Joint Support Apparatus

Field of the Invention:

The present invention relates to a joint support apparatus and, in particular, but not exclusively, to a joint support apparatus comprising a sleeve portion and a wrap-around brace portion.

Background to the Invention:

There are many joint support apparatus in existence today. Some simply comprise a support sleeve which is designed to support a joint by

compression of the joint, others include an exoskeleton structure to inhibit bending of the joint in one or more planes.

The simple support sleeves in existence today are made from elastic material, and when positioned so as to overlie a joint, will apply compression to that joint. Compression of the joint improves the stability of the joint.

Advancements in the field of support sleeves have resulted in sleeves which are configured to provide different levels of compression along the length of the sleeve. Such sleeves enable different levels of compression to be applied to different areas of the joint. While support sleeves are simple in concept, in practice they are difficult for the patient to apply to a joint, particularly if the patient has limited dexterity, strength or flexibility. In particular, due to friction between the support sleeve and the skin of the patient, a considerable amount of pulling force is required to position current support sleeves so that they overlie a joint. For example, in order to apply current support sleeves to a knee joint the patient is required to bend over and to reach their foot to thread their foot through the sleeve support. Following this the patient must apply a large pulling force to the sleeve to drag the sleeve over their foot and ankle and up along the lower leg.

Another currently used joint support apparatus includes a brace support apparatus which is formed of a wrap-around member which is designed to be wrapped tightly around a joint so as to support the joint. The wrap-around member may be fastened so it maintains its wrapped arrangement. While such brace supports do not require the user to bend over or apply a large pulling force, the compression provided by a brace support to a joint is poor in comparison to the compression which is provided by a support sleeve. Support apparatus for knee joints often include pads which can provide support to a patella. These can be doughnut-shaped or arch-shaped resilient pads which can encircle or partially encircle the patella. The pads are integral to the support apparatus and help to correct mal-positioning of the patella. However, in order for the pads to provide adequate support to a patella it is essential that the pad be positioned correctly relative to the knee joint while applying compression. In a brace support apparatus the position of the pad is dependant on the actual girth of the leg. Thus, the pads in brace support apparatus will not provide adequate support to a patella for all users. It is an aim of the present invention to obviate or mitigate one or more of the aforementioned disadvantages. Summary of the Invention:

According to a first aspect of the present invention there is provided a joint support apparatus for supporting a joint in a member, the joint support apparatus comprising:

a sleeve portion configured to provide support to a joint in use;

a wrap-around brace portion extensible above and below the sleeve portion, the wrap-around brace portion being configured to support to portions of the member above and below the joint when the joint support apparatus is in use.

The sleeve portion may be attached to the wrap-around brace portion by an attachment means. For example, the sleeve portion may be attached to the wrap-around brace portion by means of sewing or stitching with thread. To provide "support" to a joint means to add stability to that joint.

A "wrap-around brace portion" is a portion of the joint support apparatus which is configured so that it can be fully or partially wrapped around all or part of a member so as to compress all or part of that member, thereby providing support to all or part of that member or any joint in that member.

The sleeve portion may be a compressive sleeve. A compressive sleeve is a sleeve that can provide support to a joint by means of compression of the joint when the sleeve is positioned to overlie the joint.

The sleeve portion may be configured such that it can provide support to any joint. For example, the sleeve portion may be configured such that it can provide support to a knee joint, elbow joint, shoulder joint, finger joint, wrist joint, ankle joint or toe joint.

The sleeve portion may further comprise a patellar support structure.

Preferably, the patellar support structure is a patellar ring or patellar arc which is configured such that it can provide support to a patellar.

The sleeve portion may further comprise a location means which enables the user to repeatably position the sleeve portion in a predetermined position relative to a joint. Preferably, the location means enables the user to align the sleeve portion with a joint. Preferably, the location means enables the user to align the sleeve portion both axially and cirumferentially with respect to a joint. Preferably, the location means is a mark on the sleeve portion which is adapted for alignment with an anatomical landmark on the user.

