reference is now made to the figures , in which like elements indicate like elements throughout the several views . the application will be discussed by reference to several different embodiments , which may share inventive concepts or alternately may each include individual inventive concepts . fig1 is a front view of a knee extension assembly 10 and an ankle support member 30 used in conjunction with a conventional crutch 12 . fig2 is a is a side view of the elements 10 , 12 , 30 being used by a wearer 15 . fig3 is a top cross - sectional view taken transverse to the longitudinal axis of the crutch and the wearer &# 39 ; s leg of fig2 with the cross - section taken through the inflatable air bladder . fig4 is another transverse cross - section taken from the fig1 configuration , but this time the cross - section is taken just above the ankle support member 30 . the crutch as shown in fig1 is a conventional type of crutch , which is a distinctive aspect of the present invention in that conventional crutches are readily available within the market . the present invention particularly adds the use of a knee extension assembly 10 and an ankle support member 30 . the knee extension assembly 10 includes an inflatable member 20 , a plurality of straps 25 , and a conventional hand - operated pump 24 with a bleed valve 29 . the inflatable member 20 can include an inflatable bladder 22 contained within a fabric pouch 24 . the inflatable bladder 22 can , as in other configurations described herein , may be inflated by the conventional hand - operated pump 24 and deflated by use of the bleed valve 29 . the plurality of straps 25 as shown in fig2 can position the leg between the inflatable member and the crutch , while containing and attaching the inflatable member relative to the crutch . the configuration shown in fig1 - 2 includes three straps . however , other strap or bladder configurations may be used as known in the art . the ankle support member 30 includes a cradle portion 32 and a back portion 34 is attached to the crutch towards the lower end of the crutch by use of conventional fasteners such as 36 , although any suitable attachment of the ankle support member 30 to the crutch is suitable . the cradle portion 32 defines a generally upwardly ( as fig4 is viewed ) cradle which is configured to accept a length of the leg of the user . upon inflation of the inflatable member inflatable member 20 , it may be understood that a “ three point ” force combination is provided which allows for effective extension of the knee by use of an optimal , highly efficient but comfortable biomechanical application of load . this three point contact configuration is illustrated in fig2 by the force arrows “ f 1 ”, “ f 2 ”, and “ f 3 ”. force arrow “ f 1 ” illustrates force provided upwardly on the leg by the ankle support member 30 . the force arrow “ f 2 ” illustrates force provided downwardly on the leg atop the thigh of the leg by the inflatable member 20 of the knee extension assembly 10 . it may be understood that this force is translated to the crutch through tension in the straps 25 . the force arrow “ f 3 ” illustrates force provided upwardly on the leg by the upper end of the crutch ( which may be the padded underarm rest ). this three point action is further described elsewhere in this application with reference to fig1 . it should be understood that although fig2 illustrates the use of the air bladder atop the thigh , alternate locations of the air bladder are likewise contemplated ; the inflatable bladder could alternatively be placed upon the knee , or the tibia . however , the present invention contemplates adjustability of the location of the knee extension assembly 10 along the length of the crutch , as at times ( for example at the beginning of treatment ) the knee joint may be sensitive to contact , and thus the knee extension assembly 10 may be adjusted so it is atop the thigh . at the same time , biomechanically the knee is a desirable location for application of the load , so later in treatment , when the knee is not as tender , the knee extension assembly 10 may be adjusted so it is atop or at least closely adjacent the knee . under one configuration of the present invention , the ankle support member 30 will remain at least temporarily attached to the crutch during its normal use . the patient can use the crutch in the conventional manner , with the assembly 10 carried therewith on the crutch if so desired . when an orthotic session is desired , the patient will then typically sit on a chair with the upper ( underarm ) portion of the crutch positioned beneath the relevant buttock . the remainder of the elongate crutch is positioned relatively underneath the length of the patient &# 39 ; s leg , with the ankle support member 30 portion being positioned under the patient &# 39 ; s ankle . the device 10 is then attached to its position as shown in fig2 and the adjustable straps are adjusted to a comfortable tension . the bladder is then filled as desired , with pressure relief being available as desired . the straps are adjusted to provide some initial amount of pressure , with the final amount of pressure and resulting force being provided by the air . it should also be understood that the adjustability of the straps accommodates various knee positions ; it should be understood that during the initial stages of recovery , the leg may not be able to be bent very much at the knee , whereas towards the end of the recovery period , the leg preferably may be bent substantially straight at the knee . it should be understood that one portion of the present invention includes the use of straps including hook - and - loop ( such as velcro ) attachment which allow for a “ take - up ” feature ; this feature allows for the combination of large motions of the limb . however , other take - up configurations may be used such as known in the art , such as friction or other buckles , without departing from the spirit and scope of the present invention . this applies throughout this discussion . as noted above , the knee extension assembly according to the present invention is contemplated for use in conjunction with a conventional crutch member such as known in the art and conventionally available . it should be understood that such a crutch configuration could also be a special crutch specially configured to work with the orthotic device according to the present invention , or could simply be a straight board or other elongate structural member . fig5 illustrates the use of a rigid plastic or other suitable material , to provide an elongate structural member 210 which may be attached to the underside of the arm , with its lower end extending beyond the elbow , terminating in a “ free end ”. approximate this “ free end ” are attached three ( as shown ) straps 225 which connect an inflatable member 220 ( an air bladder in a fabric pouch ) to the free end of the elongate member . this member 220 is configured to be positioned adjacent to the forearm of a wearer , such that inflation of the air bag therein tends to provide pressure causing movement such as shown as m . this is conventionally called “ extension ” and is desired in certain types of orthotics . it should be understood that this fig5 configuration includes the “ three point ” force combination as described above . however , this fig5 configuration is similar to the fig6 and 7 configuration , and the “ three point ” force configuration will be described in more detail in reference to fig6 . fig6 and 7 show a third embodiment of the present invention , being an apparatus 300 configured to be attached to the arm of a wearer 315 . it should be understood that fig6 is a more simplified version . the apparatus 300 includes a substantially rigid structural frame 301 including a forearm bearing portion 302 and an upper arm bearing portion 304 , connected by one or more connecting members 306 . also included are straps 325 and an inflatable member 320 , which can include an inflatable bladder contained by a fabric pouch . as are other configurations discussed herein , the straps are sewn to the fabric pouch by conventional means . as elsewhere in this discussion velcro - type attachments at 327 may be provided for detachability and adjustability of the straps . flanges 305 ( see fig7 ) may be optionally used if desired to extend upwardly on either side of the main body to contain the forearm as desired . fig7 shows the embodiment in slightly more detail than fig6 . in fig7 the forearm bearing portion 302 , the upper arm bearing portion 304 , and two connecting members 306 are shown ; it may be understood that in the fig7 version shown they are all part of an essentially one - piece frame which in the preferred embodiment is plastic . it should be understood that the upper arm bearing portion is contoured to conform somewhat to the upper surface of the upper arm for comfort purposes when bearing downwardly thereon . the frame 301 of the apparatus can be plastic , wood , metal , a metal / fabric sling , or other material ( s ) suitable to provide the needed structural support . it should be understood that the members 302 and 305 of the frame 301 could be rigidly attached together by virtue of being part of an integral , one - piece unit , or alternately could be part of a multiple - part device which allows for relative adjustment between the members 302 , 304 as desired . as shown in fig6 it may be seen that the “ three point ” force configuration is again utilized in this embodiment , as shown by force arrows “ f 1 ”, “ f 2 ” and “ f 3 ”. force arrow “ f 3 ” illustrates the force down by the inflatable member . force arrow “ f 2 ” illustrates the force up by forearm bearing portion 302 . force arrow “ f 1 ” illustrates the force down by upper arm bearing portion 304 . it should be understood that during the initial stages of recovery , the elbow may not be able to accommodate much pressure , and for that reason the elbow may be placed off the forearm bearing portion 302 . however , towards the end of the recovery period , the elbow may be placed on the forearm bearing portion 302 for optimal biomechanical application of force . fig8 and 9 show an apparatus 400 which may not include any substantially rigid members ( although one against the stomach may be used ), but includes the use of an inflatable member 424 and a pair of straps 425 u , 425 l ( upper and lower ), together which are configured to provide external rotation of the shoulder . the upper strap 425 u may be passed around the upper torso and arm of a user , leaving the opposite arm free . the lower strap 425 l may be provided around the lower torso of the wearer , such as would a conventional belt . between the upper and lower straps are attached an inflatable member 424 ( being a bladder within a pouch ), having its upper edge attached to the upper strap , and its lower edge attached to the lower strap , with the air bladder therein configured to be inflated and deflated as noted before . to utilize the apparatus , the forearm is placed adjacent the air bladder , and the upper strap 425 u is provided in a suitably taut configuration to keep the relevant upper arm against the wearer &# 39 ; s side for optimal biomechanical effect . the air bladder is then inflated , causing external rotation of the shoulder . as may