AU2007237353A1 - A Method and Apparatus for Maintaining Various Postures During Toileting - Google Patents

Description

AUSTRALIA Patents Act 1991 COMPLETE SPECIFICATION Invention Title: A Method and Apparatus for Maintaining Various Postures During Toileting Applicants: Ajay Rane and Audrey Corstiaans The invention is described in the following statement: 2 A METHOD AND SYSTEM FOR MAINTAINING VARIOUS POSTURES DURING TOILETING Field of the Invention. The present invention relates generally to devices for maintaining 5 posture or attitude 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, 10 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 15 construction changes. Virtually every physician and physiologist who has considered the subject agrees that squatting is one of the most natural and physiologically sound posture to use for evacuation. As illustrated in Figure 3, the colon is a tube, five to six feet in length, 20 which stores wastes from the small intestine and moves the waste, by rhythmic muscular contractions, to the rectum. In the process, water is continuously extracted, to prevent dehydration. If the flow is interrupted for any reason, the continual drying process can leave wastes "cemented" to the colon wall. Faecal stagnation is a major cause of colon cancer. 25 The sitting toilet obstructs the flow, because it ignores four basic requirements: 1. The sigmoid colon (the most common site for colon cancer) needs the support of the left thigh for complete evacuation. The thigh lifts the sigmoid and opens the kink where it joins the rectum.

3 2. The caecum (the second most common site for colon cancer) needs to be squeezed by the right thigh, which pushes wastes upwards into the ascending colon. 3. The rectum (the third most common site for colon cancer) needs to relax the 5 grip of the puborectalis muscle, designed to prevent incontinence. 4. The entire colon needs to be compressed, with the ileocecal valve securely closed, to generate the required pressure for expulsion. The kink where the sigmoid joins the rectum, mentioned above in point 1, serves an important function in preventing incontinence. It "applies the brakes" to 10 the flow of peristalsis, reducing the pressure on the puborectalis muscle. The difference in the position of the puborectalis muscle in the sitting position contrasted with the position in the squat position, is illustrated in Figure 2. Normally, in the sitting position, the puborectalis muscle "chokes" the rectum to maintain continence. Squatting relaxes the puborectalis muscle, and straightens the 15 rectum. For safety, nature has deliberately created obstacles to evacuation that can only be removed by squatting. In any other position, the colon defaults to "continence mode." This is why the conventional sitting position deprives the colon of support from the thighs and leaves the rectum choked by the puborectalis muscle. 20 Pelvic floor nerve stretch injury, the root cause of most pelvic disease, affects women more frequently than men. One reason is that the vaginal canal is a structural gap which is more vulnerable to the unique stress produced by the sitting toilet. Repeated use of the Valsalva Manoeuvre (the accepted childbirth 25 method used in virtually all Western facilities) will often force the uterus, the bladder, the rectum or the small intestine into this gap. These hernias are called, respectively, uterine prolapse, cystocele, rectocele, and enterocele. The term "pelvic organ prolapse" covers all of them. A common result is damage to the pudendal nerve, which connects the 30 pelvis to the spinal cord. Nerve damage can lead to bladder incontinence and hormonal imbalance, due to the breakdown in communication between the brain and the pelvis. There have been attempts in the past to configure toilets for use in the 4 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 there through aligned with the toilet bowl, said platform being 5 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 10 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 15 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. 20 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 a method and apparatus for 25 maintaining a variety of postures during toileting, 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 squat position for 30 evacuations when using a toilet pedestal, 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 pedestal or bowl.

5 In a second form, the invention resides in a method for assisting a person in assumption of a squat position for evacuations when using a toilet pedestal, 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 5 an opening therein to at least partially receive a portion of the toilet pedestal or bowl and positioning the platform at least partially about a toilet pedestal or bowl and adjusting the height of the platform such that a user assumes at least a partial squat position. The apparatus of the present invention includes a platform. The 10 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. 15 Normally, the upper surface of the platform will be adapted to have a users 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, 20 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 25 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 30 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 provided beneath the platform.

