AN APPARATUS TO ASSIST SQUATTING ON TOILETS Field of the Invention.

The present invention relates generally to devices for maintaining postures or attitudes particularly in bowel and bladder movements or evacuations. Background Art.

The purpose of this invention is to provide the option of 3 positions during toileting:

1. The "correct" position: feet flat, lean forward - for people who cannot squat, for children and others, also called the "Perfect Pee" position.

2. The near squat position: for improved bowel and bladder evacuation in case of lack of flexibility and for children or people unable to squat.

3. The squatting position: a safe, robust piece of equipment to allow "full squatting" safely using existing toilet structures, thus preventing major construction changes. Virtually every physician and physiologist who has considered the subject agrees that squatting is one of the most natural and physiologically sound postures to use for evacuation.

Recent papers published by Rane et al and Gupta et al. show the benefits of squatting when urinating. Wennergren et al in 1984 have showed the benefits of foot support and leaning forward in children with bladder and bowel problems. Also a recent paper by El - Bahnasawy shows men urinate better in the sitting and leaning forward position than standing. All this research confirms the importance of squatting and foot support during urination in men, women and children. It has also been proven quantitatively in a research study by Devreese et al. 2000 that irregularities during micturition are less frequent in the forward- bending and anterverted positions and was concluded that the forward bending position is the most preferred urinating position to relax pelvic floor muscles.

There have been attempts in the past to configure toilets for use in the squat position or to assist users to adopt the squat position. One example is disclosed in International Patent Publication No. WO 2006/137047. This document teaches a

water closet comprising a platform mountable over the toilet bowl and formed with a main opening therethrough aligned with the toilet bowl, said platform being constructed to support a user in a natural squatting defecation posture over said opening and over the toilet bowl, the middle front of a said platform in front of main opening occupied by a folded pan located to serve as urinal pan when the user is in the squatting position, .said pan include side and front shields which are in operative vertical position prevent urine splashing outside of the urinal pan, the side shields mounted pivotally to said platform at the borders of pan to either operative approximately vertical or inoperative horizontal position, said front shield mounted pivotally in front of urinal pan to either operative vertical or to inoperative folded on the floor of urinal pan or on the backs of side shields position, said urinal pan include ropes which are connecting with one end to outer faces of side shields and with the other end to outer face of front shield thus securing concordant transverse of front and side shields from inoperable to operable position and vice versa. Whilst directed to overcoming the problem, this device has a number of disadvantages including its complex nature, its lack of adjustment to account for people (and toilet pedestals) of different heights, and its intrusive aesthetic nature.

It will be clearly understood that, if a prior art publication is referred to herein, this reference does not constitute an admission that the publication forms part of the common general knowledge in the art in Australia or in any other country.

Summary of the Invention.

The present invention is directed to an apparatus to assist squatting on toilets, which may at least partially overcome at least one of the abovementioned disadvantages or provide the consumer with a useful or commercial choice. With the foregoing in view, the present invention in one form, resides broadly in an apparatus for assisting a person in assumption of a beneficial position for evacuations when using a toilet, the apparatus including a platform adapted to raise a user's feet from the ground surface, the platform having at least one height adjustment means associated therewith and an opening therein to at least partially receive a portion of the toilet or bowl.

In a second form, the invention resides in a method for assisting a person in assumption of a beneficial position for evacuations when using a toilet, the method including the steps of providing a platform adapted to raise a user's feet from

the ground surface, the platform having at least one height adjustment means and an opening therein to at least partially receive a portion of the toilet or bowl and positioning the platform at least partially about a toilet or bowl and adjusting the height of the platform such that a user assumes at least a partial squat position. Use of the device of the present invention will preferably position the user's pelvis in the optimum position for evacuation, either micturition or defecation. The optimum position is forward bending, anteversion or near squat (knees above the Anterior Superior Iliac Spine (ASIS)) with a full squat more preferred, but fewer users, particularly Western users, will be physically able to assume this position. The position assumed will therefore typically be forward bending and anteverted and as close as possible to a full squat.

The device finds application with either western toilets having a pedestal extending above the ground level or Asian-style toilets in which the toilet is recessed into the ground and the opening is approximately at ground level. When used with Asian-style toilets, the device will normally be used in the fully collapsed or retracted condition and the opening of the device placed adjacent the opening of the toilet.

