WO2016198904A1

WO2016198904A1 - Therapeutic apparatus

Info

Publication number: WO2016198904A1
Application number: PCT/GB2016/051751
Authority: WO
Inventors: Richard Mills; Ronis PERDIOS; James Taylor
Original assignee: Swellaway Ltd
Priority date: 2015-06-12
Filing date: 2016-06-13
Publication date: 2016-12-15
Also published as: GB201610232D0; GB2540863A; GB201510279D0

Abstract

A therapeutic apparatus provides a thermal effect to a body and includes a controller (140), a thermoelectric module (160) and a contact substrate (240) for contacting the body. The contact substrate is a flexible, thermally conductive pad. A mounting wrap (120) mounts the apparatus to a body, and a compression portion maintains pressure against the body.

Description

Therapeutic Apparatus

The present invention relates to a therapeutic apparatus for the treatment of a body part, and is concerned particularly, although not exclusively, with a therapeutic apparatus for the application of heat and/or cold/ or pressure to a body part using a thermo-electric module comprising a Peltier device. The treatment of muscle, joint, tendon and ligament injuries by heating and/or cooling the affected area, sometimes in a cycle, and often accompanied by some degree of compression, is a common clinical technique. Various apparatuses have been proposed in the prior art for such treatment, and several make use of thermoelectric effects, such as the Peltier effect.

The Peltier effect uses a thermo-electric module, comprising a junction of two different types of metallic conductors. When a current is made to pass through the junction, heat is generated at, or removed from, the junction.

One such previously considered apparatus is described in US Published Patent Application US 2002/0026226 (Ein) in which a thermoelectric module is attached to a body part using a wrap .

One problem with previously considered apparatus of this type is that, due to the cost of manufacturing the thermoelectric or Peltier devices, a standard, off the shelf device is preferred. In some types of injury this may require a conductor to distribute the effect of the device over an area of the body to be treated that is greater than the device itself. The conductor, which makes contact with the body part, may be relatively inflexible, which can inhibit the forming of an intimate contact with the body part. This adversely affects the efficiency of the apparatus, ie the efficiency with which heat is applied to, or removed from, the region to be treated. Embodiments of the present invention aim to provide a therapeutic apparatus that promotes a more efficient transfer of heat between device and body part.

The present invention is defined in the attached independent claims, to which reference should now be made. Further, preferred features may be found in the sub-claims appended thereto.

According to one aspect of the present invention, there is provided therapeutic apparatus for providing a thermal effect to a body, the apparatus comprising a controller, a thermoelectric module, and a contact substrate for contacting the body, wherein the contact substrate is a flexible, thermally conductive pad.

The apparatus preferably includes a mounting wrap for mounting the apparatus to a body.

The apparatus preferably includes a compression portion for maintaining pressure against a body. The thermal effect provided to a body may be a heating effect and/or a cooling effect.

The controller preferably comprises an electronic processor. The apparatus may comprise an electronic display for displaying functional information. The apparatus may include a user interface which may comprise a GUI and/or a key pad. The apparatus may comprise a power supply arranged in use to supply electrical power to the thermoelectric module and/or the controller and/ or the compression portion.

The contact substrate preferably comprises a multi-layer pad including a main conductive layer and a skin-contacting layer suitable for placing in direct contact with skin of the user. The pad may also include a protective layer for covering the pad. The pad may comprise a thermally insulating layer for insulating the pad from ambient conditions in use.

The protective layer and the insulating layer may comprise the same layer. In a preferred arrangement the main conductive layer may comprise one or more layers of conductive material. The conductive material may comprise metallic material and/or may comprise semiconductor material,, and or may comprise carbon. In a particularly preferred arrangement the main conductive layer comprises one or more layers of graphite or graphene. In one preferred arrangement, the contact substrate comprises at least one layer of thermally conductive material, such as carbon material, and at least one, preferably separate, layer of heat retaining material, which may be metallic, such as copper, in the form of a sheet and/or a mesh.

In a preferred arrangement the thermoelectric module comprises a Peltier device.

