This invention relates to orthopedic cushions in general, and more specifically to orthopedic wheelchair or other chair or seat cushions.
A well-recognized problem for individuals who are forced to spend extended time seated in wheelchairs or other chairs or seats is the risk of incurring tissue damage, and ultimately the development of decubitus ulcers, at those points on the body that are subject to constant pressure. Decubitus ulcers expose an individual to the risks of infection and irreversible tissue damage, and in any case are difficult to treat. For wheelchair-bound persons, such ulcers typically develop over the bony prominences exposed to pressure while the person is seated, such as the ischia (bony prominences of the buttocks) and the trochanter. Another problem for such individuals is a lack of stability accompanied by a sense of physical insecurity while seated in a wheelchair, and particularly while being moved about in a wheelchair.
There are known to the art, wheelchair cushions that attempt to address these problems by reducing pressure on restricted areas of tissue over bony prominences and redistributing pressure more uniformly over a larger surface area of the buttocks and back of the thighs. Such cushions may include cushions having shaped foam bases and with a cushioning layer on the base. However, a continuing problem for the cushion user is a sense of discomfort, particularly in the trochanter region, due to a transition between the cushioning layer and the base. The transition typically feels like a bump or ridge beneath the upper thighs and, while it does not usually cause tissue damage, is a constant source of discomfort and annoyance to the user. A need therefore exists for a wheelchair or other seat or chair cushion that adequately relieves pressure on pressure points in the regions of the ischia and trochanter, provides the user a sense of stability and security, while at the same time reduces or eliminates the discomfort and annoyance associated with the transition between components of the base.
In an exemplary embodiment, a multi-layer cushion includes a shaped orthotic base, which may be foam or other acceptable material, on which is disposed a cushion layer of interconnected air cells in an array projecting upwardly from the base, wherein the air cells are not uniform in size and shape across the entire array but instead are modified in size and shape along edges of the air cell layer that are adjacent to upwardly projecting portions of the foam base, so that the tops of the air cells are approximately equal in height to the tops of the upwardly projecting portions of the foam. The modified array with air cells of varying size and shape in certain regions adjacent to upwardly projecting portions of the foam reduce the discomfort and annoyance associated with the user's sensation of what would otherwise be an abrupt, uncomfortable transition between the air cells and the foam base. The cushion includes a cover with a lower compartment for the foam base and an upper compartment for the air cell layer. The cover functions to keep the air cell layer properly in place on the foam layer.
One preferred embodiment of the cushion and cover assembled and ready for placement on a support surface is indicated generally by reference number 10 in FIG. 1. As can be seen, the preferred embodiment of cushion 10 has a generally rectangular configuration having a front edge 12, a side edge 14 and opposed side edge 16 and a rear edge 18 with truncated corners 20 and 22 between the rear edge 18 and the two side edges 14 and 16, respectively. The truncated corners facilitate positioning of cushion 10 on a support surface (not shown), such as a seat of a wheelchair or conventional chair, as will be understood. Cushion 10, when assembled, has a seating surface to accommodate the buttocks of a user, indicated generally by reference numeral 24. It will be appreciated that the cushion of the present invention can have other configurations dictated by the environment in which it is employed, without departing from the scope of the invention
In a preferred embodiment, base 26 is a foam base, shown in
Bolster 44 includes a facing edge 49 that is angled downwardly toward the front edge of the base. Bolster 44 with its angled support surface 46 provides raised but gently sloping support beneath the thighs while the lower plateau in the portion of the cushion that bears the greatest weight, i.e. surface 48, to accommodate the human buttocks shape. The angled facing edge 49 provides a more comfortable surface for the user's thighs and, with cells of the inflatable cushion 28, forms a transition zone to enhance comfort. There is a pommel 50 on the front bolster to fit between the user's thighs and separate and angle the legs in a comfortable position and to stabilize the user's pelvis.
