Abstract:
A compression therapy device for vascular diseases and other therapies comprising a bladder a lever arm acting on the outer surface of the bladder such that cyclical operation of an actuator on the lever arm creates cyclical changes in pneumatic pressure in the therapeutic portion of the bladder.

Description:
TECHNICAL FIELD 
       [0001]    The present disclosure relates to a compression device for applying cyclic external pressure to the outer surface of a patient receiving compression therapy. In particular, the present disclosure relates to a compression device that utilizes a lever advantage to cyclically apply pressure to a limb requiring compression therapy efficiency and precision. 
       BACKGROUND 
       [0002]    Compression therapy systems are used in several medical applications to apply rapid compressions to one or more appendages (e.g., arms, hands, legs, and feet) of a body. For example, compressions therapy systems are used to treat chronic wounds by applying pressure to an appendage having wounds to improve circulation around the wounds, or to improve blood circulation to treat angina or congestive heart failure (CHF), e.g., as in enhanced external counterpulsation (EECP) devices. 
         [0003]    In some prior art compression therapy systems, a compressor may be utilized to compress air for storage into a storage tank. The stored air is then delivered from the storage tank to the inflatable compression device through a valve in rapid low pressure bursts to apply compression to the appendage. After each burst of air fills the inflatable device, another valve is opened on the release the air to the ambient conditions thereby removing compression from the appendage being treated. While such prior art systems may have had utility, the continuous need for significant amounts of air from the storage tank require the use of a relatively large compressor requiring significant amount of power and capital expense. Further, in some instances, it may be difficult for the compressor to keep up with the rapid cycling required of particular applications, and/or the valving used may not be precise enough to provide compression as precisely as desired. 
         [0004]    Accordingly, some prior art similar systems have attempted to address some of these issues. For example, U.S. Pat. No. 6,984,215 to Shah (“Shah”) discloses a compression therapy system that utilizes a piston system and a supplementary bladder to overcome some of the aforementioned issues. In particular, instead of venting to the ambient air, the system disclosed in Shah utilizes a supplementary bladder and valve such that the air that would otherwise be vented and compensated for by the compressor of prior art systems is recycled by a bladder and forced back into the compression device by direct compression from a piston. 
         [0005]    While the Shah disclosure represents an improvement over prior-art systems in efficiency and control, the direct use of a piston, operating directly on the compressed air in a supplementary bladder, is not as mechanically efficient as possible. Additionally, such a system may require complex and expensive piston position sensors in order to ensure that the use of the piston doesn&#39;t exceed the maximum pressure in the compression device, the potential failure of which could potentially result in significant patient injury. Accordingly, it would be desired to have a system and method for providing cyclic compression to a therapeutic device which is more efficient than prior art designs, does not require complex and expensive position sensors, and which provides a fail-safe for potential over-inflation of the compression device. 
       SUMMARY 
       [0006]    The present disclosure provides a compression therapy device for vascular diseases and other therapies that overcomes some of the deficiencies of prior art compression devices. The compression device of the present disclosure may include a bladder including a therapeutic portion, a reservoir portion and a lever arm acting on the reservoir portion. In embodiments of the present disclosure, a compression therapy device may be provided that is specifically adapted for use on a patient&#39;s lower leg and foot and may be boot-shaped. The compression therapy device disclosed herein may be adapted and sized to receive a patient&#39;s foot and calf therein and may include an anterior portion that opens and closes, allowing for the patient&#39;s foot and calf to be inserted and removed. The therapeutic portion may surround the patient&#39;s calf when in the boot and the reservoir portion may be positioned anywhere in fluid communication with the therapeutic portion. There may be a constriction in the bladder between the therapeutic portion and the reservoir portion. A lever arm may be provided and arranged in such a way as to apply pressure to the reservoir portion, thereby forcing air into the therapeutic portion. An actuator, such as a piston, solenoid or other mechanical device, may be provided to operate the lever arm between an extended, non-compression position wherein the reservoir portion is allowed to expand and a retracted, compression position in which pneumatic pressure from the reservoir portion is forced into the therapeutic portion of the provided bladder. 
         [0007]    The foregoing summary is illustrative only and is not intended to be in any way limiting. In addition to the illustrative aspects, embodiments, and features described above, further aspects, embodiments, and features will become apparent by reference to the drawings and the following detailed description. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0008]    The foregoing and other features of the present disclosure will become more fully apparent from the following description and appended claims, taken in conjunction with the accompanying drawings. Understanding that these drawings depict only several embodiments in accordance with the disclosure and are, therefore, not to be considered limiting of its scope, the disclosure will be described with additional specificity and detail through use of the accompanying drawings. 
