  FIG. 2 ; 
         FIG. 5  is a side elevational view of a further aspect of an unweighting invention and a variation of the embodiment shown in  FIG. 2 ; 
         FIG. 6  is a side elevational view of a further aspect of the invention similar to  FIG. 3  except it is unhinged at the rotational axis of the knee; 
         FIG. 7  is a side elevational view of a further aspect of an unweighting invention; 
         FIG. 8  is a side elevational view of further aspect of an unweighting invention attached to a leg in an initial step position of stride; 
         FIG. 9  is a side elevational view of the embodiment of  FIG. 8  shown at the end of stride position commonly known as “toe-off”; 
         FIG. 10  is a side elevational view of a further aspect of the invention showing functional range of motion thereof; and 
         FIG. 11  is a front elevational view of  FIG. 10 . 
     
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     Referring now to  FIG. 1  a weighted aspect of the swing walker or suspension walker in accordance with the invention is illustrated. The swing walker depicted in  FIG. 1  mitigates the impact forces subjected upon the foot if a patient is required to walk in a cast or a soft boot cam walker type construction. The swing walker  100  in accordance with a first aspect of the invention broadly includes a rocker base  110 , a boot  112  and a plurality of straps  114 . 
     Rocker base  110  includes rocker base sole  116  operably coupled to medial (not shown) and lateral yoke portions  118 , each of which is coupled to medial (not shown) and lateral extension legs  120  extending from the yoke portion  118 . The rocker base sole  116  includes a rocker base  122  that includes a substantially flat, weight bearing surface portion  124  for contacting the ground and first and second end portions  126 ,  128  that extend upwardly to form an acute angle  130  with the ground  132 . First and second end portions  126 ,  128  may be made from a material that is resilient to allow them to dynamically deform during the gait cycle. Suitable materials that may be utilized include plastics, polymers and resilient metals. Weight bearing surface portion  124  may also be made from a material that is resilient to allow it to dynamically deform during the gait cycle. Suitable materials that may be utilized to construct rocker base sole  116  include polyolefin; polypropylene, open and closed cell foams and graphites. Yoke  118  and extension legs  120  may be made from rigid or semi-rigid materials such as plastics known to those of skill in the art. 
     Medial (not shown) and lateral yokes  118  take the shape of an upside down Y in cross section. Thus each of medial and lateral yokes  118  include distal and proximal arms  134 ,  136  defining an aperture therethrough. Distal and proximal arms  134 ,  136  may be integrally formed with rocker base sole  116  but be comprised of a different material construct. Alternatively, distal and proximal arms  134 ,  136  may be non-integrally formed with rocker base sole  116 . Distal and proximal arms  134 ,  136  converge at an apex  140  to form extension leg  120 . Proximal arm may define a first slot  142  therethrough for one of the plurality of straps  114  designed for use with the swing walker  100  in accordance with the invention. 
     Medial (not shown) and lateral extension legs  120  extends axially from apex  140  and defines an upper slot  144  and a mid-slot  146  therethrough for receiving two of said plurality of straps  114  designed for use with the swing walker  100  in accordance with the invention. 
     Inner boot  112  may be constructed of hard or soft plastics known to those of skill in the art and is suspended by a resilient yoke strap  148  including a front portion  150  that fits over the dorsum of the patient&#39;s foot and up underneath the planter surface of the arch. Resilient yoke strap  148  includes medial (not shown) and lateral portions  149  that are integrally or non-integrally formed with front portion  150 . Medial and lateral portions  149  extend up the inside of extension legs  120  and exit through mid-slot  146  in the extension leg  120  and then is tractionable or tensionable by pulling down and fastening it to a fastener  152  located on the outside of extension leg  120 . Fastener  152  may comprise Velcro and have a corresponding mating piece  153  on strap  148 . Thus, resilient yoke strap  148  may be tensioned via fasteners  152 ,  153  to allow the inner boot  112  to be suspended off the weight bearing surface  124  or plane of support of the rocker base sole  116 . 
