GB2367763A

GB2367763A - Ankle exercising and assessment device

Info

Publication number: GB2367763A
Application number: GB0024729A
Authority: GB
Inventors: Alan Raymond Tree; Richard Maxwell Waller
Original assignee: Individual
Current assignee: Individual
Priority date: 2000-10-10
Filing date: 2000-10-10
Publication date: 2002-04-17
Also published as: GB0024729D0

Abstract

Apparatus for stretching or assessing the Achilles tendon comprises a support member 1 extending in a first direction from front to back and a second direction normal to the first adapted to incline the foot of the person standing thereon wherein the angle I1 and I2 is variable, the variation in angle is by moving the body relative to the support (figures 3-19) or inverting the device. The support surface may be inclined in the second direction (13 figure 3). It may also be fixed between side members 3. The surfaces may be planar or curved. It may comprise layers of compressible material (41-47 figure 9) and (51-55 figure12) having varying density to incline the foot . A separate part may be provided for each foot. Means may be provided to adjust the pressure pattern. The angle may be changed by motors. The underside may be arcuate (62 figure 14) and supported on wheels (63 figure 14). Detection devices may be provided for assessment purposes. Guides may be provided for the feet. Also disclosed is a method of assessing ankle dorsiflexion or osseous limitation comprising increasing the angle of the invention until pulling is felt or when posture changes.

Description

Exercising And Assessment Device Field of the Invention This invention relates to devices for use in the exercising and assessment of the body, and in particular to the exercising and assessment of the lower limb, and the Achilles tendon thereof.

Background to the Invention Tight Achilles tendons and posterior calf muscles are a well documented source of a wide range of foot, leg and postural problems.

This is due to the ankle joint being limited in its ability to dorsiflex (bending of the top of the foot towards the front of the leg). This motion is required during the process of taking a normal step and it is generally accepted that an 80 degree angle made by the lateral border of the foot in relation to the lateral border of the leg is needed in order for a normal step to be completed. The Achilles tendon when taught pulls back on the heel bone which normally moves downwards when the front of the foot moves upwards.

The angle of a sloping surface upon which a person can comfortably stand upright depends upon the range of dorsiflexion at his ankles. Too steep a slope generates a painful"pulling"sensation in the calf muscles and causes a marked and obvious change in posture.

The foot is capable of compensating and adapting to uneven terrain by twisting and turning primarily at two complex multi-faceted joints (subtalar and midtarsal joints) and it is by using these mechanisms that the foot can compensate for the limited ankle dorsiflexion caused by the short Achilles tendons. When this compensation occurs, dorsiflexion is gained at these other joints, but the subtalar and midtarsal joints have different axes to the ankle joint and this results in other motions occurring at the same time as the dorsiflexion. In effect the foot rolls inwards in order for this dorsiflexion to be gained. This occurs when it is normal for the foot to be rolling outwards, just before the heel leaves the ground when taking a stride. This foot motion is directly linked to the leg motion by what is, in effect, a universal joint, and therefore the leg is rotating inwards when it is normal for it to be rotating

outwards. It can readily be seen that done on a continual basis there is a tendency for knee, hip, and back problems to develop.

From the above description it will be appreciated that tight Achilles tendons, leading to a limitation in ankle dorsiflexion, can lead to problems in other parts of the body.

The benefits of Achilles tendon stretching exercises are acknowledged, and a device which provides for such exercising and for the assessment of the range of motion of the ankle is known. This device comprises two spaced apart side members, between which a platform is adjustably mounted, so that when the device is placed on a flat surface, the platform is inclined thereto.

The platform is pivotally mounted to the side members at one end. The other end of the platform is fixed to the side members by means of pins which pass through holes in the side members and into the platform. A series of vertically spaced apart apertures is provided to provide for adjustment of the inclination of the platform.

Whilst such a device provides for a range of angles of inclination of the platform, it is expensive to manufacture, and can be detrimental to individuals having certain foot conditions, such as ligaments laxity or damaged plantar muscle.

It would therefore be desirable to be able to produce a device having the benefits of the known device but with reduced manufacturing costs.

It would also be desirable to produce a device which could be used by individuals having ligaments laxity, or damaged plantar muscle, tendon, or ligament structures.

It would also be desirable to produce a device which could be used to support parts of the body other than the foot so that other exercises may be completed.