           [0009]    In the drawings: 
           [0010]      FIG. 1  is a side perspective view of an example embodiment of a compression therapy device consistent with aspects of the disclosure; 
           [0011]      FIG. 2  is a partially schematic side view of the example compression therapy device of  FIG. 1 ; 
           [0012]      FIG. 3  is a partially schematic side view a three-way valve that may be used with the example compression therapy device of  FIGS. 1 and 2 ; 
           [0013]      FIG. 4  is an example control diagram for use with embodiments of the current disclosure; 
           [0014]      FIG. 5  is a schematic side view of another example compression therapy device according to the current disclosure; 
           [0015]      FIG. 6  is a schematic side view of another example compression therapy device according to the current disclosure; 
           [0016]      FIG. 7  is a schematic side view of another example compression therapy device according to the current disclosure; 
           [0017]      FIG. 8  is a schematic side view of another example compression therapy device according to the current disclosure; 
           [0018]      FIG. 9  is a schematic side view of another example compression therapy device according to the current disclosure; and 
           [0019]      FIG. 10  is a block diagram of an example computer suitable for use in connection with the compression therapy device of the present disclosure. 
       
    
    
     DETAILED DESCRIPTION 
       [0020]    In the following detailed description, reference is made to the accompanying drawings, which form a part hereof. In the drawings, similar symbols typically identify similar components, unless context dictates otherwise. The illustrative embodiments described in the detailed description, drawings, and claims are not meant to be limiting. Other embodiments may be used, and other changes may be made, without departing from the spirit or scope of the subject matter presented here. It will be readily understood that the aspects of the present disclosure, as generally described herein, and illustrated in the Figures, may be arranged, substituted, combined, and designed in a wide variety of different configurations, all of which are explicitly contemplated and make part of this disclosure. 
         [0021]    As shown in  FIGS. 1 and 2 , a therapeutic compression device  10  may be provided in the form of a boot  100 . The boot  100  may be sized and shaped to receive a patient&#39;s foot and lower leg therein and may include an anterior portion  102  that opens and closes about a hinge  104  approximate the toe of the boot  100  and a posterior portion  106  (in the current embodiment, the anterior portion  102  pivots up an away from the posterior portion  106  to open the boot). Pivoting open the anterior portion  102  about hinge  104  allows for the patient&#39;s foot and calf to be inserted and removed from the boot  100  (the broken line  FIG. 2  illustrates the boundary  105  between the anterior portion  102  and posterior portion  106  when closed). In the current embodiment, the anterior portion  102  includes covers the patient&#39;s shin and top of the patient&#39;s foot, and the posterior portion covers the patient&#39;s calf and the back and bottom of the patient&#39;s foot. The boot  100  may include a strap  108  (or any other suitable clamping or locking mechanism) to secure the anterior portion  102  to the posterior portion  106  when the patient&#39;s foot and lower leg is received therein. In the current embodiment the strap  108  is fixedly attached on one end (not shown) to the posterior portion  106  and the strap  108  may include a hole  110  on the other end thereof. The strap may extend across the anterior portion  102  and may be coupled to a diametrically opposite end of the posterior portion from which it is attached by mating the hole  110  onto receiving a nub  112  located on the base portion  106  thereby securing the anterior portion  102  to the posterior portion  106 . In an embodiment of the disclosure, in the closed, therapeutic position, the anterior portion  102  and posterior portion are designed such that the angle of the patient&#39;s shin/calf with respect to the patient&#39;s foot may be between 15 and 20 degrees, and more preferably, approximately 18 degrees. 
         [0022]    Surrounding the patient&#39;s foot and lower leg, when in the boot  100 , may be a bladder  114 . The bladder  114  may be filled with air (or another gas, fluid or non-Newtonian fluid) to provide pneumatic pressure around a patient&#39;s limb when inserted in the boot  100  by means of a pneumatic supply line  115  that is attached to a pneumatic pressure source  117 . The bladder  114  may include a therapeutic portion  116  and a reservoir portion  118 . In the current embodiment, the anterior portion  106  extends from a base  140  that provides a working chamber  142  below the boot  100 . The reservoir portion  118  extends into the working chamber  142  and may be connected to the therapeutic portion  116  by a constriction  120 . The boot  100  may have an inner floor  122  for separating the boot  100  from the working chamber  142  and for supporting a foot of a patient thereon. The constriction  120  of the bladder  114  may extend through an orifice or hole  124  in the inner floor  122  to connect the therapeutic portion  116  of the bladder  114  with the reservoir portion  118  of the bladder  114 . The inner floor  122  may be used to separate a therapy chamber  126  of the boot  100  from a reservoir cavity  128  portion of the working chamber  142 . 