The apparatus of the present invention includes a platform. The platform will typically include a substantially planar upper surface. The platform will also preferably be suitably sturdy in order to maintain its shape and position under the weight of a person, even if the entire weight of the person is placed on to the platform. According to a particularly preferred invention, the platform is typically rated to 150 kg-

Normally, the upper surface of the platform will be adapted to have a user's feet placed thereon during use. The upper surface of the platform may therefore

• be provided with marking indicia to indicate that the "correct" position of the feet during use. There may be different indicia provided for use of the platform on by a child in contrast to use by an adult. The marking indicia may be of any form, including embossing the marking indicia onto the surface. Alternatively, the marking indicia may be depressions. Preferably, the marking indicia will be foot-shaped markings.

The platform is preferably provided with arcuate edges in order to minimise the chance of injury to a user when using the apparatus. The platform may

be of any shape, although a generally rectangular shape when viewed in plan is preferred. In this form, the platform will normally have a pair of side edges, a front edge and upper and lower surfaces. The front corners of the platform will generally be rounded when viewed in plan. The apparatus also includes at least one height adjustable means in order to adjust the separation distance of the platform from the ground or floor surface. Normally a plurality of height adjustable means will be provided. Typically, the height adjustable means are provided beneath the platform.

Preferably, a height adjustable means is provided at or adjacent to each corner of the platform and/or spaced about the platform in order to stabilise the platform, particularly during use. The height adjustable means may also be used to allow for any irregularity in the surface of the floor or ground such that the platform is maintained in a substantially horizontal orientation for use.

It is particularly preferred that the height adjustable means are fixable or lockable to at least temporarily fix the height of the platform. Normally, the height adjustable means will allow the platform to be fixed at a number of predetermined heights, such as at approximately 80 mm, approximately 150 mm, approximately 230 mm and approximately 400 mm. Normally, the maximum height at which the platform can be located will be at or slightly beneath the upper edge of the toilet bowl. Most countries have a reasonably standard height of toilet bowl and the apparatus of the invention is preferably adaptable to suit.

According to the above, locking means may be provided for each height adjustable means.

According to a particularly preferred embodiment, the height adjustable means include telescoping legs or similar. It is further preferred that the telescoping legs be provided with enlarged lower portions in order to improve stability and also to spread the load over a large area.

Alternatively, the height adjusting means may include one or more scissor-action extendible portions to raise and lower the height of the platform. The height adjustment means will also preferably be provided with a movement prevention/safety device adapted to prevent the platform being raised or lowered if bearing a weight above a threshold limit. The threshold limit will normally

be quite low particularly given that the apparatus of the present invention can be used by children.

The platform included in the present invention includes an opening to at least partially receive a portion of the toilet opening or bowl. The opening will normally be in a rear portion of the platform. The opening may have any shape, but will preferably have an at least partially arcuate portion given that most toilet bowls have a rounded appearance. The opening will normally be shaped and sized to fit a majority of toilets. A portion of the opening may in use, abut the toilet or bowl but this is not necessarily the case. However, a portion of the opening/platform will preferably abut the toilet or bowl when the platform is raised in order to stabilise the platform.

The apparatus of the invention preferably further includes a substantially planar foot portion. The foot portion preferably corresponds in size and shape to the platform. Normally, the height adjustment means are located between the foot portion and the platform, that is, preferably extend between an upper portion of the foot portion and a lower portion of the platform. According to an embodiment, a lower portion of the height adjustable means may extend partially into or through the foot portion.

According to a particularly preferred embodiment, the platform and foot portion will contain the height adjustment means when the platform is fully lowered. When fully lowered, the platform and foot portion will normally form an apparatus of approximately 80-100 mm in height.

The platform and/or the foot portion may be provided with opening(s) therein in order to receive the collapsed height adjustment means. The platform may be provided with handles in order to assist the user with maintaining their balance on the apparatus.

It is also preferred that the apparatus of the present invention may be adapted to support the user's weight such that the user does not contact the toilet bowl or opening during use of the device. The foot portion will also preferably have an opening to at least partially receive the toilet opening or bowl. The opening in the foot portion will preferably be shaped similarly to the opening in the platform although the openings may not necessarily have the same shape. In particular, the opening in the foot portion

is preferably shaped to abut the toilet in order to assist with the correct positioning of the apparatus relative to the toilet for use.