Summary of the Invention The invention provides a free standing device for exercising and/or assessing the Achilles tendon, the lower limb, or other parts of the body, comprising a support member having upper and lower faces, wherein one or both of the upper and lower faces are support surfaces to support an individual's body or part thereof, the or each support surface extending in first and second directions, the first direction extending from the front to the back of the device and the second direction being substantially normal to the first, and wherein the or each support surface is adapted to incline the part of the body supported thereby and provides for more than one angle of inclination, characterised in that in use, movement of the body or part thereof relative to the support surface, or inversion of the device, causes the supported part of the body to be inclined to a different angle.

One of the said at least one support surface may be inclined in the second direction.

One of the said at least one support surface may be substantially planar.

In one embodiment of the invention, the support surface is fixed at opposite sides thereof to side members. The support member may be fixed to the said side members so as to provide first and second angles of inclination, transition between the first and second angles of inclination being achieved by inverting the device.

The side members may serve as guides to align the feet of the individual in the correct orientation. Alternatively, separate guide means may be provided, and such guide means may take the form of ridges or markings on at least one of the upper and lower faces of the support member.

In another embodiment, the support surface of the support member is convex, concave, or curvilinear in the first direction and/or the second direction.

In another embodiment of the invention the support member comprises a first layer of compressible material, which is adapted to incline an individual's body or part thereof by providing for the compressibility of the compressible material to vary along the first direction and/or the second direction.

Preferably, the compressibility of the compressible material decreases in the first direction. The support member may further comprise a second layer upon

which the first layer of compressible material is mounted. The second layer may be solid or compressible. The first layer may be fixed to the second layer, and is preferably fixed thereto by means of a third layer between the first and second layers. The third layer is preferably in the form of a membrane, which may be rigid or flexible.

The variation in the compressibility of the compressible material may be provided by forming holes in the material, the compressibility of the material increasing with the number and/or size of the holes. Alternatively, the support member may be constructed of discrete layers of compressible materials of differing compressibilities. The upper face of the support member is suitably substantially planar or curved. The upper face of the support member may be substantially parallel with the lower face, or inclined thereto.

In one embodiment of the invention, the support member is split into two sections, each section being shaped and dimensioned to receive the foot of an individual. The angle of inclination in the first and/or second direction of the two sections of the support member may differ. Also, one section may lie in a plane which is higher than that in which the other section lies. Dividing the support member into two sections enables individuals having legs of differing lengths to use the device.

In another embodiment of the invention the support member is provided with means for adjusting the pressure pattern applied to the supported part of the body, e. g. the sole of the foot. Such means may comprise pouches which can be inflated with fluid, or segments which can be moved vertically by wedges or inflatable pouches for example.

A further embodiment of the invention provides a device for exercising and assessing the Achilles tendon, the lower limb, and other parts of the body, comprising a support member extending in first direction from the front to the back thereof and a second direction substantially normal to the first direction, and adapted to incline the foot of a person standing thereon, wherein the said support member provides for the angle of inclination to be substantially continuously variable between upper and lower limits.

Preferably, the angle of inclination of the support member is controllably variable by means of a motor, such as an electric or hydraulic motor. The motor may be linear or rotary, and preferably is a stepper motor.

The support member may comprise at least one arcuate member, the said arcuate member being mounted on at least a pair of spaced apart wheels or rollers. By rotating one of the wheels or rollers, the angle of inclination of the support member may be varied. Means to detect the angle of inclination to which the Achilles tendon of an individual may be stretched may be provided.

Such means may comprise a pressure sensor to detect a change in pressure on part of the foot, such as an increase or decrease in pressure on the heel.

Alternatively, a reference point, such as a bar, may be provided so that movement of a part of the leg towards or away from the reference point may be detected. A sensor may be provided to sense movement of a part of the leg towards or away from the reference point, and may for example incorporate a light beam, an ultra-sound emitter, or a pressure sensor.

The invention also provides a method of assessing ankle dorsiflexion. In the method of assessment, the individual being assessed stands upright upon the support surface of a device according to the invention with both his legs straight and his feet pointing forwards. The angle of inclination of the support surface is increased to the point at which the individual experiences a definite, but not painful, pulling sensation in the back of his legs. The angle of inclination of the support surface at which this occurs is the maximum angle of dorsiflexion, and is the assessed angle.