         [0023]    The reservoir portion  118  may be located primarily in the working chamber  142  of the base  140  and be positioned between the inner floor  122  and a lever arm  130  that is mounted on one end thereof to a hinge or pivot  132  for pivotal movement within working chamber  142 . In the current embodiment, the anterior end of the lever arm is coupled to the pivot  132  approximate the toe portion of the boot and extends posteriorly across the inner floor and provides the reservoir cavity  128  between the lever arm  130  and the inner floor  122  into which the reservoir portion  118  of the bladder is positioned. On the posterior end of the lever arm  130 , an actuator  136  is mounted so as to affect pivotal movement of the lever arm  130  about the pivot  132  in compression  133  (up towards inner floor  122 ) and release  135  (down away from inner floor  122 ) directions. It will be understood, in accordance with the disclosure, that actuator  136  could be a piston, servo, solenoid, air actuator, electrical linear actuator, cam with an electrical motor, etc. In accordance with one embodiment of the disclosure, the lever arm  130  and pivot may be located proximate a toe end of the boot  100 , the actuator  136  may be located at a heel end of the boot  100 , and the reservoir portion  118  of the bladder  118  may be positioned between the lever arm  130  and the inner floor  122 . 
         [0024]    In accordance with this embodiment, the reservoir portion  118  may be positioned such that actuation of the actuator  136 , and the corresponding lever arm  130 , in the compression  133  direction compresses the reservoir portion  118  against the bottom of the inner floor  122  creating a decrease in the volume of the boot  100  and a corresponding relative increase in pressure in the therapeutic portion  116  of the bladder  114 . Conversely, actuation of the actuator  136  in the release direction  135 , and the corresponding lever arm  130  (or the release of any resistance to movement thereof), allows expansion of the reservoir portion  118  of the bladder  114  into the reservoir cavity  128  thereby increasing the volume of the boot  100  and, correspondingly, decreasing relative pressure in the therapeutic portion  116  of the bladder  114 . In this manner, a cyclic increase and decrease in pressure may be accorded in the therapeutic portion  116  of the bladder as may be desired. More specifically, cyclic compression therapy may be provided to a limb, such as a foot, ankle, and/or calf of a patient as desired. For example, the actuator  136  may be connected to a patient heart rate monitor (such as via an EKG monitor, finger-tip pulse monitor, wrist pulse monitor or the like) so that the pressure in the therapeutic portion  116  of the bladder  114  fluctuates between high and low pressure states in timing with a patient&#39;s heartbeat 
         [0025]    In the current embodiment, the actuator  136  includes a pneumatic driven piston  137  and a three-way valve  138 A in fluid communication between the pneumatic supply line  115  and the piston  137 . Referring to  FIGS. 2 and 3 , the three way valve  138  may have at least two settings, an energized setting in which the pneumatic pressure source  117  provides pneumatic pressure to the piston  137 , causing the piston  137  to move lever arm  130  up in direction  133 , and a de-energized setting, in which the air is evacuated from the piston  137 . Pneumatic pressure source  117  may be a compressor, but may be any other pneumatic source or hydraulic source as known by those of ordinary skill. In the configuration of the valve  138 A in  FIG. 4 , the pressurized air from pneumatic pressure source  117  P(IN) is blocked by o-ring  139  while o-ring  141  is un-blocked allowing air from piston, through line  149 , to be exhausted out to the Ambient through R (EXH)  145 . In this configuration, the valve  138 A is in the de-energized setting. In an energized setting, the center shaft  143  moves vertically allowing o-ring  141  to block R (EXH) and o-ring  139  to unblock P (IN), allowing pressurized air from pneumatic pressure source  117  to flow through P (IN) and out (OUT) A and into piston  137  through line  149 . In operation, in the current embodiment, when switching from the energized setting to the de-energized setting, pressure within the bladder  114  will force the lever arm  130  downward again (direction  135 ) forcing the air within the piston  137  will be evacuated out through the valve  138 A. The three-way valve  138 A allows rapid inflation and deflation of the piston  137  with one electric valve. It may also provide a safety feature in that deflation occurs in the case of power loss. With the current system, there is no particular requirement for the pneumatic pressure source (e.g., quick and precise response as may be required by prior art systems) other than the pneumatic pressure source  117  provide the amount of pressure for therapy. 