The location means may be a linear mark which the user can align with a midline of a leg. The location means may be a circular or arcuate mark which the user can align with a patella. The location means may be a circular or arcuate mark which the user can align with a portion of a patella. The location means may be an arcuate mark which the user aligns with an upper portion of a patella. The location means may be an arcuate mark which the user aligns with a lower portion of a patella. The location means may be the patellar support structure. The sleeve portion may comprise elastic material. Preferably, the sleeve portion comprises elastic fabric material. The wrap-around brace portion may be fully or partially wrapped around all or part of a member so as to compress all or part of that member. Compression of all or part of the member may provide support to all or part of the member or any joint in that member.

The wrap-around brace portion may comprise at least a first flap member and a second flap member. Preferably, the first flap member extends above the sleeve portion when the joint support apparatus is in use and the second flap member extends below the sleeve portion when the joint support apparatus is in use. Preferably, the first flap member is arrangeable to provide support to a portion of a member which is above the joint, and the second flap member is arrangeable to provide support to a portion of a member which is below the joint. Preferably, the wrap-around brace portion comprises four flap members. The wrap-around brace portion may comprise a first and second flap member each of which extend above the sleeve portion when the joint support apparatus is in use and a third and fourth flap member each of which extends below the sleeve portion when the joint support apparatus is in use.

Preferably, the first and second flap members are co-operable to provide support to a portion of a member which is above a joint. Preferably, the third and fourth flap members are co-operable to provide support to a portion of a member which is below the joint.

Preferably, the wrap-around brace portion further comprises a securing means which may be used to secure the wrap-around brace in a wrapped position. The securing means may take any suitable form, for example the securing means may be a hook and loop fastener.

The wrap-around brace member may or may not be configured to define an aperture when in use. Where provided, the aperture is configured such that a portion of the user's body can extend through the aperture when the joint support apparatus is in worn. Preferably, the wrap-around brace member is configured to define an aperture through which a patella or elbow can extend. It is to be understood that the presence of such an aperture is not essential and may or may not be present. Where the wrap-around brace member is configured not to define an aperture in use, the brace member wraps completely around a joint when worn.

The wrap-around brace portion may further comprise auxiliary fasteners which are operable to further increase the compression applied to member. For example, the fasteners may comprise one or more straps each of which is co-operable with a corresponding buckle. A fastener may be pulled through a corresponding buckle to cause the further tightening of the wrap-around brace portion.

The wrap-around brace portion may be configured so that it at least partially overlaps the sleeve portion when the joint support apparatus is in use.

The wrap-around brace portion may be configured such that a least a portion thereof can directly contact the skin of the user when the joint support apparatus is in use. The wrap-around brace portion may comprise an elastic or substantially inelastic material. Preferably, the wrap-around brace portion comprises inelastic fabric material. The wrap-around brace portion may comprise one or more side-stays.

Preferably, the or each side-stay is removable from the wrap-around brace portion. The or each side-stay may further comprise a hinged joint which is operable to allow flexion of the side-stay.

The wrap-around brace portion may comprise one or more receiving members each of which is suitable for receiving an electrode.

Preferably, the or each receiving member is a stud.

The or each receiving member may be configured to allow an electrode to be snap fitted thereto. The or each receiving member may be configured to allow an electrode to be adhered thereto.

The or each receiving member may be integral to the wrap-around brace portion. The or each receiving member may comprise carbon.

The or each receiving member may comprise electrically conducting material. The or each receiving member may be configured such that it is suitable for making direct contact with the skin of a user when the joint support apparatus is in use. The wrap-around brace portion may comprise one or more electrodes provided integrally on the wrap-around brace portion.

Preferably, the or each electrode will be snap fitted to, or adhered to, a receiving member.

The or each electrode may be configured such that it is suitable for adhering to, or snap fitting to, a receiving member.

The or each electrode may be configured such that it is suitable for making direct contact with the skin of a user when the electrode is in use.