If the angle of inclination of the support surface is increased to such an extent that the individual cannot stand upright and/or experiences an uncomfortable feeling in the back of his legs, then the maximum angle of dorsiflexion has been exceeded and the angle of inclination of the support surface must be decreased.

For an individual who is elderly or infirm the starting angle of inclination would be 6 to 9 degrees. For an individual who is young and healthy the starting angle of inclination would be 12 to 15 degrees.

The method also provides for the detection of osseous limitation. in the method an individual stands upon a device according to the invention.

Osseous limitation is detected when the angle of inclination of the support surface is increased until the individual displays a marked postural change, but does not feel a pulling sensation in the back of his legs, in particular in his calf muscles.

The invention provides a simple device which enables the Achilles tendon, lower leg muscles, and other parts of the body to be exercised to different degrees in a controlled programme, thereby allowing individuals to benefit from such exercise without the danger of over stretching or slipping, and without having to manually adjust the angle of inclination of the support member.

By providing curved surfaces individuals having ligaments laxity, or damaged plantar muscle, tendon, or ligament structures can use the device to improve their conditions.

The invention also provides a reliable and efficient method of assessing ankle dorsiflexion which can be carried out without medical supervision. For instance, a gymnasium instructor could carry out assessments.

Brief Description of the Drawings In the drawings: Figure 1 illustrates a lower limb to which a force is applied ; Figure 2 is a schematic representation of one embodiment of the invention; Figure 3 is a schematic representation of one embodiment of the invention; Figure 4 is a rear elevation of the embodiment shown in Figure 3; Figure 5 is a sectional view of the embodiment shown in Figure 3, on the plane Yi-Y2 ; Figure 6 is a side view of another embodiment of the invention; Figure 7 is a side view of a further embodiment of the invention; Figure 8 is a side view of a further embodiment of the invention; Figure 9 is schematic representation of another embodiment of the invention; Figure 10 is schematic representation of another embodiment of the invention; Figure 11 is a projection of the embodiments shown in Figures 9 and 1 0; Figure 12 is a schematic representation of a further embodiment of the invention; Figure 13 is a projection of the embodiment shown in Figure 12; Figure 14 is side view of another embodiment of the invention; Figure 15 shows schematic representations of another embodiment of the invention; Figure 16 is a side view of the embodiment shown in Figure 15; Figure 17 is a side view of a device according to another embodiment of the invention; Figure 18 shows schematic representations of another embodiment of the invention; and Figure 19 is a side view of the embodiment shown in Figure 18.

Detailed Description of the Preferred Embodiments Referring now to figure 1, there is shown a lower limb to which an upward force U is applied. The body's own weight acting through the pivot of the ankle A produces a pulling force P on the Achilles tendon T, and the muscle fibres M to which the Achilles tendon T is attached. The muscle M and tendon T adapt to the force P by lengthening.

Referring now to Figure 2, there is shown a device 1 comprising a support member 2 having a front F and a back B, and upper and lower support surfaces 4,5. The support member 2 is fixedly connected at its sides to side members 3. The support member 2 is connected to side members 3 so that the device 1 provides two different angles of inclination 11 and 12. By inverting the device 1, so that either support surface 4 or support surface 5 is uppermost, the individual can select the desired angle of inclination.

The ability to move from the angle 12 with surface 5 uppermost to 11 with support surface 4 uppermost is particularly desirable, because this allows the individual to first exercise at a relatively shallow angle of inclination, and then to exercise at a steeper angle of inclination. This reduces the risk of injury and enables different exercises to be undertaken.

Preferably angle 11 is in the range 10 to 25 degrees, whilst 12 is in the range 5 to 15 degrees. In one embodiment of the invention angle 11 is approximately 30 degrees. Rather than standing on the support member with his feet extending in the first direction from the front to the back of the device, he may stand with his feet at an angle to the first direction, with one foot below the other. This is particularly suitable for skiers.

The upper and lower edges of side members 3 are coated with a nonslip surface, so that the device is unlikely to move when being used.

Referring now to Figures 3 to 5, there is shown a device 10 having a front F and a back B. Device 10 comprises side members 11 between which is mounted a support member 12 having a support surface 13. Support surface 1 3 is curved from front to back to provide an angle of inclination y.