     A second strap  154  runs anteriorly from side to side around the front portion of the boot at an upper edge. Second strap  154  prevents forward excursion of the inner boot  114  inside the swing walker. A third strap positioned through first slot  142  in the proximal arm  136  of yoke  118  provides posterior support behind and slightly above the heel and is designed to prevent excessive posterior excursion of the inner boot  112 . When a patient inserts his foot in the swing walker  100  and weight bears in the construct, it creates tension on the flexible yoke strap  148  which may be operably coupled to and tension second and third straps  154 ,  156  to allow for a centering effect that holds the inner boot  112  more centrally located and stable during gait. Thus, when the patient propels during the normal gait cycle, there would not be quite as much free excursion or motion of the foot. 
     The basic premise of the swing walker in accordance with the invention including different aspects of the invention as disclosed herein is that the rocker base  110 , which is a common component to all aspects of the invention, provides stability during the gait cycle allowing the foot excursion to move forward to load and suspend as it moves posteriorly and to swing up posteriorly providing different levels of support at heel strike, mid-stride and toe off based on the positioning of the leg during the gait cycle. 
     Turning now to  FIG. 2  a further aspect of the swing walker  200  or suspension walker in accordance with the invention is illustrated. Components that are similar to the swing walker depicted in  FIG. 1  are labeled with like numerals. The swing walker  200  in accordance with a further aspect of the invention comprises an unweighting swing walker and broadly includes a rocker base  110 ; boot  112 ; and cable system  214 . 
     Rocker base  110  includes rocker base sole  116  operably coupled to medial (not shown) and lateral yoke portions  118 , each of which is coupled to medial (not shown) and lateral double extension legs  220  extending from the yoke portion  118 . The rocker base sole  116  includes a rocker base  122  that includes a substantially flat, weight bearing surface portion  124  for contacting the ground and first and second end portions  126 ,  128  that extend upwardly to form an acute angle  130  with the ground  132 . First and second end portions  126 ,  128  may be made from a material that is resilient to allow them to dynamically deform during the gait cycle. Suitable materials that may be utilized include plastics, polymers and resilient metals. Weight bearing surface portion  124  may also be made from a material that is resilient to allow it to dynamically deform during the gait cycle. Suitable materials that may be utilized to construct rocker base sole  116  include polyolefin; polypropylene, open and closed cell foams and graphites. Yoke  118  and double extension legs  220  may be made from rigid or semi-rigid materials such as plastics known to those of skill in the art. 
     Medial (not shown) and lateral yokes  118  take the shape of an upside down Y in cross section. Thus each of medial and lateral yokes  118  include distal and proximal arms  134 ,  136  defining an aperture therethrough. Distal and proximal arms  134 ,  136  may be integrally formed with rocker base sole  116  but may be comprised of a different material construct. Alternatively, distal and proximal arms  134 ,  136  may be non-integrally formed with rocker base sole  116 . Distal and proximal arms  134 ,  136  converge at an apex  140  to form medial (not shown) and lateral double extension legs  220 . Double extension legs  220  include a distal extension leg  221  and a proximal extension leg  223 . Distal and proximal extension legs  221 ,  223  are hingedly coupled together at first hinge axis  225 . As those of skill in the art will appreciate, first hinge axis  225  is aligned with the rotational axis of the knee. A second end of proximal extension leg  225  is hingedly coupled to an above the knee collar  227  at second hinge axis  229 . Above the knee collar  227  may totally or partially circumferentially surround the patient&#39;s leg and may be operably coupled to third hinge axis  222 . 
     Inner boot  112  may be constructed of hard or soft plastics known to those of skill in the art and is suspended by cable system  214 . Cable system  214  broadly includes a below the knee suspension collar  231  operably coupled to a plurality of cables  233 . Below the knee suspension collar  231  may totally or partially circumferentially surround the patient&#39;s leg and is operably coupled to distal extension leg  221  at hinge axis  222 . As those of skill in the art will appreciate, cables  233  may have variable attachment points on boot  112  such as the heel of the foot, at mid-foot (as shown) and other points. Inner boot  112  may be constructed of hard or soft plastics known to those of skill in the art. 