be understood , when desired , the air bladder may be deflated as needed , in order to remove the device , or in order to alleviate pain . it should be understood that other configurations are also contemplated for maintaining the upper arm against the side of the user , such as but not limited to a cuff ( not shown ) to contain the arm but allow it to rotate as it is strapped to the body . as shown in fig1 , the two - strap apparatus as shown in fig7 may be complimented with a foam block or wedge 550 to provide a range of motion of external rotation which is different from the range of motion provided in the apparatus shown in fig8 and 9 . in this configuration , the forearm is oriented generally forwardly , and along the conventional line of sight of the user / patient 515 , and the inflatable member 524 is located between the foam member and the forearm . it should also be noted that the foam block 550 could be a separate air bag 550 , which could be inflated to a desired size and temporarily sealed . internal rotation could further be provided , by use of additional straps 525 a and an additional inflatable air member 524 a ( shown in dotted line ) to provide movement towards the body . these straps 524 a would have one of their ends attached to the air bladder , and their other ends attached relative to the patient &# 39 ; s body , preferably at about the right shoulder . therefore , internal and external rotation could be provided by the use of a pair of bladders as desired “ ir ” and “ er ”. it should be understood that the configurations described above which include the two oppositely located bladders may be used to provide “ cpm ”, otherwise known as continuous passive motion . fig1 illustrates a sixth embodiment 600 of the present invention , including a pair of horizontally - oriented straps 625 u , 624 l , an upper strap 624 u located about the upper torso and approximate the armpit region , and the lower strap 625 l being strapped about the lower torso of the body slightly upwardly of the belt region . between the two straps is supported a foam pad , which fits generally underneath the armpit region of a particular arm of the wearer 615 . an inflatable member 624 is located intermediate the underneath of the upper arm and the foam pad , such that inflation of the air bladder by the air pump 628 by the wearer 615 causes abduction of the shoulder . although not shown , it should also be understood that a second inflatable member ( not shown ), with accompanying straps , could be used to cause movement in the opposite direction . a third shoulder - to - crotch strap 626 extends to underneath the groin region could also be used in order to provide support for pulling the scapula downwardly . this isolates motion to the glenohumeral joint ( otherwise known as the arm / shoulder blade joint ) as opposed to the acronmioclavicular joint . this embodiment of the invention comprises a device 700 which uses a substantially rigid structural member 701 , an inflatable member 724 , and straps 725 which connect the structural member 701 to the inflatable member 724 . an additional hand strap 740 is provided to discourage movement of the inflatable member from its shown position to a position more towards the elbow . another set of conventional straps such as 750 may be used to attach the structural member 701 relative to the upper arm . as may be understood , by inflating the inflatable member 724 , the straps 725 are drawn into tension and flexion of the elbow joint is provided . fig1 relates the use a orthotic device 800 which include the use of alternating air flow to respective air bladders to cause range of motion in , for example , an ankle . this is referred to as providing “ continuous passive motion ”. the device includes a hard shell boot 810 , within which the lower leg , ankle , and foot of a patient is inserted . two air bladders 824 u , 824 l , ( although additional bladders could be used ), are included within the boot . one air bladder is located above the foot proximate the toe area , whereas the other air bladder is located beneath the sole of the foot proximate the toe area . the “ upper ” bladder 824 u is separate from the “ lower ” bladder 824 l , and the upper and lower bladders can be inflated and deflated separately , in order to provide an up and down motion of the foot , translating into an up and down motion of the ankle . at least two types of flexion are intended to be provided under the present invention . these two types of flexion are plantarflexion , and the other type is dorsiflexion . in an alternate embodiment of the present invention , two hinged flaps are also used within the boot cavity , one atop the foot and below the upper bladder , and the other below the foot and above the lower bladder . these two flaps correspond to the two bladders , such that inflation of the lower bladder pushes upwardly on the lower pivoting flap , causing upper flexion ( dorsi ) flexion , and increased air within the upper bladder , creates downward movement of the upper flap , causing the opposite type of flexion . the two bladders are connected by two corresponding air lines , each of which are attached at their opposite ends to a common air source . under one configuration of the present invention , the lines are alternatively filled and evacuated , causing the dual motion desired under the present invention . this apparatus 900 includes a substantially flat base 901 , an inflatable member 920 , and a floating yoke member 930 . the substantially flat base 901 includes a pair of upwardly - directed holes 902 ( as fig1 is viewed ) which slidably accept a corresponding pair of downwardly - directed feet 911 which extend downwardly and leftwardly at an incline from the inclined yoke plate 910 . straps 925 are attached intermediate the upper end of the inclined yoke plate 910 and the inflatable member 920 . a vertical anchor strap 935 is connected intermediate the upper end of the inclined yoke plate 910 and the base plate 901 . the inclined yoke plate 910 includes a tonguelike pad at 950 to provide a cushion as described below for the upper side of the foot . the tonguelike pad at 950 is located at the top of the yoke and can act as a type of “ tramoline ” pushing on the dorsum of the foot with a cushioning effect . an air pump 990 with a quick release valve 991 is also included to inflate and deflate the air bladder within the fabric pouch of the inflatable member 920 . such a yoke concept accommodates different sized feet , as a variety of feet can be slipped into the gap defined by angled yoke plate . after the straps are properly adjusted to take out slack , the air pump 990 is used to inflate the inflatable member 920 , tensioning the straps and providing a force on the calf of the leg of the wearer . this causes the ankle into desired dorsiflexion . the downwardly - directed feet 931 do not bottom out in the holes 902 , but instead are allowed to slide or “ float ” upwardly and downwardly therein . since the straps are in tension , it may be understood that a force is applied to the top of the foot by the angled yoke plate 930 at the location of the tonguelike pad at 950 . this causes the foot to be maintained in place due to pressure of the yoke atop the foot , instead of allowing the heel of the foot to lift from its location atop the base plate 901 . a heel cup or stop 909 also may be used as shown in dotted line in fig1 . the spherically shaped member 950 is configured to allow the base plate 901 to be put on a level supporting surface such as a floor surface such that the spherically shaped member 950 can provide a rolling pivot or rocking point about which the base plate 901 can rotate . this conveniently allows the lower leg to be maintained in a substantially consistent orientation while the forces within the apparatus cause the ankle of the foot into desired dorsiflexion . this can be quite convenient as it allows the user / patient to sit comfortably while undergoing the process . this device 1000 includes a substantially rigid structural member 1001 which resembles a open - backed “ slipper ” portion 1002 with a front vertical flange 1003 which extends upwardly from the top of the slipper portion and along the front of the shin of the wearer 1015 . the wearer &# 39 ; s front foot may be placed in the cavity of the slipper portion 1002 , and an inflatable member 1020 may be placed behind the calf . this inflatable member is attached relative to the upper , free , end of the front vertical flange 1003 by one or more straps 1025 . after initial adjustment of the straps 1025 , the inflatable member may be inflated by use of the air pump , causing the straps to be drawn into tension , and the calf to be pulled forward . this causes desired dorsiflexion of the ankle . an optional strap at 1035 may be used to maintain the foot in place . the spherically shaped member 1009 of the substantially rigid structural member 1001 is configured to allow the substantially rigid structural member 1001 to be put on a level supporting surface such as a floor surface such that the spherically shaped member 1009 can provide a rolling pivot or rocking point about which the substantially rigid structural member 1001 can rotate . this conveniently allows the lower leg to be maintained in a substantially consistent orientation while the forces within the apparatus cause the ankle of the foot into desired dorsiflexion . as noted above this can be quite convenient as it allows the user / patient to sit comfortably while undergoing the process . it should be understood that this configuration 1000 may be used instead or in combination with the fig1 configuration , if the yoke of fig1 applies too much pressure . fig1 shows another orthotic device 1100 which can be used to provide dorsiflexion of the ankle . this device 1100 includes a base 1101 , a cuff 1102 fixed to the base , a selectively positionable foot plate 1103 , an inflatable member 1120 , and connecting straps 1125 . the selectively positionable foot plate 1102 is mounted to the base 1101 via a pivotable connection as known in the art , which allows for initial adjustment . however , it should be understood that when the orthotic device 1100 is in use , the pivoting connection is fixed such that the foot plate 1103 is fixed relative to the base 1101 . the cuff 1102 is fixed to the base , and allows for the lower leg of the wearer 1115 to slide therein as described below . after initial adjustment of the foot plate 1102 and the straps 1125 , the inflatable member 1125 is inflated , causing the straps to be drawn into tension . the inflatable member 1125 pushes down on the leg , namely the anterior aspect of the distal thigh , with the kneed flexed approximately 90 degrees . this causes the lower leg to move downwardly while being contained by the cuff 1102 . this forces the ankle into dorsiflexion as the foot of the wearer bears against the foot plate 1103 . pressure may be relieved as desired . fig1 is an illustrative view 1200 of a pair of exemplary limb members ( such as an upper and lower leg , or such as an upper and lower arm ), and how such members can be captured by the “ three point ” force configuration described above . such a configuration provides an optimally efficient biomechanical application of force by positioning the inflatable