The angle of inclination becomes greater moving from the front F to the back B, being in the region of 3 degrees at F and increasing progressively to approximately 24 degrees at B. Also, support surface 13 is curved from the sides of the support member towards the centre to provide an angle of

inclination v. The angle of inclination v becomes larger moving from the sides of support member towards the centre thereof, being in the region of 3 degrees at the sides of the support member and increasing progressively to approximately 24 degrees at the centre thereof. The angle of v has the effect of supporting the arch of the foot. This is particularly important for those having ligaments laxity, painful plantar muscles or tibialus posterior muscle dysfunction because without the support surface 13 being curved from the sides of the support member to the centre thereof stretching the Achilles Tendon would aggravate the ligaments laxity, painful plantar muscles or tibialus posterior muscle dysfunction.

By placing the feet further towards the back and/or the centre of the support surface 13, a greater upward force U is generated causing a greater pulling force P to be generated in the Achilles tendon and muscle M (see Figure 1). The curvature of the support surface 13 causes the feet to be tipped onto their outside edges. This causes the Achilles tendon to be stretched further.

Figures 6 to 8 illustrate three different embodiments of a device according to the invention. In each case the device is formed so that it is a free standing object, the difference between the embodiments lying in the shape of the support surface. Each embodiment shown in Figures 6 to 8 may be made from any relatively incompressible material, such as wood, or plastics materials. Where plastics materials are used, the device may be formed by injection moulding or rotary moulding.

The device shown in Figure 6 comprises a support member 20 which is a discreet object, and the upper face of which is curved to form a support surface 21. The support surface 21 provides two convex portions 22,24, one concave portion 23, and one substantially planar portion 25.

The device shown in Figure 7 comprises a support member 28 which is a discreet object, and the upper face of which is curved to form a support surface 29. The support surface 29 is convex 27.

In Figure 8, the device comprises a curved support member 31 which is a discreet object, and the upper face of which is curved to form a support surface 29. The support surface is concave 30.

In each of the embodiments 20, 28, 31 of the device shown in Figures 6 to 8, the radius of curvature of the curved surfaces varies from front to back.

This enables one device to generate different forces U (see Figure 1). The angle made by a tangent to the curved surface with the horizontal varies from approximately 3 degrees to approximately 24 degrees.

Referring now to Figures 9 to 11, there is shown a block which is compressible. In Figure 9 the support member 40 comprises an upper layer of compressible material, such as foam, mounted on a solid base 42. The compressibility of upper layer 41 decreases from the front F to the back B of the device, as is shown in Figure 9. The effect of the decreasing compressibility of layer 41 is that when an individual stands upon the support member 40, his heels sink into the foam to a greater depth than his toes, thereby creating an upward force U (see Figure 1). Solid base 42 is in the form of a wedge, thereby providing an inherent angle of inclination. The upper face 43 of the solid base 42 may be curved as shown in Figure 6 to 8 and 15 to 17.

In Figure 10 the support member 45 comprises upper and lower compressible layers 41,47. The compressibility of lower layer 47 increases from the front F to the back B of the support member 45. At the interface of layer 41 and 47, there may be provided a rigid or flexible membrane. The combination of upper and lower layers of compressible material has the effect of compensating for different body weights of individuals supported by the support member 45 in order to maintain a constant generated angle of inclination for similar heel positions. The support member 45 may be inverted, both the upper and lower faces being support surfaces. This can be used to produce a different stretching effect on the Achilles tendon.

In the embodiment shown in Figure 9 an individual would generally stand on the support surface 43 of support member 40, whilst in the embodiment shown in Figure 10 an individual could stand on either upper face 44 or lower face 46 of the support member 45, both being support surfaces.

Figure 11 shows a projection of the devices shown in Figure 9 and 10.

Referring now to Figures 12 and 13, a device according to the invention comprising a support member 50 is shown. Support member 50 comprises a series of laminated layers of compressible material 51 to 55. Each layer is

uniformly compressible, but the compressibility of each layer is different. The compressibility of the layers 51 to 55 decreases from the front F to the back B of the support member 50. In the embodiment shown in Figures 12 and 13, the layers 51 to 55 are inclined so as to slant forwards. The effect of so inclining the layers is twofold. First, when an individual stands upon the support member 50 the upper face will become curved beneath his feet. By selecting layers 51 of different compressibilities it is possible to produce a support surface which becomes convex or concave beneath his feet.