     As will be appreciated by those of skill in the art, the swing walker in accordance with a second aspect of the invention allows for additional unweighting other than just shock absorption. The swing walker in accordance with a second aspect of the invention decreases the impact force that is vertical and posterior or sheering at the heel upon impact during the gait cycle. The swing walker depicted in  FIG. 2  allows for additional unweighting of the foot at above the knee suspension collar  227 . 
     The below the knee collar  231  acts as a suspension collar for cables  233 . Cables  233  may be coupled to the inner boot  112  which could be segmented to weight different segments of the forefoot, mid-foot, heel, lower leg, and upper leg to transmit the pressures of weight bearing suspension to a particular area. 
     For example, if a patient had a heel ulcer it would be desirable to weight the leg components at the mid-foot or forefoot with the cables  233  instead of the heel. The unweighting component comprises the below the knee collar  231  attached at the hinge axis  222  and suspending the segment attached by the cables. 
     Thus depending upon the desired pathology suspension collars may be coupled at various levels to various areas within the internal cast to allow for free swinging range of motion during gait. At heel strike the foot would be anterior to the vertical extension legs and would start to swing posteriorly and as it goes from a set down to pickup position, different cables from different suspension collars or locations would weight, load and unweight sequentially to allow for a continued level of support throughout the gait cycle. So certain cables for instance in this position right at toe off when this is about to be picked up or unweighted, the foot has already swung posteriorly and all the weight is really coming down from either above knee or below knee suspension collar and the cables are all loaded. On the patellar surface the cables are relatively unloaded to the leg or foot. However, because of the position of the leg as it passes the extension arm and the patellar surface during gait and because it is parallel to the ground, the system loads. Those of skill in the art will appreciate that the collars described herein may be constructed of known rigid, semi-rigid or resilient materials. 
     Referring now to  FIG. 3  a third aspect of a swing walker  300  in accordance with the invention is shown. Components that are similar to the swing walker depicted in  FIGS. 1 and 2  are labeled with like numerals. The swing walker  300  in accordance with a third aspect of the invention comprises an unweighting swing walker and broadly includes a rocker base  110 ; inner boot  112 ; and patellar suspension system  314 . 
     Rocker base  110  includes rocker base sole  116  operably coupled to medial (not shown) and lateral yoke portions  118 , each of which is coupled to medial (not shown) and lateral double extension legs  220  extending from the yoke portion  118 . The rocker base sole  116  includes a rocker base  122  that includes a substantially flat, weight bearing surface portion  124  for contacting the ground and first and second end portions  126 ,  128  that extend upwardly to form an acute angle  130  with the ground  132 . First and second end portions  126 ,  128  may be made from a material that is resilient to allow them to dynamically deform during the gait cycle. Suitable materials that may be utilized include plastics, polymers and resilient metals. Weight bearing surface portion  124  may also be made from a material that is resilient to allow it to dynamically deform during the gait cycle. Suitable materials that may be utilized to construct rocker base sole  116  include polyolefin; polypropylene, open and closed cell foams and graphites. Yoke  118  and double extension legs  220  may be made from rigid or semi-rigid materials such as plastics known to those of skill in the art. 
     Medial (not shown) and lateral yokes  118  take the shape of an upside down Y in cross section. Thus each of medial and lateral yokes  118  include distal and proximal arms  134 ,  136  defining an aperture therethrough. Distal and proximal arms  134 ,  136  may be integrally formed with rocker base sole  116  but may be comprised of a different material construct. Alternatively, distal and proximal arms  134 ,  136  may be non-integrally formed with rocker base sole  116 . Distal and proximal arms  134 ,  136  converge at an apex  140  to form medial (not shown) and lateral double extension legs  220 . 
     Double extension legs  220  include a distal extension leg  221  and a proximal extension leg  223 . Distal and proximal extension legs  221 ,  223  are hingedly coupled together at first hinge axis  225 . As those of skill in the art will appreciate, first hinge axis  225  is aligned with the knee at the rotational axis of the knee. A second end of proximal extension leg  225  is fixedly coupled to above the knee collar  227 . 