         [0026]    Filling and deflating the bladder from the pneumatic source  117  involves a pair of one-way valves: an exhaust valve  138 B and a fill valve  138 C. To deflate the bladder  114 , exhaust valve  138 B is actuated and fill valve  138 C is deactivated, allowing gas to flow from the bladder  114  through line  152  and out through an exhaust port in valve  138 B. To fill the bladder  114 , exhaust valve  138 B is deactivated and fill valve  138 C is activated, allowing gas to flow from the pneumatic pressure source  117  to the bladder  114  through line  152 . When filling the bladder  114 , the fill pressure will be at the maximum desired pressure for treatment, as discussed below. For example, the desired pressure for treatment of peripheral vascular disease is generally between approximately 50-60 mmHg. However, much higher pressures for different treatments (such as therapies for congestive heart failure) are contemplated and consistent with the present disclosure. The device  10  may also be configured with a pressure relief valve  150  to prevent over pressurization inflation of the bladder  114 . Such a pressure relief valve  150  may be a poppet style and may be set at an opening pressure depending upon the purpose of boot. In an exemplary embodiment, the valve  150  be provided on line  152  and may have an opening pressure of 1.9 PSI. In an embodiment, line  152  may also include a pressure sensor  154 . 
         [0027]    Consistent with an embodiment of the disclosure, one general operation of the boot  100  to provide therapy to a patient may be as follows. Initially, the actuator  136  may be set to zero (compression) state by an operator meaning that the actuator  136  is set to the farthest travel in the compression direction  133 . The valve  138 B in the pneumatic supply line  115  may be opened to the vent setting thereby allowing bladder  114  to achieve atmospheric pressure therein. The anterior portion  102  of the boot  100  may be rotated forward allowing the patient to place his foot and lower leg within the therapeutic portion  116  of the bladder  114 . Next, the anterior portion  102  may be rotated closed about the patient&#39;s ankle and the strap  108  may be wrapped around the anterior portion and secured to the posterior portion  106  by nub  112  thereby securing the patient&#39;s ankle and foot securely in the boot  100 . Next the valve  138 C may be positioned in the fill setting and, utilizing the pneumatic pressure source  117  and sensor  154 , pneumatic pressure may be supplied to the bladder  114  up to the desired maximum therapeutic pressure (determined based upon the therapy being provided). Thereafter, the valves  138 B and  138 C may be positioned in the therapeutic setting, thereby sealing bladder  114  to egress and ingress of pneumatic pressure. At this time, the actuator  136  may be cyclically actuated according to the timing and duration required by the therapy being delivered. As discussed above, the timing may be determined using control systems known to those of ordinary skill in the art for timing the actuator based upon heartbeat, heart rate, and/or other physiological readings, or based on a predetermined timing cycle. 
         [0028]    As can be seen best in  FIG. 1 , the boot  100  may be formed to surround and cover the foot and calf regions of a patient. However, it is to be understood that the precise extent of the body regions in contact with the therapeutic portion  116  of the bladder  114  may vary depending upon the type of condition being addressed and the location of the affected body region. Accordingly, it should be understood that many types of inflatable bladder designs may be readily adapted for use in conformance with the therapeutic compression device  10  disclosed herein, and therefore more detailed aspects of the bladder design including but not limited to size, shape, materials, forms of attachments, etc., are therefore omitted for sake of clarity. While a calf and foot therapeutic bladder is shown for illustration, other therapeutic bladders are envisioned to be equally suitable, such as for a calf alone, a foot alone, thigh, arm, hand, finger or toe, for examples, and are considered within the scope of the disclosure. 