Preferably, the or each receiving member or integrally provided electrode(s) is located on the wrap-around brace portion such that electrodes received onto the receiving members will locate at pre-defined positions with respect to the joint when the joint support apparatus is in use. For example, when the joint support is a joint support apparatus which is suitable for providing support to a knee joint, four receiving members or integrally provided electrodes may be located on the wrap-around brace portion such that, when the joint support apparatus is in use, two electrodes can be located above the patella, one medial and one lateral relative to the patella, and two electrodes can be located below the patella, one medial and one lateral relative to the patella. Conveniently, wiring to the electrodes may be integrally provided with the wrap-around brace portion. For example, if the wrap-around brace is made from fabric the wiring to the electrodes may be integral to the fabric.

The sleeve portion may be configured so as to enable an electrode which is located on a receiving member, or an integrally provided electrode, to make direct contact with the skin of a user. Preferably, the sleeve portion comprises one or more cut-away portions to allow an electrode to make direct contact the skin of a user. The wiring may be led to a multi-pole connector, or a set of single pole connectors, to which the user can connect the electrotherapy generator.

In accordance with the invention, there is also provided a joint support apparatus suitable for providing support to a joint in a member, the joint support apparatus comprising,

a sleeve portion which is configured such that it can provide support to the joint when the joint support apparatus is in use;

a wrap-around brace portion which can extend above and below the sleeve portion and which is configured such that it can provide support to a portion of the member which is above the joint and to a portion of the member which is below the joint, when the joint support apparatus is in use.

In accordance with the invention there is also provided a kit comprising,

a sleeve portion which is configured such that it can provide support to the joint when the joint support apparatus is in use;

a wrap-around brace portion which can extend above and below the sleeve portion and which is configured such that it can provide support to a portion of the member which is above the joint and to a portion of the member which is below the joint, when the joint support apparatus is in use.

The kit may further comprise one or more electrodes suitable for attaching to the wrap-around brace member.

Brief Description of the Drawings:

An embodiment of the invention will now be described by way of example only, with reference to the accompanying drawings in which,

Figure 1 provides a perspective view of a joint support apparatus according to the present invention;

Figure 2 provides a perspective view of the joint support apparatus with electrodes attached thereto;

Figure 3 illustrates how the sleeve portion is attached to the wrap-around brace portion;

Figure 4 provides a side view of the joint support apparatus;

Figure 5 provides a frontal view of the joint support apparatus when in use. Detailed Description of the Drawings:

In the following example a joint support apparatus suitable for a knee joint will be described. It will be understood that the joint support apparatus according to the present invention could be provided for any other joint, such as, but not limited to, an elbow joint, wrist joint or ankle joint.

Figure 1 provides a perspective view of a joint support apparatus 1 according to the present invention. The joint support apparatus 1 is shown to comprise a sleeve portion 3 and a wrap-around brace portion 5. The sleeve portion 3 is shown to overlie a knee joint (not visible) of a leg member 7 of a user.

The length 'L' of the sleeve portion 3 is intentionally limited so as to correspond substantially to the length of the knee joint.

The sleeve portion 3 is made from an elastic fabric. The sleeve portion 3 is a compressive sleeve. The sleeve portion 3 compresses the knee joint so as to provide additional support to the knee joint.

The sleeve portion 3 comprises a patellar arc 9 which is configured to provide support to the patella of the knee joint of the user.

The wrap-around brace portion 5 has a length 'J'. The length 'J' of the wrap- around brace portion 5 is greater than the length 'U of the sleeve portion 3 and is thus greater than the length of the knee joint. The larger length 'J' of the wrap-around brace portion 5 ensures that the wrap-around brace portion 5 extends above and below the sleeve portion 3 and thus extends above and below the knee joint.

The wrap-around brace portion 5 is made from a substantially inelastic fabric. It will be understood that the wrap-around brace portion 5 could be made from any material, for example, the wrap-around brace portion 5 could be made from an elastic fabric.

The wrap-around brace portion 5 comprises a first flap member 11 and second flap member 13, each of which extend above the sleeve portion 3 and knee joint, and a third flap member 15 and fourth flap member 17, each of which extend below the sleeve portion 3 and knee joint.