6 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 5 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 10 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 15 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. 20 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. 25 The platform included in the present invention includes an opening to at least partially receive a portion of the toilet pedestal 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 30 majority of toilets. A portion of the opening may in use, abut the toilet pedestal or bowl but this is not necessarily the case. However, a portion of the opening/platform will preferably abut the toilet pedestal or bowl when the platform is raised in order to stabilise the platform.

7 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 the legs preferably extend between an upper 5 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 10 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 foot portion will also preferably have an opening to at least 15 partially receive the toilet pedestal 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 pedestal in order to assist with the correct positioning of the apparatus relative to the toilet for use. 20 Normally, the height adjustment means/legs are attached to both the platform and foot. Such attachment may be either temporary or permanent attachment. 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 25 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 30 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 8 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. 5 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. 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. 10 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 15 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 20 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. 25 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 30 children. Brief Description of the Drawings. Various embodiments of the invention will be described with reference 9 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 5 puborectalis muscle in the sitting position contrasted with the position in the squat position. Figure 3 is a schematic view of the large intestine of a human. Figure 4 is a front elevation view of an apparatus according to a preferred embodiment of the present invention in a raised condition. 10 Figure 5 is a view from above of the apparatus illustrated in Figure 4. Figure 6 is a front elevation view of the apparatus illustrated in Figure 4 in the collapsed condition. Figure 7 is a perspective view from below of the apparatus illustrated in Figure 6. 15 Figure 8 is a perspective view from above of the apparatus illustrated in Figure 4. Figure 9 is a view from the side of the apparatus illustrated in Figure 4. Figure 10 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. 20 Figure 11 is a perspective view of a male seated on a toilet and using the device illustrated in Figure 10. Figure 12 is a side elevation view of a male seated on a toilet and using the device illustrated in Figures 10 and 11. Figure 13 is a front elevation view of a male seated on a toilet and 25 using a device according to a second preferred embodiment of the present invention. Figure 14 is a perspective view of a male seated on a toilet and using the device illustrated in Figure 13. Figure 15 is a side elevation view of a male seated on a toilet and using the device illustrated in Figures 13 and 14. 30 Figure 16 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 17 is a perspective view of a male seated on a toilet and using the device illustrated in Figure 16.

10 Figure 18 is a side elevation view of a male seated on a toilet and using the device illustrated in Figures 16 and 17. Figure 19 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. 5 Figure 20 is a front elevation view of a male seated on a toilet and using the device illustrated in Figure 19. Figure 21 is a side elevation view of a male seated on a toilet and using the device illustrated in Figures 19 and 20. Figure 22 is a front elevation view of a child seated on a toilet and 10 using a device according to a fifth preferred embodiment of the present invention. Figure 23 is a perspective view of a child seated on a toilet and using the device illustrated in Figure 22. Figure 24 is a side elevation view of a child seated on a toilet and using the device illustrated in Figures 22 and 23. 15 Figure 25 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 26 is a front elevation view of a female seated on a toilet and using the device illustrated in Figure 25. Figure 27 is a side elevation view of a female seated on a toilet and 20 using the device illustrated in Figures 25 and 26. Figure 28 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 29 is a front elevation view of a female seated on a toilet and using the device illustrated in Figure 28. 25 Figure 30 is a side elevation view of a female seated on a toilet and using the device illustrated in Figures 28 and 29. Figure 31 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 32 is a front elevation view of a female seated on a toilet and 30 using the device illustrated in Figure 31. Figure 33 is a side elevation view of a female seated on a toilet and using the device illustrated in Figures 31 and 32. Detailed Description of the Preferred Embodiment.