         [0029]    As shown in  FIG. 4 , an example control system  160  for the current system  10  is diagramed. The control system  160  may include one or more computerized controllers, control circuits and/or microprocessors  162  as known to those of ordinary skill. The controller  162  may have outputs for operating the bladder fill valve  138 C, the bladder exhaust valve  138 B and/or the actuator  136  (which may include the three-way valve  138 A in an exemplary embodiment as discussed above). Inputs to the controller  162  may include the bladder pressure sensor  154 , a pulse sensor input  164  and/or a cardiac (e.g., EKG) device  166  input. The controller  162  is configured, through software, circuits and/or hardware, to operate according to the operations described herein. 
         [0030]      FIGS. 5-9  illustrate alternative embodiments to the current disclosure. Each embodiment utilizes an actuator to act upon a lever or movable housing component of the boot to cycle the volume of the boot according to a therapeutic timing cycle. In the embodiment of the boot  200  shown in  FIG. 5 , the lever arm  230  acted upon by actuator  236  is pivotally connected to a posterior portion of the boot by pivot  232 , and a reservoir portion  218  of the bladder  214  extends from a toe portion of the boot to be acted upon by the lever arm  230 , while the therapeutic portions  216  of the bladder  214  surround the patient&#39;s foot and lower leg. In another embodiment of the boot  300  shown in  FIG. 6 , the lever arm  330  acted upon by actuator  336  is pivotally connected midway between the toe and heel of the boot such that the arm  330  pivots in a see-saw manner about pivot  332 . In this embodiment an anterior reservoir portion  318  extends above an anterior portion of the arm  330  (between arm  330  and inner floor  322 ). This positioning of the pivot  332  with respect to the arm  330  may be desired for higher pressure therapy embodiments. The therapeutic portions  316  of the bladder  314  surround the patient&#39;s foot and lower leg. In yet another embodiment of the boot  400  shown in  FIG. 7 , rather than using a separate lever arm, a portion of the boot housing, such as an anterior wall  402 , is acted upon by actuator  436  to cyclically increase and decrease the volume of the boot  400 . In the embodiment shown in  FIG. 7 , the anterior wall  402  is connected via pivot  404  approximate an upper foot portion of the boot. A separate reservoir portion of the bladder  414  is not required in this embodiment since the anterior wall  402  acts directly upon the bladder  414  approximate the patient&#39;s shin. In yet another embodiment of the boot  500  shown in  FIG. 8 , the lever arm  530  acted upon by actuator  536  is pivotally connected approximate an upper end of the posterior portion  506  of the boot at pivot  532  and extends downward along the posterior portion (e.g., from calf to heel). The reservoir portion  518  of the bladder  514  extends out from approximate the heel of the boot  500  and up between the lever arm  530  and the posterior portion  506 , while the therapeutic portions  516  of the bladder  514  surround the patient&#39;s foot and lower leg. In the embodiment shown in  FIG. 9 , the anterior portion  602  of the boot  600  is pivotally connected at pivot  604  to the base and posterior portion of the boot and is acted upon by actuator  636 . A separate reservoir portion of the bladder  614  is not required in this embodiment since the anterior portion  602  acts directly upon the bladder  614  approximate the patient&#39;s shin and upper foot. Obviously, there may be numerous additional configurations that perform substantially the same function of cyclically increase/decreasing the volume of the boot by acting upon a bladder contained within the boot via a mechanical advantage mechanism; all of which are within the scope of the current disclosure. 
         [0031]    As shown in  FIG. 2 , the therapeutic portion  116  of the bladder  114  is a single-chamber bladder design. However, multiple chamber designs for sequential inflation/deflation of the chambers such as may, for example, be desired to treat venous or lymphatic conditions as is known in the art are contemplated and within the scope of the present disclosure. Suitable operator controls (e.g., power switch, pressure selector control, etc.), sensors, indicators, gauges, and/or other operator information and controls may be provided as is known to those of ordinary skill in the art. Additionally, sensors, including various pressure sensors and physiological sensors may be used to assist in the operation of the therapeutic compression device  10  of the present disclosure as well as to help provide the desired therapy. 
         [0032]    Generally, program modules for the computer control of the controller  162  may include routines, programs, components, data structures, etc., that perform particular tasks or implement particular abstract data types. Moreover, those skilled in the art will appreciate that the methods according to the present disclosure may be practiced with other computer system configurations, including single-processor or multiprocessor computer systems, minicomputers, mainframe computers, as well as personal computers, hand-held computing devices, microprocessor-based, hardware-based or programmable consumer electronics, and the like. 
         [0033]    Some aspects of the present disclosure may also be practiced in distributed computing environments where certain tasks are performed by remote processing devices that are linked through a communications network. In some example distributed computing environments, program modules may be located in local and/or remote memory storage devices. 