Each of the four flap members 1 1 ,13,15,17 are interconnected by means of an intermediate portion 23. The intermediate portion 23 comprises opposing concave sides 25A, 25B.

Each of the first 1 1 and third 15 flap members comprise a hook patch 19 provided on an inner surface 21 A, 21 B of the first and third 5 flap members respectively. Each of the second 13 and fourth 17 flap members comprise a corresponding loop patch (not shown) on an outer surface. The hook patch 19 on the first flap member 1 1 is engagable with the loop patch on the second flap member 13 to secure the first flap member 1 1 to the second flap member 13. The hook patch 19 on the third flap member 15 is engagable with the loop patch on the fourth flap member 17 to secure the third flap member 15 to the fourth flap member 17. Securing the flap members

1 1 ,13, 15,17 in this manner ensures that the wrap-around brace portion 5 is maintained in a wrapped position around the leg member 7. The second flap member 3 and the fourth flap member are further provided with a plurality of receiving members in the form of carbon studs 27. Four carbon studs 27 are provided. The second flap member 13 comprises a pair of carbon studs 27 on an inner surface 29A thereof and the fourth flap member 17 comprises a second pair of carbon studs 27 on an inner surface 29B thereof. Each carbon stud 27 is suitable for receiving an electrode such that four electrodes can be connected to the wrap-around brace portion 5. Each of the studs 27 are located such that when the joint support apparatus is in use to support the knee joint, each electrode which has been received onto a respective stud will locate at pre-defined positions with respect to the knee joint. In the embodiment shown in figure 1 the studs 27 are positioned such that electrodes attached thereto will be suitably positioned for the application of transcutaneous electrical nerve stimulation (TENS) to the knee joint. The studs 27 are positioned such that when the joint support apparatus is in use, electrodes which have been placed on the studs 27 of second flap member 13 will locate above the patella, one medial and one lateral relative to the patella, and electrodes which have been placed on the studs 27 of fourth flap member 17 will locate below the patella, one medial and one lateral relative to the patella. It will be understood that any number or studs may be provided. It will be understood that the studs may be provided at different positions, for example a single stud may be provided directly above the patella, along a midline of the patella, and a single stud may be provided directly below the patella, along a midline of the patella.

It will be understood that the receiving members can take any suitable form and are not limited to studs. It will be understood that the wrap-around brace portion 5 is not limited to having four receiving members. Any number of receiving members may be provided. For example additional, or a lesser number of receiving members may be provided such that additional or a lesser number of electrodes can be attached to the wrap-around brace portion 5. Also, it will be understood that the receiving members can have any other suitable arrangement on the wrap-around brace portion 5. For example, receiving members could be arranged horizontally on the flap members 1 1 , 13,15,17.

Figure 2 provides a perspective view of the joint support apparatus 1 wherein electrodes 31 have been applied to each of the studs 27 on the respective inner surfaces 29A, 29B of second 13 and fourth 17 flap members. Each electrode 31 has been snap fitted onto a respective stud 27. The electrodes 31 are configured such that they are suitable for making direct contact with the skin of the user's leg member 7.

The electrodes 31 are suitably positioned for the application of

transcutaneous electrical nerve stimulation (TENS) to the knee joint, when the joint support apparatus 1 is in use. The electrodes 31 are positioned such that two electrodes 31 will locate above the patella of the knee joint, one medial and one lateral relative to the patella, and two electrodes 31 will locate below the patella of the keen joint, one medial and one lateral relative to the patella, when the joint support apparatus 1 is in use.

Figure 3 provides a perspective view of how the sleeve portion 3 and wrap- around brace portion 5 are attached to one another. The sleeve portion 3 is sewn or stiched, by means of thread, to the wrap-around brace portion 5 along a seam 15 at the back of the sleeve portion 3.