A first lateral bolster 51 is positioned along edge 34 and a second lateral bolster 52 is positioned atop and along edge 36. The lateral bolsters positioned along the side edges provide support at the sides of the cushion to conform to the shape of the human buttocks and provide lateral stability. Lateral bolsters 51 and 52 are mirror images. Each is substantially wedge-shaped and has an interior support surface 54 that slopes downwardly and inwardly toward support surface 48. Each lateral bolster extends nearly the entire length of the side as shown in
In an exemplary embodiment, base 26 is formed from urethane foam. Sections of the base can be formed from foam of varying firmness. For example, the main section of the foam base, including support area 48, has relatively firmer foam in the mid portion and the lateral bolsters and relatively softer foam beneath the thighs. The base can be molded or formed from one piece of material or the various sections, for example the bolsters, can be formed separately and attached, glued or bonded together to form base 26. Although preferably formed from foam material, base 26 can be formed or molded from other materials, depending upon the support characteristics desired, such as gel, molded plastic, fiberglass or even wood, without departing from the scope of the invention.
The rear edge of base 26 in the illustrated embodiment has truncated corners 55, 56, shaped to fit into the curve of a wheelchair backrest, as explained above in reference to FIG. 1. The dimensions of the foam cushion are adapted to accommodate a variety of human body sizes, and the foam contours are adaptable to fit a large proportion of users of a particular cushion size.
The cushion includes a shock-absorbing layer, which, in a preferred embodiment is an air cell layer 28. Air cell layer 28 is comprised of an inflatable air cell cushion having flexible base 57 with individual air-filled cells 58 in an array. Generally, the cells 58 are parallel to each other and arranged on the base 56 in an array comprised of transverse and longitudinal rows of cells. The air cells 58 are fabricated from a resiliently flexible inflatable material such as neoprene, plastic or the like. The air cell layer 28 can be formed by conventional dip molding or vacuum molding.
It will be noted that, regardless of the configuration of the cell, each individual cell 58 is a four-finned collapsible or foldable cell. The foldable aspect of the cell is important in that it allows the cells to be spaced far enough apart to facilitate molding and to provide a reasonable amount surface area between the cells to permit solid bonding of top of the cushion to the bottom layer. The foldable four-fin design allows the cells to expand when inflated until they touch forming a continuous support surface.
Generally air cell layer 28 is dip molded from neoprene, as explained above. On the other hand, the cushions can be vacuum molded from a plastic material with the cells closer together than when dip molding and while avoiding thinning. Vacuum molding of plastic materials is simpler and less expensive than dip molding of neoprene. The cell geometry allows cells of any configuration to be vacuum molded, making individual seat cushions of differing cell configurations commercially feasible. The cell designs allow for pre-contoured seating surface that can be achieved by using different sizes and heights of cells.
The volume of air within the air cells 58 is adjustable and the cells are interconnected through flexible base 57 so that air flows from cell to cell. The cells are inflated by means of an inflation tube 60, which is in fluid communication with one of the interconnected cells 58. Tube 60 includes a manually operated open and close valve 62. When the air is introduced through tube 60 is flows from cell to cell so that the pressure in the cells is equalized. The air cells exert a generally uniform force on the buttocks and legs of a user. On the other hand, the cells of the array can be divided into individual inflation zones, each zone inflated to a desired pressure.
When the cushion is in use by a seated user, the air-filled cells deform under the weight load to equalize forces and conform closely to the shape of the user's body, thereby reducing the deformation of skin tissue. The shape of the air cells, for example a modified cruciform shape as shown in the figures, is selected to deform without any resistance other than the volume of air within. The height of the cells is adaptable to accommodate the differences in body contours.
In the illustrated embodiment, the air cells are not uniform in size and shape across the entire array, but instead are in some portions of the cushion tapered or reduced in height so that the tops of the air cells when disposed on the foam base are approximately equal in height to adjacent, upwardly projecting cells or portions of the foam base, such as the front bolster, as shown in FIG. 10. This arrangement of rows of cells of varied sizes can be seen in
For example, in one embodiment the first row 64 of air cells in the array, positioned along the front edge of the foam base, is reduced in height relative to the remaining cells in the array. This provides that the transition between the front row of air cells 64 and the front edge of the foam base is barely perceived by the user, and the front edge of the foam base adjacent to the modified air cells comes into contact with the user. More specifically, in the illustrated embodiment, the air cells 58 of the first row of air cells 64 that are disposed along the front edge of the foam base, beneath the thighs, have a reduced height and a wedged shape, as at 65. The air cells of such a geometry provide a smooth transition from the air cell layer to the downwardly angled facing edge 49 of the base foam structure to provide added comfort beneath the thighs, reducing or eliminating the user's sense of a bump or ridge.