Normally, the height adjustment means/legs are attached to both the platform and foot. Such attachment may be either temporary or permanent attachment.

The apparatus a further include one or more lifting mechanisms. In use, the lifting mechanisms will typically provide a positive lifting force for the platform in order to raise the platform above ground level should this be required. Preferably, the lifting mechanisms may be biased into an extended condition. Further, the lifting mechanisms will preferably have a locking means in order to lock the lifting mechanisms at any level or degree of extension. Although the lifting mechanisms may have any form, according to a most preferred embodiment, gas springs or a similar hydraulic ram mechanism will be used.

In use, the apparatus of the invention is placed adjacent a toilet and the platform is raised to a height which, when a user places their feet on the platform in the designated positions, the user will by default, assume at least partially squatting position in order to achieve the advantages of this position. The height of the apparatus may be adjusted to assume a more shallow or more deeply squatting position. This adjustment can provide advantages for a number of reasons including the ability to adjust the height of the platform in order that a user to become comfortable in assuming a squat position and adjusting the depth of the squat as required.

However, some users, for example women and children, may have difficulty in achieving a full squat, even though the full squat position is most beneficial for women in particular. The adjustable nature of the invention allows a gradual increase in the depth of squat achieved. It also allows a comfortable depth squat to be assumed.

The invention preferably therefore provides an apparatus and method of use thereof which assists a user to assume three main positions, namely the "correct", semi-squat and full squat positions, but any intervening position as well due to the adjustable nature of the device. The apparatus can be adjusted to suit use by children, females and males to account for their different anatomy and idiosyncratic factors

such as flexibility and comfort in different depth squat positions.

Advantages of Squatting and Near Squatting

1. Makes elimination faster, easier and more complete. This helps prevent "fecal stagnation," a prime factor in colon cancer, appendicitis and inflammatory bowel disease.

2. Protects the nerves that control the prostate, bladder and uterus from becoming stretched and damaged.

3. Securely seals the ileocecal valve, between the colon and the small intestine. In the conventional sitting position, this valve is unsupported and often leaks during evacuation, contaminating the small intestine.

4. Relaxes the puborectalis muscle which normally chokes the rectum in order to maintain continence.

5. Uses the thighs to support the colon and prevent straining. Chronic straining on the toilet can cause hernias, diverticulosis, and pelvic organ prolapse.

6. A highly effective, non-invasive treatment for hemorrhoids, as shown by published clinical research.

7. For pregnant women, squatting avoids pressure on the uterus when using' the toilet. Daily squatting helps prepare one for a more natural delivery. 8. Bladder function improves in the "correct" and near squat position along with the squat position by preventing stagnation.

9. Good foot support and elevation helps cure bowel and bladder problems in children.

Brief Description of the Drawings. Various embodiments of the invention will be described with reference to the following drawings, in which:

Figure 1 is a view from the side of a male in the traditional full squat position.

Figure 2 is a schematic view of the difference in the position of the puborectalis muscle in the sitting position contrasted with the position in the squat position.

Figure 3 is a front elevation view of an apparatus according to a

preferred embodiment of the present invention in a raised condition.

Figure 4 is a view from above of the apparatus illustrated in Figure 3.

Figure 5 is a front elevation view of the apparatus illustrated in Figure 3 in the collapsed condition. Figure 6 is a perspective view from below of the apparatus illustrated in Figure 5.

Figure 7 is a perspective view from above of the apparatus illustrated in Figure 3.

Figure 8 is a view from the side of the apparatus illustrated in Figure 3. Figure 9 is a front elevation view of a male seated on a toilet and using a device according to a first preferred embodiment of the present invention.

Figure 10 is a perspective view of a male seated on a toilet and using the device illustrated in Figure 9.

Figure 11 is a side elevation view of a male seated on a toilet and using the device illustrated in Figures 9 and 10.

Figure 12 is a front elevation view of a male seated on a toilet and using a device according to a second preferred embodiment of the present invention.

Figure 13 is a perspective view of a male seated on a toilet and using the device illustrated in Figure 12. Figure 14 is a side elevation view of a male seated on a toilet and using the device illustrated in Figures 12 and 13.