11 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 5 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 pedestal 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. 10 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 15 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 11 in order to stabilise the platform 11, particularly during use. 20 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 I1 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 25 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. 30 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 12 13 to receive a portion of the toilet pedestal 14 or bowl 15. The opening 13 is in a rear portion of the platform 11. The opening 13 is shaped and sized to fit a majority of toilets. A forward edge of the opening 18 abut the toilet pedestal 14 or bowl 15 particularly when the platform 11 is raised in order to stabilise the platform 11. 5 The illustrated apparatus further includes a substantially planar foot 19. The foot 19 corresponds in size and shape to the platform 11. The platform 11 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 10 platform 11. According to a particularly preferred embodiment, the platform 11 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. 15 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. In the present specification and claims (if any), the word "comprising" and its derivatives including "comprises" and "comprise" include each of the stated 20 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 25 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. In compliance with the statute, the invention has been described in language more or less specific to structural or methodical features. It is to be 30 understood that the invention is not limited to specific features shown or described since the means herein described comprises preferred forms of putting the invention into effect. The invention is, therefore, claimed in any of its forms or modifications within the proper scope of the appended claims (if any) appropriately interpreted by 13 those skilled in the art.

Claims (20)

1. An apparatus for assisting a person in assumption of a squat position for evacuations when using a toilet pedestal, the apparatus including a platform adapted to raise a user's feet from the ground surface, the platform having at least 5 one height adjustment means associated therewith and an opening therein to at least partially receive a portion of the toilet pedestal or bowl.

2. An apparatus according to claim I wherein an upper surface of the platform is provided with marking indicia to indicate that the "correct" position of a user's feet during use. 10

3. An apparatus according to claim 2 wherein at least two sets of different indicia are provided, for use of the platform by a child and an adult.

4. An apparatus according to claim I or claim 2 wherein the marking indicia include foot-shaped markings.

5. An apparatus according to any one of the preceding claims wherein a plurality of 15 height adjustable means is provided, one at or adjacent to each corner of the platform.

6. An apparatus according to any one of the preceding claims wherein the height adjustable means are fixable or lockable to at least temporarily fix the height of the platform. 20

7. An apparatus according to any one of the preceding claims wherein the height adjustable means allows the platform to be fixed at a number of predetermined heights.

8. An apparatus according to any one of the preceding claims wherein the maximum height at which the platform can be located is at or slightly beneath the upper 25 edge of the toilet bowl.

9. An apparatus according to any one of the preceding claims wherein the height adjustable means include telescoping legs.

10. An apparatus according to any one of the preceding claims wherein the height adjustment means is associated with a movement prevention/safety device 30 adapted to prevent the platform being raised or lowered if bearing a weight above a threshold limit. 15

11. An apparatus according to any one of the preceding claims wherein a portion of the opening abuts the toilet pedestal or bowl when the platform is raised in order to stabilise the platform.

12. An apparatus according to any one of the preceding claims further including a 5 substantially planar foot portion to which the height adjustable means are attached.

13. An apparatus according to claim 12 wherein the height adjustment means are located between the foot portion and the platform.

14. An apparatus according to either one of claims 12 or 13 wherein the platform and 10 foot portion contain the height adjustment means when the platform is fully lowered.

15. An apparatus according to claim 14 wherein the platform is provided with openings therein in order to receive the collapsed height adjustment means.

16. An apparatus according to any one of claims 12 to 15 wherein an opening is 15 provided in the foot portion, shaped to abut the toilet pedestal in order to assist with the correct positioning of the apparatus relative to the toilet for use.

17. A method for assisting a person in assumption of a squat position for evacuations when using a toilet pedestal, the method including the steps of providing a platform adapted to raise a user's feet from the ground surface, the platform 20 having at least one height adjustment means and an opening therein to at least partially receive a portion of the toilet pedestal or bowl and positioning the platform at least partially about a toilet pedestal or bowl and adjusting the height of the platform such that a user assumes at least a partial squat position.

18. An apparatus according to any one of the preceding claims wherein the height of 25 the platform is adjustable to position a user in a semi-squat, near full squat or full squat position.

19. An apparatus substantially as described herein with reference to the accompanying drawings.

20. A method substantially as described herein with reference to the accompanying 30 drawings.