A second row 66 of cells 58 of reduced height positioned adjacent the first row 64 forms a transition area between the front bolster and first row of cells and the next three rows of cells, 68, 70, 72. Referring to
Air cell layer 28 includes a pair of rear cells 80, 82 along the rear edge of the air cell layer. Cells 80 and 82 are generally elongated rectangles and can be greater in vertical height than the other cells of the array. These larger cells form a rear bolster when the air cell layer is positioned on the base.
The modified air cells more closely match the profile of the adjacent portions of the foam base, thus reducing the feel of the transition between the air cell layer and the foam base. Further, the array of air cells can include a gradual successive change in the height or profile of each successive row of air cells, to more gradually change the profile of the cushion. As shown in
The unique design of the front transition rows of cells already has been discussed. It will be appreciated that the cell size and arrangement of cells in the inflatable cushions illustrated are one exemplary shown to work well in the instant invention. However, the various numbers of cells, sizes of cells and arrangements of cells in rows may be varied to suit the needs of a user. Any cushion layer design is intended to be encompassed by the scope of the invention. Furthermore, the multi-layer cushion can be constructed so that the upper deformable layer comprises a material other than an air cell cushion 28. For example, the upper layer could be comprised of cells filled with elastomeric gel. The layer could be configured form a gelatinous cushioning media or gelatinous elastomer formed in a honeycomb arrangement or in columns or any other material of resilient, shock-absorbing deformable material that can be used to produce a deformable yet resilient layer that fits appropriately with the base and cooperates with the base to provide the desired smooth translational areas between the upper layer and the base.
An outer cover 30 fits over the air cell layer 28 and base 26 and holds the two layers in place relative to one another. One embodiment of a cover design is shown in
The inner compartment 94 is subdivided by a flexible cloth or polymer middle panel 96 that divides the cover into an upper compartment or pocket 98 and a lower compartment or pocket 100. There is an inner zipper 102 comprised of opposed, interengaging toothed tracks 102A, 102B that attaches the edge of the middle panel 96 to the inside of the upper panel so as to close the upper compartment. A main outer zipper 103 comprised of opposed interengaging toothed tracks 103A and 103B extends from side panel to side panel and transects the rear panel. The main zipper 103, when closed, functions to close the lower compartment 100 resulting in the two layers 26 and 28 being tightly secured inside the cover, each in its own compartment.
Any type of known securing means, such as zippers, hook-and-loop type fabric strips, hooks, snaps or the like can be used to close the cover and retain the air cell layer in its pocket and base in its pocket. This novel arrangement keeps the upper layer appropriately positioned on the base, and prevents the upper air cell cushion layer from being displaced during user movement or other movement of the cushion.
There is an opening 104 in one side panel covered by a flap 106. The opening allows the air tube 60 to protrude out of the cover. The flap 106 and the side panel have opposed segments of hook and loop fastener 108A, 108B.
An opening or hole (not shown) in the middle panel 96 near opening 104 allows the air filling tube 60 to protrude out of compartment 98 and through the cover at opening 104. Tube 60 can be pressed against the side panel and the flap 106 secured closed to keep the valve out of the way. The bottom panel 84 of the cover can have attachment means 110, such as hook and loop fastener, to facilitate attachment of the cushion 10 to a wheelchair seat, vehicle seat, chair or other seating device. The bottom can include a strap that can be fastened upon itself by hook and loop fastener, such as Velcro® to secure the cushion to a seat.
The combination of the base layer with bolsters and upper layer of soft or resilient material such as an air cell cushion or gel type cushion provides a cushion that reduces and redistributes pressure from restricted pressure points in the ischial and trochanter regions, and provides the user with a sense of postural stability and security, while also reducing discomfort and annoyance due to the transition between air-filled cells and the foam base. Furthermore, the cover functions to provide an aesthetically pleasing seating surface, protect the cushion and base and, importantly, keep the upper layer in proper position on the base layer so to reap full advantage of the cell and bolster arrangement that eliminates uncomfortable transition areas and unwanted pressure to increase comfort and safety in use.
This application claims priority provisional application Ser. No. 60/378,236 filed May 6, 2002 and to provisional application Ser. No. 60/417,338, filed Oct. 9, 2002.
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