Figure 15 is a front elevation view of a male seated on a toilet and using a device according to a third preferred embodiment of the present invention.

Figure 16 is a perspective view of a male seated on a toilet and using the device illustrated in Figure 15.

Figure 17 is a side elevation view of a male seated on a toilet and using the device illustrated in Figures 15 and 16.

Figure 18 is a perspective view of a male seated on a toilet and using a device according to a fourth preferred embodiment of the present invention. Figure 19 is a front elevation view of a male seated on a toilet and using the device illustrated in Figure 18.

Figure 20 is a side elevation view of a male seated on a toilet and using the device illustrated in Figures 18 and 19.

Figure 21 is a front elevation view of a child seated on a toilet and using a device according to a fifth preferred embodiment of the present invention.

Figure 22 is a perspective view of a child seated on a toilet and using the device illustrated in Figure 21. Figure 23 is a side elevation view of a child seated on a toilet and using the device illustrated in Figures 21 and 22.

Figure 24 is a perspective view of a female seated on a toilet and using a device according to a sixth preferred embodiment of the present invention.

Figure 25 is a front elevation view of a female seated on a toilet and using the device illustrated in Figure 24.

Figure 26 is a side elevation view of a female seated on a toilet and using the device illustrated in Figures 24 and 25.

Figure 27 is a perspective view of a female seated on a toilet and using a device according to a seventh preferred embodiment of the present invention. Figure 28 is a front elevation view of a female seated on a toilet and using the device illustrated in Figure 27.

Figure 29 is a side elevation view of a female seated on a toilet and using the device illustrated in Figures 27 and 28.

Figure 30 is a perspective view of a female seated on a toilet and using a device according to a eighth preferred embodiment of the present invention.

Figure 31 is a front elevation view of a female seated on a toilet and using the device illustrated in Figure 30.

Figure 32 is a side elevation view of a female seated on a toilet and using the device illustrated in Figures 30 and 31. Figure 33 is a perspective view from the side from slightly above of a device of a further preferred embodiment.

Figure 34 is a perspective view from the side from slightly behind of a device as illustrated in Figure 33.

Figure 35 is a front view of the device as illustrated in Figure 3334. Figure 36 is a rear view of the device as illustrated in Figure 33.

Figure 37 is a top view of the device as illustrated in Figure 33. Detailed Description of the Preferred Embodiment. According to a particularly preferred embodiment of the present

invention, an apparatus 10 for assisting a person in assumption of the near and/or full squat position for evacuations is provided.

The apparatus as illustrated in Figures 4 to 9 includes a platform 11 adapted to raise a user's feet from the ground surface, the platform 11 having height adjustable legs 12 associated therewith and an opening 13 therein to at least partially receive a portion of the toilet 14 or bowl 15.

The platform include a substantially planar upper surface with foot- shaped marking indicia 16 to indicate that the "correct" position of the feet during use. There are two sets of marking indicia provided for use on the platform illustrated, one set for use by a child and one set for use by an adult.

The platform 11 is generally rectangular shape when viewed in plan having a pair of side edges, a front edge and upper and lower surfaces. The front corners of the platform 11 will generally be rounded when viewed in plan as illustrated in Figure 5 in particular. The apparatus also includes a plurality of height adjustable legs 12 in order to adjust the separation distance of the platform 11 from the ground or floor surface. A leg 12 is provided at or adjacent to each corner of the platform 1 1 in order to stabilise the platform 11, particularly during use.

It is particularly preferred that the legs 12 are lockable to at least temporarily fix the height of the platform 11. Normally, the height adjustable legs of the preferred embodiment allows the platform 11 to be fixed at a number of predetermined heights, such as at approximately 80 mm, approximately 150 mm, approximately 230 mm and approximately 400 mm as are illustrated in Figures 10 to

33. Normally, the maximum height at which the platform can be located will be slightly beneath the upper edge of the toilet bowl as illustrated in Figures 19 to 21.

According to the illustrated embodiment, the height adjustable legs 12 are telescoping legs with enlarged lower portions 17 in order to improve stability and also to spread the load over a large area. The height adjustment is important as in a recent trial of the device of the present invention, only two thirds of women and children could actually perform a full squat.