     Turning now to the above the knee patellar suspension system  670 , the system broadly includes an above the knee collar  227 , plurality of cables  374  and knee support  316 . Plurality of cables  374  are coupled to the knee support  316  at a first end thereof and coupled at a second end to above the knee collar  227 . Each coupling of cables  374  to knee support  316  are at different coupling locations on knee support  316  and each coupling of the second end of cables  374  to the above the knee collar  227  are at various locations on the above the knee collar  227 . Those of skill in the art will appreciate that plurality of cables  374  may comprise wires, straps, tethers, filaments and the like and may be constructed from flexible, resilient or semi-rigid materials. Above the knee collar  227  may partially or totally circumferentially surround the patient&#39;s leg. 
     Strap  318  assists in securing knee support  316  to the leg at a position below the knee. Strap  318  may be constructed of resilient or non-resilient fabric or other materials known to those of skill in the art. 
     Referring now to  FIG. 4  an unweighting swing walker with a below the knee suspension system is shown  400 . The weighted swing walker with below the knee suspension system  400  broadly includes rocker base  110 , below the knee suspension system  450  and above the knee collar  227 . Rocker base  110  is substantially similar to previously described embodiments and includes rocker base sole  116  operably coupled to medial (not shown) and lateral yoke portions  118 , each of which is coupled to medial (not shown) and lateral double extension legs  220  extending from the yoke portion  118 . The rocker base sole  116  includes a rocker base  122  that includes a substantially flat, weight bearing surface portion  124  for contacting the ground and first and second end portions  126 ,  128  that extend upwardly to form an acute angle  130  with the ground  132 . First and second end portions  126 ,  128  may be made from a material that is resilient to allow them to dynamically deform during the gait cycle. Suitable materials that may be utilized include plastics, polymers and resilient metals. Weight bearing surface portion  124  may also be made from a material that is resilient to allow it to dynamically deform during the gait cycle. Suitable materials that may be utilized to construct rocker base sole  116  include polyolefin; polypropylene, open and closed cell foams and graphites. Yoke  118  and double extension legs  221  may be made from rigid or semi-rigid materials such as plastics known to those of skill in the art. 
     Medial (not shown) and lateral yokes  118  take the shape of an upside down Y in cross section. Thus each of medial and lateral yokes  118  include distal and proximal arms  134 ,  136  defining an aperture therethrough. Distal and proximal arms  134 ,  136  may be integrally formed with rocker base sole  116  but may be comprised of a different material construct. Alternatively, distal and proximal arms  134 ,  136  may be non-integrally formed with rocker base sole  116 . Distal and proximal arms  134 ,  136  converge at an apex  140  to form medial (not shown) and lateral double extension legs  220 . 
     Double extension legs  220  include a distal extension leg  221  and a proximal extension leg  223 . Distal and proximal extension legs  221 ,  223  are hingedly coupled together at first hinge axis  225 . As those of skill in the art will appreciate, first hinge axis  225  is aligned with the knee at the rotational axis of the knee. Proximal extension leg  225  is fixedly coupled to above the knee collar  227 . Distal extension leg  221  is fixedly coupled to below the knee collar  452 . 
     Below the knee suspension system  450  operates to suspend boot  112  and includes below the knee collar  452  operably coupled to a plurality of cables  454 . Below the knee collar  452  circumferentially surrounds the patient&#39;s leg below the knee. As those of skill in the art will appreciate, cables  454  may comprise wires, straps, tethers, filaments and the like and may be flexible, resilient or semi-rigid. Cables  454  act to suspend boot  112  to eliminate impact forces with the ground and to allow for free range of motion of the foot during the gait cycle. 
     Referring now to  FIG. 5  an alternative embodiment of a weighted swing walker in accordance with the invention  500  is shown.  FIG. 5  is substantially similar to the embodiment shown in  FIG. 4  except an above the knee suspension system  550  is used. The weighted swing walker with above the knee suspension system  550  broadly includes rocker base  110 , above the knee suspension system  450  and above the knee collar  414 . Rocker base  110  is substantially similar to previously described embodiments and includes rocker base sole  116  operably coupled to medial (not shown) and lateral yoke portions  118 , each of which is coupled to medial (not shown) and lateral double extension legs  220  extending from the yoke portion  118 . The rocker base sole  116  includes a rocker base  122  that includes a substantially flat, weight bearing surface portion  124  for contacting the ground and first and second end portions  126 ,  128  that extend upwardly to form an acute angle  130  with the ground  132 . First and second end portions  126 ,  128  may be made from a material that is resilient to allow them to dynamically deform during the gait cycle. Suitable materials that may be utilized include plastics, polymers and resilient metals. Weight bearing surface portion  124  may also be made from a material that is resilient to allow it to dynamically deform during the gait cycle. Suitable materials that may be utilized to construct rocker base sole  116  include polyolefin; polypropylene, open and closed cell foams and graphites. Yoke  118  and double extension legs  221  may be made from rigid or semi-rigid materials such as plastics known to those of skill in the art. 