Secondly, a different compression pattern will be produced by inverting the device.

Layers 51 to 55 are suitably formed from foam.

The support member shown in Figures 12 and 13 may be shaped to provide an angle of inclination from the sides of the support member to the centre thereof. This is to tip the feet onto their edges to produce a greater stretching effect. Also, the upper and lower faces 56,57 may not be parallel so as to produce an inherent angle of inclination.

In the devices shown in Figures 9 to 13, by standing at different positions on the support surface, between the front and the back thereof, the supported part of the body can be inclined to different angles. For instance, where the foot is the supported part of the body, the Achilles tendon is stretched by different amounts.

In each of the devices shown in Figures 9 to 13, the compressible material may be covered, preferably by a layer of wear resistant material, which may be substantially impervious.

The device 60 shown in Figure 14 comprises a base 65 in which are mounted rollers 63. The rollers 63 are themselves mounted on spindles 64. A motor (not shown) is also provided to rotate one or both the rollers 63.

Support member 61 has a curved base 62 which rests upon rollers 63.

Friction between the rollers 63 and curved base 62 ensures that rotation of rollers 63 causes the angle of inclination of support member to change. A bar 66 extends across the width of the of the support member 61 at a height level with the back of the knee. Mounting 67 to which bar 66 is attached provides for the height of the bar 66 above support member 61 to be adjusted to the knee height of the individual being assessed.

In assessment a person stands on the flat support surface of support member 61 so that the back of his leg is touching the bar 66 at about knee height. The angle of inclination of the support member is increased until the back of the leg no longer touches the bar 66. This point represents the point at which the person being assessed feels pain, and to counteract that pain he brings his knee forward to reduce the force on the Achilles tendon. A light beam or pressure pad may be arranged to detect when the back of the leg leaves contact with bar 66. Such light beams and pressure pads are known.

Where no measuring means is provided, the assessor uses his eye to detect the point at which the back of the leg leaves contact with the bar 66.

In another embodiment of the device shown in Figure 14, instead of a bar 66 being provided, a pressure pad is mounted in the support surface of support member 61. During assessment the person being assessed stands so that his heels are resting on the pressure pad. It has been noted that at the point where the person being assessed feels pain in the Achilles tendon, there is a slight decrease in pressure on the heel. To assess the Achilles tendon, the angle of inclination of the support surface of support member 61 is increased until there is an decrease in pressure on the pressure pad.

Referring now to Figures 15 and 16, there is shown another embodiment of an exercising and assessment device 70 according to the invention comprising a support member having support surfaces 71, 72. The support surface 72 is curved 73. When an individual stands on the support surface 72, his feet are inclined. Figure 16 shows how the angle of incline of surface 72 increases from the front to the back of the device, in steps of 3 degrees thereby providing a range of angles of inclination from 0 degrees to 30 degrees to the horizontal. By moving to a different part of the support surface, the part of the body supported thereby is inclined to a different angle.

When the device 70 is inverted, the individual is supported on the flat surface 71. However, the angle of inclination of the surface 71 can still be altered, simply by moving to a different position on the support surface 71, or by the individual altering his posture, thereby distributing his weight differently.

This has the effect of causing the device 70 to rock backwards or forwards.

An individual can stand upon the device 70 in order to exercise or assess the Achilles tendons for example, in which case he stands with his feet

pointing from the front to the back of the device. Alternatively, he may stand with his feet pointing from the back of the device to the front. A particularly good exercise for skiing is one in which the individual stands on one of the support surfaces of the device 70 and bends at the knees, and hence lowering the upper body. When the individual stands in this manner on the flat support surface 71, the device rocks on the curved surface 72, thereby increasing the angle to which the flat surface 71 is inclined.

An individual may stand with his feet pointing from one side of the device to the other. Where the curved support surface 72 is in contact with the ground, shifting his weight will cause the angle of inclination of the support surface 71 to change.

The device 70 need not be used to support the feet. It may be used to support other parts of the body. For example the back, the legs, the hip, the shoulder, the head or the neck.