         [0034]    As shown in  FIG. 10 , an example computer controller may include a variety of computer-readable media. Computer-readable media may include any available media that can be accessed by the computer and includes both volatile and non-volatile media, as well as removable and non-removable media. By way of example, and not limitation, computer-readable media may comprise computer storage media and communication media. Computer storage media may include volatile and non-volatile, removable and non-removable media implemented in any method or technology for storage of information such as computer readable instructions, data structures, program modules or other data. Computer storage media includes, but is not limited to, RAM, ROM, EEPROM, flash memory or other memory technology, CD-ROM, digital video disk (DVD) or other optical disk storage, magnetic cassettes, magnetic tape, magnetic disk storage or other magnetic storage devices, or any other medium which can be used to store the desired information and which can be accessed by the computer. 
         [0035]    An example computing environment  1300  for implementing various aspects includes a computer  1302 , which may include a processing unit  1304 , a system memory  1306  and/or a system bus  1308 . The system bus  1308  may couple system components including, but not limited to, the system memory  1306  to the processing unit  1304 . The processing unit  1304  can be any of various commercially available processors. Dual microprocessors and other multi-processor architectures may also be employed as the processing unit  1304 . 
         [0036]    The system bus  1308  can be any of several types of bus structures that may further interconnect to a memory bus (with or without a memory controller), a peripheral bus, and/or a local bus using any of a variety of commercially available bus architectures. The system memory  1306  may include read only memory (ROM)  1310  and/or random access memory (RAM)  1312 . A basic input/output system (BIOS) may be stored in a non-volatile memory  1310  such as ROM, EPROM, EEPROM. BIOS may contain basic routines that help to transfer information between elements within the computer  1302 , such as during start-up. The RAM  1312  can also include a high-speed RAM such as static RAM for caching data. 
         [0037]    The computer  1302  may further include an internal hard disk drive (HDD)  1314  (e.g., EIDE, S ATA), which may also be configured for external use in a suitable chassis, a magnetic floppy disk drive (FDD)  1316  (e.g., to read from or write to a removable diskette  1318 ), and/or an optical disk drive  1320  (e.g., reading a CD-ROM disk  1322  or, to read from or write to other high capacity optical media such as the DVD). The hard disk drive  1314 , magnetic disk drive  1316 , and/or optical disk drive  1320  can be connected to the system bus  1308  by a hard disk drive interface  1324 , a magnetic disk drive interface  1326 , and an optical drive interface  1328 , respectively. The interface  1324  for external drive implementations may include at least one or both of Universal Serial Bus (USB) and IEEE 1394 interface technologies. Other external drive connection technologies are within the scope of the disclosure. 
         [0038]    The drives and their associated computer-readable media may provide nonvolatile storage of data, data structures, computer-executable instructions, and so forth. For the computer  1302 , the drives and media may accommodate the storage of any data in a suitable digital format. Although the description of computer-readable media above refers to a HDD, a removable magnetic diskette, and a removable optical media such as a CD or DVD, it should be appreciated by those skilled in the art that other types of media which are readable by a computer, such as zip drives, magnetic cassettes, flash memory cards, cartridges, and the like, may also be used in an example operating environment, and further, that any such media may contain computer-executable instructions. 
         [0039]    A number of program modules can be stored in the drives and RAM  1312 , including an operating system  1330 , one or more application programs  1332 , other program modules  1334 , and/or program data  1336 . All or portions of the operating system, applications, modules, and/or data can also be cached in the RAM  1312 . It is to be appreciated that various commercially available operating systems or combinations of operating systems may be utilized. 
         [0040]    A user can enter commands and information into the computer  1302  through one or more wired/wireless input devices, e.g., a keyboard  1338  and a pointing device, such as a mouse  1340 . Other input devices may include a microphone, an IR remote control, a joystick, a game pad, a stylus pen, touch screen, or the like. These and other input devices are often connected to the processing unit  1304  through an input device interface  1342  that is coupled to the system bus  1308 , but can be connected by other interfaces, such as a parallel port, an IEEE 1394 serial port, a game port, a USB port, an IR interface, etc. 
         [0041]    A monitor  1344  or other type of display device may also connected to the system bus  1308  via an interface, such as a video adapter  1346 . In addition to the monitor  1344 , a computer typically includes other peripheral output devices, such as speakers, printers, etc. 