member as far as possible from the pivoting point , whether that pivoting point be the joint ( as shown in the fig6 ), or the interface between the limb and the structural member ( see fig2 ). such a combination of the “ three point ” force configuration , the inflatable member , tensioning straps , and structural member is submitted to be a significant improvement over the prior art as pressure is not provided across the joint , as might be provided by a simple “ wrap ” or the known cited art . fig2 and 21 are pictorial and end views , respectively , of a forearm supination and pronation device 1300 . this device 1300 includes a base 1301 , right and left adjustable base flanges 1302 l , 1302 r , respectively , an inflatable member 1320 , straps 1325 , a retaining cuff 1327 , and a glove assembly 1350 including a thumb retainer 1351 . the base 1302 is configured to be stationary and to provide support for the other members . the right and left adjustable base flanges 1302 l , 1302 r , respectively , are configured to the attached to the base , and to be adjustable . during use they are rigidly affixed relative to the base 1302 . the straps 1325 are positioned intermediate one of the base flanges and the rigid post member 1350 . the rigid post member 1350 is attached to the glove assembly 1340 . this attachment can be temporary through velcro , snaps , or even a clothespin configuration . alternately the post 1350 could be pivotally attached to the plate 1301 . the glove assembly 1340 can be attached to a user &# 39 ; s hand by various means , but the invention contemplates the insertion of the hand into the glove assembly , which is snugged as desired by use of various straps or bands . the glove assembly includes a thumb retainer 1351 perpendicular to the longitudinal axis of the forearm . by selectively adjusting the flanges and the straps supination and prontation of the forearm may be provided , while the glove twists atop the base plate 1301 . although a glove assembly is disclosed above , it should be understood that the present invention also contemplates use of the device without a glove assembly . such contemplation includes the use of some other means for attaching the post to the arm such that the longitudinal axis of the post is substantially parallel to the plane of the palm of the hand . such an alternate configuration includes a strap which can fit around the hand across the palm and around the back of the hand , or a “ clip ” which can attach to the hand , or a “ thumb sock ”, which can be used to contain the thumb relative to the post . however , it should be understood that for optimal biomechanical effect the thumb should be oriented generally alongside and parallel to the elongate post . it should also be understood that different fluids other , than atmospheric air may be used , such as water , etc . alternatively , hot or cold fluids , which may provide some therapeutic value , may likewise be used . various straps as known in the art may be used in order to maintain the outer boot in place on the wearer &# 39 ; s limb . it should be understood that under an alternative configuration according to the present invention , in order to provide an improved mechanical advantage , a boot may be used with a bent leg ( providing an exposed upper horizontal surface ) may be used . in such a configuration , the boot would include a strap which would go up and over the top of the knee , which is advantageous especially when providing the dorsi - type flexion of the ankle . it should also be understood that the provision of air to the bladders according the present invention could be provided by automatic means , which may be advantageous in a long term type of treatment , such as the use of periodic inflation and deflation throughout a night time of wearing . furthermore , manual inflation and deflation for the provision of specific stretching of tissues may be provided by manual inflation and deflation of one of the bladders . finally , it may be understood that is not necessary that two bladders be used during a particular orthotic session ; only one bladder may be used if only one type of motion is desired to stretch the limb against muscle tension . as noted above , a structural member may be used to provide structural support for various of the orthotic devices discussed herein . such a structural device could be made of plastic , wood , metal , a metal / fabric sling , or other material ( s ) suitable to provide the needed support . it should be noted that although the structural support will need some type of stiffness to provide its support , it does not have to be perfectly rigid ; some bending or deflection is possible and may be desirable . therefore it may be seen that the present invention provides a plurality of devices which provide improvements over known prior art othrotic devices . while this invention has been described in specific detail with reference to the disclosed embodiments , it will be understood that many variations and modifications may be effected within the spirit and scope of the invention as described in the appended claims .
an inflatable bladder position a distance from a joint is attached to an external structural support which crosses the joint but does not support it . by inflating the bladder one limb segment is forced towards the external support thereby increasing the ranges of motion of that joint . further , the inflatable bladder has an instant release valve which , when pressed , will instantly release the pressure within the bladder . the limb is positioned intermediate the bladder and the external structural support for optimal biomechanical efficiency .