Figure 4 provides a side view of the joint support apparatus 1 shown in figures 1-3. Like features are awarded the same reference numerals. The wrap-around brace portion 5 is shown to comprise a first side stay 41 which is arranged to be positioned at a side of the knee joint when the joint support apparatus 1 is in use. A second side stay (not shown) is provided and is arranged to be positioned at an opposing side of the knee joint when the joint support apparatus 1 is in use. The side stays 41 provide rigidity to the wraparound brace portion 5. Each side-stay 41 comprises a hinged joint 43 which is operable to allow flexion of the side-stay. Each side stay 41 is housed in a pocket 37 which is defined in the wraparound brace portion 5. The pocket 37 opens at an end face 35 of the wraparound brace portion 5 to define an aperture 33 in the end face 35. Each side-stay 41 can be removed from its respective pocket through the aperture 33 so as to allow the joint support apparatus 1 to be used without the side stays.

Figure 4 also shows the first flap member 11 arranged to overlie the second flap member 13 and how the inner surface 29A of the second flap member 13 would thus directly contact the skin of the user's leg when the joint support apparatus 1 is in use.

The support member 1 can serve two purposes; it can be used simply to provide support to a joint; or it can be used with the electrodes (as shown in figure 2) for the application of transcutaneous electrical nerve stimulation (TENS).

To apply the joint support member for the purposes of providing support to the knee joint of leg member 7, the user first threads the leg member 7 through the sleeve portion 3. The user subsequently drags the sleeve portion 3 such that it passes over the foot and lower leg portion of the leg member 7. The user continues to drag the sleeve portion 3 over the leg member 7 until the sleeve portion 3 overlies the knee joint. In this position the sleeve member 3 will act to compress the knee joint thereby providing added stability to the knee joint. Additionally, the patellar arc 9 of the sleeve portion 3 will provide support to a patella of the user. The patellar arc 9 will also act as a location means which enables the user to repeatably position the sleeve portion 3 at a predetermined position with respect to a joint. As discusses above, due to frictional forces between the skin of the user and the sleeve support, the force required to move any sleeve support over a member (e.g. a leg member) is directly proportional to the surface area a sleeve. Unlike currently used sleeve supports, because the sleeve portion 3 of the present invention has a length which is limited to correspond

substantially to the length of the knee joint, the sleeve portion 3 of the present invention will have a smaller surface area compared to the surface area of the, much longer, existing sleeve supports. Thus, since the sleeve portion 3 of the present invention has a reduced surface area compared to currently used sleeve supports, the force required to drag the sleeve portion 3 into a position in which it overlies the knee joint will be less compared to the force required to drag exiting sleeve supports into the same position. After the sleeve portion 3 has been dragged into position the wrap-around brace portion 5 is then secured both above and below the knee joint by the user. To secure the wrap-around brace portion 5 above the knee joint the user first pulls the second flap member 13 across the portion of the leg member 7 which is directly above the knee joint. The inner surface 29A of second flap member 13 rests on the surface of the leg member 9 so that it directly contacts the skin of the user's leg member. While maintaining the second flap member 15 in position, the user tightly pulls the first flap member 1 1 across the leg member 7 in the opposite direction such that the first flap member 1 1 overlies the second flap member 13. In this manner the portion of the leg member 7 which is directly above the knee joint is compressed between the first 1 1 and second 13 flap members. Compression of the portion of the leg member 7 which is directly above the knee joint provides support to this portion of the leg member 7. The hook patch 19 on the inner surface 21 A of the first flap member 1 1 engages the loop patch on the outer surface of the second flap member 13 to secure the first flap member 1 1 to the second flap member 13. Once secured, the first flap member 1 1 and the second flap member 13 will be maintained in their wrapped position thereby ensuring that compression, and therefore support, of the region directly above the knee joint is maintained.

The third 15 and fourth 17 flap members are secured below the knee joint in a similar manner to which the first 1 1 and second 13 flap members are secured. The portion of the leg member 7 which is directly below the knee joint is compressed between the third 15 and fourth 7 flap members so that the area below the knee joint is supported. Thus, the first 1 1 and second 13 flaps are co-operable to provide support above the joint and the third 15 and fourth 17 flaps are co-operable to provide support below the joint when the joint support apparatus is in use.