     Medial (not shown) and lateral yokes  118  take the shape of an upside down Y in cross section. Thus each of medial and lateral yokes  118  include distal and proximal arms  134 ,  136  defining an aperture therethrough. Distal and proximal arms  134 ,  136  may be integrally formed with rocker base sole  116  but may be comprised of a different material construct. Alternatively, distal and proximal arms  134 ,  136  may be non-integrally formed with rocker base sole  116 . Distal and proximal arms  134 ,  136  converge at an apex  140  to form medial (not shown) and lateral double extension legs  220 . 
     Double extension legs  220  include a distal extension leg  221  and a proximal extension leg  223 . Distal and proximal extension legs  221 ,  223  are hingedly coupled together at first hinge axis  225 . As those of skill in the art will appreciate, first hinge axis  225  is aligned with the knee at the rotational axis of the knee. Proximal extension leg  225  is fixedly coupled to above the knee collar  552 . Distal extension leg  221  is fixedly coupled to below the knee collar  556 . Both above the knee collar  552  and below the knee collar  556  circumferentially surround the patient&#39;s leg. 
     Above the knee suspension system  550  operates to suspend boot  112  and includes above the knee collar  552  operably coupled to a plurality of cables  554 . As those of skill in the art will appreciate, cables  554  may comprise wires, straps, tethers, filaments and the like and may be flexible, resilient or semi-rigid. Cables  554  act to suspend boot  112  to eliminate impact forces with the ground and to allow for free range of motion of the foot during the gait cycle. 
     Referring now to  FIG. 6  an embodiment of an unweighting swing walker  600  similar to the embodiment in  FIG. 3  is shown. Like elements are labeled with like numerals. The swing walker in accordance with the invention depicted in  FIG. 6  broadly includes a rocker base  110 ; a boot  112  and an above the knee patellar suspension system  670 . As the rocker base is substantially identical to previous embodiments further explanation will not be provided. 
     Turning now to the above the knee patellar suspension system  670 , the system broadly includes an above the knee collar  672 , plurality of cables  674  and knee support  676 . Plurality of cables  674  are coupled to the knee support  676  at a first end thereof and coupled at a second end to above the knee collar  672  along the longitudinal axis of the proximal extension arm  221 . Each coupling of cables  674  to knee support  676  are at different coupling locations on knee support  676  and each coupling of the second end of cables  674  to the above the knee collar  672  are at various locations on the above the knee collar  672 . Those of skill in the art will appreciate that plurality of cables  674  may comprise wires, straps, tethers, filaments and the like and may be constructed from flexible, resilient or semi-rigid materials. Above the knee collar  672  totally or partially circumferentially surrounds the patient&#39;s thigh. 
     Proximal extension arm  221  of the rocker base  110  is hingedly coupled to above the knee collar  672  at point  673 . Those of skill in the art will appreciate that the above the knee patellar suspension system provide a weight bearing surface that allows for unweighting at the patellar surface and the anterior knee and superior shin. The above the knee patellar suspension system thus acts to suspend the leg at the at the patellar surface and the anterior knee and superior shin depending on the type of foot pathology that is being treated and the desired correction and allows for free swinging range of motion during gait. 
     Turning now to  FIG. 7  a modified version of the embodiment shown in  FIG. 6  is depicted.  FIG. 7  depicts an unweighting swing walker with an above the knee patellar support suspension system which is partially unweighted by diagonal suspension with a second set of cables  678  from above the knee collar to inner boot  112 . 