Figure 17 shows another embodiment of the invention similar to that shown in Figures 15 and 16, a device 80 comprising a support member having a curved upper support surface 81. The support member is divided into a plurality of discrete sections 82 to 88. The support member may be formed by injection or rotary moulding a plastics material. By providing discrete sections 82 to 88, the upper surface is disturbed less when loaded than would by the case for the device shown in Figures 15 and 16. The discrete sections 82 to 88 may extend across part or the full width of the support member. The degree to which the surface 81 is curved increases from the front of the device to the back, each change in angle of three degrees being marked on the figure.

Figure 18 comprises a support member 20 which is a discreet object, and the faces of which are planar and form a support surface 89 and 90 in figure 19. The invention is a footprint-like shape cut from a wedge of material of suitable properties with maximum angle along the line AA to BB. The device has a degree of symmetry so that inversion makes it suitable for either the left or the right foot. With surface 89 placed on the floor surface 90 becomes the surface on which patients stand, and via versa. Figure 19 shows the cross section along AA to BB perpendicular to the plan of the shape shown in figure 18.

In each embodiment of the invention, the support surfaces may be provided with a non-slip surface. Such non-slip surfaces may be in the form of a rubber, or synthetic layer, or where the support member is formed from wood, ridges may be provided in the or each surface thereof.

Claims

Claims 1. A free standing device for exercising and/or assessing the Achilles tendon, the lower limb, or other parts of the body, comprising a support member having upper and lower faces, wherein one or both of the upper and lower faces are support surfaces to support an individual's body or part thereof, the or each support surface extending in first and second directions, the first direction extending from the front to the back of the device and the second direction being substantially normal to the first, and wherein the or each support surface is adapted to incline the part of the body supported thereby and provides for more than one angle of inclination, characterised in that in use, movement of the body or part thereof relative to the support surface, or inversion of the device, causes the supported part of the body to be inclined to a different angle.
2. A device according to Claim 1, wherein one of the said at least one support surfaces is inclined in the second direction.
3. A device according to Claim 1 or 2, wherein one of the said at least one support surface is substantially planar.
4. A device according to any preceding claim, wherein the support surface is fixed at opposite sides thereof to side members.
5. A device according to Claim 4, wherein the support member is fixed to the said side members so as to provide first and second angles of inclination, transition between the first and second angles of inclination being achieved by inverting the device.
6. A device according to any preceding claim, wherein at least one support surface of the support member is convex, concave, or curvilinear in the first direction and/or the second direction.
7. A device according to any preceding claim, wherein the support member comprises a first layer of compressible material, which is adapted to incline an individual's body or part thereof by providing for the compressibility of the compressible material to vary along the first direction and/or the second direction.
8. A device according to Claim 7, wherein the compressibility of the compressible material decreases in the first direction.
9. A device for exercising and/or assessing the Achilles tendon, the lower limb, or other parts of the body, substantially as described with reference to, or as shown in, the drawings.

9. A device according to Claim 8, wherein the support member further comprises a second layer upon which the first layer of compressible material is mounted.

10. A device according to Claim 9, wherein the second layer is solid or compressible.

11. A device according to Claim 9 or 10, wherein the first layer is fixed to the second layer.

12. A device according to Claim 11, wherein the first layer is fixed to the second layer by means of a third layer between the first and second layers.

13. A device according to Claim 12, wherein the third layer is a membrane.

14. A device according to any of Claims 7 to 13, wherein the variation in the compressibility of the compressible material is provided by forming holes in the material, the compressibility of the material increasing with the number and/or size of the holes.

15. A device according to any of Claims 7 to 14, wherein the support member is constructed of discrete layers of compressible materials of differing compressibilities.

16. A device according to any of Claims 7 to 15, wherein the upper face of the support member is substantially parallel with the lower face, or inclined thereto.

17. A device according to any preceding claim, wherein the support member is split into two sections, each section being shaped and dimensioned to receive the foot of an individual.

18. A device according to Claim 17, wherein the angle of inclination in the first and/or second direction of the two sections of the support member differ.

19. A device according to Claim 17 or 18, wherein one section lies in a plane which is higher than that in which the other section lies.

20. A device according to any of Claims 1 to 6, wherein the support member is provided with means for adjusting the pressure pattern applied to the supported part of the body.

21. A device according to Claim 20, wherein the said means comprise pouches which can be inflated with fluid, or segments which can be moved vertically by actuators.