         [0042]    The computer  1302  may operate in a networked environment using logical connections via wired and/or wireless communications to one or more remote computers, such as a remote computer(s)  1348 . The remote computer(s)  1348  can be a workstation, a server computer, a router, a personal computer, portable computer, microprocessor based entertainment appliance, a peer device, and/or other common network node, and/or may include many or all of the elements descrisupport structure relative to the computer  1302 , although, for purposes of brevity, only a memory/storage device  1350  is illustrated. The logical connections depicted include wired/wireless connectivity to a local area network (LAN)  1352  and/or larger networks, e.g., a wide area network (WAN)  1354 . Such LAN and WAN networking environments are commonplace in offices and health care facilities, and facilitate enterprise-wide computer networks, such as intranets, all of which may connect to a global communications network, e.g., the Internet. 
         [0043]    When used in a LAN networking environment, the computer  1302  may be connected to the local network  1352  through a wired and/or wireless communication network interface or adapter  1356 . The adaptor  1356  may facilitate wired or wireless communication to the LAN  1352 , which may also include a wireless access point disposed thereon for communicating with the wireless adaptor  1356 . 
         [0044]    When used in a WAN networking environment, the computer  1302  can include a modem  1358 , or may be connected to a communications server on the WAN  1354 , or may have other devices for establishing communications over the WAN  1354 , such as by way of the Internet. The modem  1358 , which can be internal or external and a wired or wireless device, may be connected to the system bus  1308  via the serial port interface  1342 . In a networked environment, program modules depicted relative to the computer  1302 , or portions thereof, can be stored in the remote memory/storage device  1350 . It will be appreciated that the network connections shown are exemplary and other means of establishing a communications link between the computers can be used. 
         [0045]    The computer  1302  is operable to communicate with any wireless devices or entities operatively disposed in wireless communication, e.g., a printer, scanner, desktop and/or portable computer, portable data assistant, communications satellite, any piece of equipment or location associated with a wirelessly detectable tag, and/or telephone. This includes at least Wi-Fi and Bluetooth™ wireless technologies. Thus, the communication can be a predefined structure as with a conventional network or simply an ad hoc communication between at least two devices. 
         [0046]    Wi-Fi, or Wireless Fidelity, allows connection to the Internet from a couch at home, a support structure in a hotel room, or a conference room at work, without wires. Wi-Fi is a wireless technology similar to that used in a cell phone that enables such devices, e.g., computers, to send and receive data indoors and out; anywhere within the range of a base station. Wi-Fi networks use radio technologies called IEEE 802.11x (a, b, g, etc.) to provide secure, reliable, fast wireless connectivity. A Wi-Fi network can be used to connect computers to each other, to the Internet, and to wired networks (which use IEEE 802.3 or Ethernet). Wi-Fi networks can operate in the unlicensed 2.4 and 5 GHz radio bands. IEEE 802.  11  applies to generally to wireless LANs and provides 1 or 2 Mbps transmission in the 2.4 GHz band using either frequency hopping spread spectrum (FHSS) or direct sequence spread spectrum (DSSS). IEEE 802.11a is an extension to IEEE 802.11 that applies to wireless LANs and provides up to 54 Mbps in the 5 GHz band. IEEE 802.1 a uses an orthogonal frequency division multiplexing (OFDM) encoding scheme rather than FHSS or DSSS. IEEE 802.11b (also referred to as 802.11 High Rate DSSS or Wi-Fi) is an extension to 802.11 that applies to wireless LANs and provides 11 Mbps transmission (with a fallback to 5.5, 2 and 1 Mbps) in the 2.4 GHz band. IEEE 802.11g applies to wireless LANs and provides 20+ Mbps in the 2.4 GHz band. Products can operate in more than one band (e.g., dual band), so the networks can provide real-world performance similar to the basic I0BaseT wired Ethernet networks used in many offices. 
         [0047]    While example embodiments have been set forth above for the purpose of disclosure, modifications of the disclosed embodiments as well as other embodiments thereof may occur to those skilled in the art. Accordingly, it is to be understood that the disclosure is not limited to the above precise embodiments and that changes may be made without departing from the scope. Likewise, it is to be understood that it is not necessary to meet any or all of the stated advantages or objects disclosed herein to fall within the scope of the disclosure, since inherent and/or unforeseen advantages may exist even though they may not have been explicitly discussed herein.