     Above the knee patellar support suspension system  700  includes a second plurality of cables  678  that are coupled at a first end thereof the boot  112  and to above the knee collar  672  at a second end thereof. Cables  678  run in a diagonal attachment pattern from above the knee collar  672  to boot  112 . As those of skill in the art will appreciate because the knee patellar support suspension system  700  does not hinge at the knee the leg does not swing through the channel created between extension arms  220 ,  221 . Thus, the leg is held in a fixed position while still allowing the patient to ambulate through the gait cycle. 
     Turning now to  FIGS. 8 and 9  a side elevational view of a thigh walker  800  in accordance with the invention showing the invention attached to the upper thigh of a patient with the leg in an initial step position of stride ( FIG. 8 ) and shown at the end of stride ( FIG. 9 ) during the gait cycle. As can be seen from the FIGS. the thigh walker include rocker base  110 , which is substantially similar to previous embodiments, boot  112  with upper boot collar  113  and thigh suspension system  880 . 
     Thigh suspension system  880  includes upper collar  882  and V-shaped legs  884  that join at apex  886 . Those of skill in the art will appreciate that upper collar  882  may totally or partially circumferentially surround the patient&#39;s thigh and may be lower on the thigh than as shown. Apex  886  is hingedly coupled to single extension leg  888  of the rocker base system  110 . Those of skill in the art will appreciate that single extension leg  888  is hingedly coupled by hinge joint  225  to apex at the rotational axis point  225  of the knee as in previously disclosed embodiments. Thus, the lower leg can move through the channel created by upright extension legs  888  but movement is constrained by hinge joint  225 . 
     Turning now to  FIGS. 10 and 11  a further aspect of the present invention is shown. The crutch walker  1000  in accordance with the invention is a progression for the swing walker that adds stability during the gait cycle. When the crutch walker  1000  is picked up and placed down and the leg is swinging and moving through it, the stabilization is provided by right and left arm components  1300 ,  1300 ′ that fits between the torso and the shoulder underneath the arm. The arm components  1300 ,  1300 ′ includes right and left hinge component  1200 ,  1200 ′ that operably couples the arm components  1300 ,  1300 ′ with the rocker base system  110 . The hinge components  1200 ,  1200 ′ allows the patient to actually rock posteriorly when the crutch walker  1000  is set down in front of them and hinge and rotate anteriorly as the leg swings posteriorly. The crutch then moves anteriorly so it provides for a counterbalance during gate for stability. The crutch walker includes a right side  1400  and a left side  1500 . On the right side, the crutch walker includes the arm component  1300 , hinge component  1200  and rocker base system  1500 . The left side  1400  includes the arm component  1300 ′ and hinge component  1200 ′ with a short extension arm  1410  hingedly coupled thereto. Short extension arm  1410  is coupled to rocker base system  1500  by bar  1600 . Hinges  1200 ,  1200 ′ are at or above the level of the rotational knee axis. Bar  1600  provides stability that allows the patient to use the same type of crutch component on the right side but the other leg could walk free without being inside a swing walker for stability. The crutch walker in accordance with the invention is an advancement over prior art crutch systems because the crutches do not need to be splayed out at an angle and attack the ground at an angle potentially causing the crutch to kick out or slip especially in situations involving ice and snow. The crutch walker  1000  in accordance with the invention traps and stabilizes the pathological extremity in a stable support that does not allow it to be impacted from either side; allows for multiple levels of unweighting to occur; and allows for free swinging or motion during the gait cycle which facilitates more normal function, less disuse and atrophy of the extremity, and improves blood flow. 
     Those of skill in the art will appreciate that the crutch walker depicted in  FIGS. 10 and 11  does not need to be a “full” crutch with underarm support  1310 . Rather arm component  1300  may comprise a single element that may be coupled to an above-the elbow position and hingedly attached to the upright support element. 
     Those of skill in the art will also appreciate that the disclosed embodiments in accordance with the invention are designed to accommodate numerous modifications as hereinbefore described. Thus, although the present invention has been described with reference to certain embodiments, those of ordinary skill in the art will recognize that changes may be made in form and detail without departing from the spirit and scope of the invention.