22. A device according to Claim 21, wherein the actuators are wedges or inflatable pouches.

23. A device for exercising and assessing the Achilles tendon, the lower limb, and other parts of the body, comprising a support member extending in first direction from the front to the back thereof and a second direction substantially normal to the first direction, and adapted to incline the foot of a person standing thereon, wherein the said support member provides for the angle of inclination to be substantially continuously variable between upper and lower limits.

24. A device according to Claim 23, wherein the angle of inclination of the support member is controllably variable by means of a motor.

25. A device according to Claim 24, wherein the motor is linear or rotary.

26. A device according to Claim 25, wherein the motor is an electric or hydraulic motor.

27. A device according to one of Claims 23 to 26, wherein the support member comprises at least one arcuate member, the said arcuate member being mounted on at least a pair of spaced apart wheels or rollers.

28. A device according to any of Claims 23 to 27, further comprising detection means to detect the angle of inclination to which the Achilles tendon of an individual may be stretched.

29. A device according to Claim 28, wherein the said detection means comprises a pressure sensor to detect a change in pressure on part of the foot.

30. A device according to Claim 29, wherein the pressure sensor detects a change in pressure on the heel.

31. A device according to Claim 28, wherein the detection means comprises a reference point so that movement of a part of the leg towards or away from the reference point may be detected.

32. A device according to Claim 31, wherein a sensor is provided to sense movement of a part of the leg towards or away from the reference point.

33. A device according to Claim 32, wherein the sensor includes a light beam, an ultra-sound emitter, or a pressure sensor.

34. A device according to any preceding claim, further comprising guide means to align a supported part of an individual's body in a desired orientation.

35. A device according to Claim 34, wherein the guide means comprise ridges or markings on at least one of the upper and lower faces of the support member.

36. A device according to Claim 34 when dependent on Claim 4 or 5, wherein the side members serve as guides to align the feet of the individual in the correct orientation.

37. A method of assessing ankle dorsiflexion of an individual, comprising the steps of. a) the individual standing upright upon the support surface of a device according to the invention with both his legs straight and his feet pointing forwards; and b) increasing the angle of inclination of the support surface to the point at which the individual experiences a definite, but not painful, pulling sensation in the back of his legs.

38. A method of detecting osseous limitation of an individual, comprising the steps of--18-a) the individual standing upright on the support surface of a device according to the invention; b) increasing the angle of inclination of the support surface until the individual displays a marked postural change, without feeling a pulling sensation in the back of his legs.

39. A device for exercising and/or assessing the Achilles tendon, the lower limb, or other parts of the body, substantially as described with reference to, or as shown in, the drawings. Amendments to the claims have been filed as follows

Claims 1 A free standing device for exercising and/or assessing the Achilles tendon, the lower limb, or other parts of the body, comprising a support member having upper and lower faces, wherein one or both of the upper and lower faces are support surfaces to support an individual's body or part thereof, the or each support surface extending in first and second directions, the first direction extending from the front to the back of the device and the second direction being substantially normal to the first, and wherein the or each support surface is adapted to incline the part of the body supported thereby and provides for more than one angle of inclination, characterised in that in use, movement of the body or part thereof relative to the support surface, or inversion of the device, causes the supported part of the body to be inclined to a different angle.

2. A device according to Claim 1, wherein one of the said at least one support surfaces is inclined in the second direction.

3. A device according to Claim 1 or 2, wherein one of the said at least one support surface is substantially planar.

4. A device according to any preceding claim, wherein at least one support surface of the support member is convex, concave, or curvilinear in the first direction and/or the second direction.

5. A device according to any preceding claim, further comprising guide means to align a supported part of an individual's body in a desired orientation.

6. A device according to Claim 5, wherein the guide means comprise ridges or markings on at least one of the upper and lower faces of the support member.

7. A method of assessing ankle dorsiflexion of an individual, comprising the steps of : a) the individual standing upright upon the support surface of a device according to the invention with both his legs straight and his feet pointing forwards; and b) increasing the angle of inclination of the support surface to the point at which the individual experiences a definite, but not painful, pulling sensation in the back of his legs.

8. A method of detecting osseous limitation of an individual, comprising the steps of: a) the individual standing upright on the support surface of a

device according to the invention ; b) increasing the angle of inclination of the support surface until the individual displays a marked postural change, without feeling a pulling sensation in the back of his legs.