Although not illustrated, the height adjustment legs of the illustrated embodiment are also provided with a safety device adapted to prevent the platform 11 being raised or lowered if bearing a weight above a threshold limit.

The platform 11 included in the present invention includes an opening

13 to receive a portion of the toilet pedestal 14 or bowl 15. The opening 13 is in a rear portion of the platform 1 1. The opening 13 is shaped and sized to fit a majority of toilets. A forward edge of the opening 18 abuts the toilet pedestal 14 or bowl 15 particularly when the platform 11 is raised in order to stabilise the platform 1 1.

The illustrated apparatus further includes a substantially planar foot 19.

The foot 19 corresponds in size and shape to the platform 1 1. The platform 1 1 is provided with openings therein in order to receive the collapsed height adjustment legs 12. The height adjustment legs 12 are located between the foot portion 19 and the platform 11, that is, the legs 12 extend between an upper portion of the foot 19 and the platform 11.

According to a particularly preferred embodiment, the platform 1 1 and foot 19 contain the height adjustment legs 12 when the platform 11 is fully lowered. When fully lowered, the platform and foot portion will normally form an apparatus of approximately 80-100 mm in height as illustrated in Figures 6 and 7.

The foot 19 also has an opening to at least partially receive the toilet pedestal 14 or bowl 15. The opening in the foot 19 of the illustrated embodiment is shaped similarly to the opening 13 in the platform 11.

An alternative device is illustrated in Figures 33 to 37. The approximate dimensions of the illustrated device are: 1> Minimum height : 80mm 2> Maximum height : 400mm 3> Width : 690mm 4> Length : 510mm 5> Footrest width : 151mm

The vertical elevation of the device can be adjusted anywhere between 80mm and 400mm. (400mm being the global standard height for toilet seats).

Two gas springs 80 are used to balance the load the user on the device. Only one gas spring 80 is lockable, thus avoiding the tilting of the device that could occur due to mismatch in locking of the 2 gas springs 80 at a later point of time.

Mild steel has been used for the fabrication of the alpha prototype in order to produce a low cost initial prototype and test the concept of the design. Nylon has been used for the rollers for the scissor legs in order to minimize friction and have

a smooth sliding operation.

After a sufficient and satisfactory testing cycle, PVC can be used for the upper and lower plates with a 5mm rubber surface at the bottom to avoid the lateral movement of the device when being used. PVC was selected basically because of the following reasons: 1> Water resistant 2>Ease of moulding into complex shapes.

The main difference with the embodiment illustrated in Figure 33 to 37 is the inclusion of the scissor mechanism legs 81 between the foot 19 and the platform 11 and the inclusion of the gas springs 80. The gas springs 80 are biased into the extended configuration and may be forced into the retracted configuration through the application of sufficient force once the gas springs 80 have been unlocked.

The legs are typically baced against lateral movement by the provision of crosspieces 82 extending between the legs at an upper and lower point. These crosspieces may also be used to attach the platform 11 and the foot 19 to the scissor legs 81.

The gas springs 80 are lockable at any measure of extension and upon unlocking will tend to a fully extended condition, unless force is applied to retract the gas springs 80. It can be seen from the embodiment illustrated in Figures 33 to 37 that the gas springs 80 of the illustrated embodiment extend at an angle between the foot 19 and the platform 11. Each of the respective ends of the gas springs 80 will preferably be pivotally attached to the foot 19 and the platform 11. This will allow the device to be decreased in height much more than if the gas springs 80 were provided in a substantially vertical orientation.

It is also evident from the illustrated embodiment of the gas springs are oriented substantially parallel to one of the legs of the scissor mechanism. This may provide additional support and stability to the device.

In the present specification and claims (if any), the word "comprising" and its derivatives including "comprises" and "comprise" include each of the stated integers but does not exclude the inclusion of one or more further integers.

Reference throughout this specification to "one embodiment" or "an embodiment" means that a particular feature, structure, or characteristic described in

connection with the embodiment is included in at least one embodiment of the present invention. Thus, the appearance of the phrases "in one embodiment" or "in an embodiment" in various places throughout this specification are not necessarily all referring to the same embodiment. Furthermore, the particular features, structures, or characteristics may be combined in any suitable manner in one or more combinations.