Once the first 1 1 and second 13 flap members and the third 15 and fourth 17 flap member have each been secured, the wrap-around brace portion 5 will act to provide support to the areas of the leg member 7 which is directly above and directly below the knee joint. Together, the sleeve portion 3 and the wrap-around brace portion 5 provide support to the whole knee joint region of the leg member 7.

The side stays 41 on either side of the wrap-around brace portion 5 provide rigidity to the joint support apparatus 1. The side stays 41 will provide added support to the knee joint. The hinged joints 43 in each side stay 41 will allow the joint support apparatus 1 to flex, thus enabling the user to flex the knee joint once the joint support apparatus 1 has been applied. Optionally, the user can remove the side-stays 41.

To use the joint support apparatus 1 for the application of transcutaneous electrical nerve stimulation (TENS), the user applies the sleeve portion 3 as described above. Before the user wraps the wrap-around brace portion 5 about the leg member 7 they will first apply four electrodes 31 to each of the four studs 27 provided on the inner surfaces 29A,29B of the second 13 and fourth 17 flap members. Once the electrodes have been secured the user electrically connects each of the electrodes 31 to an electrotherapy generator.

Before the electrotherapy generator is activated the wrap-around brace portion 5 is first secured to the leg member 7 by securing first 1 1 and second 13 flap members and third 15 and fourth 17 flap members, as described above. Once wrap-around brace portion 5 is secured the electrodes will be forced to directly contact the skin of the user's leg member 7. The

compression force of the wrap-around brace portion 5 will enhance electrical coupling of the electrodes to the skin of the user's leg member 7. In present example two electrodes will locate above the patella, one medial and one lateral, and two electrodes below the patella, one medial and one lateral. This particular arrangement of electrodes is optimal for the application of transcutaneous electrical nerve stimulation (TENS) to the knee joint of the leg member 7. This particular arrangement of electrodes will also ensure that contact of the electrodes with sensitive regions of the leg member 7 (such as the tibial crest) is avoided.

Once the wrap-around portion 5 has been secured to the leg member 7 the user activates the electricity supply to electrically stimulate each of the electrodes. The electrodes in turn conducted electrical impulses to the knee joint.

Figure 5 provides a frontal view of the joint support apparatus 1 when in use to provide support to the knee joint of the leg member 7. As shown in figure 5 the opposing concave sides 25A, 25B of the intermediate portion 23 of the wrap-around member 5 co-operate to define an aperture 47 through which the patella region of the knee joint extends. The intermediate portion 23 is thus shown to overlap most, but not all, of the sleeve portion 3 when the first 1 1 and second 13 flap members flap members, and the third 5 and fourth 17 flap members have been secured to one another. The aperture 47 provides for improved mobility of the knee joint and improves comfort.

The wrap-around brace portion 5 is shown to further comprise a fastening means in the form of straps 51 , 52 and buckles 55, 57. It will be understood that the fastening means may take any other suitable form. Figure 5 shows a first strap 51 which is attached to the first flap member 1 1 at a seam 52. A corresponding first buckle 55 is provided on the second flap member 13. The first buckle 55 is configured to receive the first strap 51. A second strap 53 is attached to the third flap member 15 at a seam 54. A corresponding second buckle 57 is provided on the fourth flap member 17. The second buckle 57 is configured to receive the second strap 53. In use, once the first flap member 1 1 has been secured to the second flap member 13 to compress the region above the knee joint, the user can subsequently thread the first strap 51 through the first buckle 55. Pulling on the first strap 51 after it has been threaded through the first buckle 55 will further increase compression of the region above the knee joint. Compression of the region below the knee joint can be increased in a similar manner using the second strap 53 and its corresponding second buckle 57. Advantageously, the straps 51 , 53 and corresponding buckles 55,57 allow the user to optionally increase the compression force applied to the regions above and below the knee joint. It will be understood that any number of straps and buckles may be provided.

Various modifications and variations to the described embodiments of the invention will be apparent to those skilled in the art without departing from the scope of the invention as defined in the appended claims. Although the invention has been described in connection with specific preferred embodiments, it should be understood that the invention as claimed should not be unduly limited to such specific embodiment.