The compression portion preferably comprises an inflatable bladder. The compression member is preferably arranged so that it can be inflated and/or deflated. The compression member may comprise one or more valves and may comprise one or more pumps for pumping an inflation fluid, such as air, into the bladder. The compression device is preferably arranged to inflate and/or deflate in accordance with a control signal from the controller. The thermoelectric module may comprise a heat dissipator. The heat dissipator may comprise a heat sink. The heat dissipator may comprise a fan.

The mounting wrap may include one or more mounting locations, which may comprise pockets or pouches for receiving one or more of the components of the apparatus. At least one of the mounting locations may be arranged to removably receive a component of the apparatus . In a preferred arrangement the mounting wrap comprises a first mounting location for receiving the controller. The mounting wrap may comprise a second mounting location for receiving the thermoelectric module. The mounting wrap may comprise a third mounting location for receiving the power supply. The mounting wrap may include a pocket, pouch or cavity, for receiving the compression portion.

In a preferred embodiment, the wrap comprises at least one pull tab for use in pulling the wrap into position around a body part. The pull tab is preferably angled so that it extends at least transverse to a longitudinal extent of the wra .

The invention also includes a thermal regulation pad, for increasing the effective area of a thermal device acting upon a surface, the pad comprising a main conductive layer and a surface-contacting layer suitable for placing in direct contact with a surface to be acted upon.

The main conductive layer may comprise one or more layers of conductive material. The conductive material may comprise metallic material and/or may comprise semiconductor material, and or may comprise carbon. In a particularly preferred arrangement the main conductive layer comprises one or more layers of graphite or graphene.

In one preferred arrangement, the pad comprises at least one layer of thermally conductive material, such as carbon material, and at least one layer of heat retaining material, which may be metallic, such as copper, in the form of a sheet and/or a mesh.

The thermal device may comprise a Peltier device. The pad may also include a protective layer for covering the pad. The pad may comprise a thermally insulating layer for insulating the pad from ambient conditions in use. According to another aspect of the invention, there is provided a method of treatment of a human or animal body, wherein the method comprises contacting a part of the body with an apparatus comprising a controller, a thermoelectric module and a contact substrate comprising a flexible, thermally conductive pad, and forming an intimate contact between the substrate and the body part, and wherein the method comprises providing a thermal effect to the body.

The method may comprise attaching the apparatus to the body using a mounting wrap.

The method may comprise maintaining pressure against the body by using a compression portion of the apparatus. The thermal effect may comprise a heating and/or cooling effect .

The method may comprise supplying electrical power to the thermoelectric module and/or the controller and/ or the compression portion.

The method may comprise applying pressure to the body part by inflating and/or deflating an inflatable bladder of the compression portion. The method may comprise treating the human or animal body using therapeutic apparatus or a pad according to any statement herein. The invention may include any combination of the features or limitations referred to herein, except such a combination of features as are mutually exclusive, or mutually inconsistent. A preferred embodiment of the present invention will now be described, by way of example only, with reference to the accompanying diagrammatic drawings, in which:

Figure 1 shows, schematically a set of apparatus according to an embodiment of the present invention;

Figure 2 is a schematic cross-sectional view of part of the apparatus of Figure 1, taken along line A-A' of Figure 1; Figure 3 is a perspective view of a thermo-electric module of the apparatus of Figure 1 together with a thermally conductive pad;

Figure 4 shows the module of Figure 3 with a cover removed;

Figure 5 is a sectional view through the module of Figures 3 and 4 taken along line B-B' of Figure 3;

Figure 6 is a side view of the module of Figures 3, 4 and Figure 7 is a plan view of the module of Figures 3-6 with a case cover removed;

Figure 8 is a plan view of the module of Figures 3-7 with a decorative cover removed;

Figure 9 is a plan view of the module of Figures 3-8 with a decorative cover replaced; Figure 10 shows an alternative embodiment of mounting wrap, according to the invention, in a first view;

Figure 11 shows the embodiment of wrap of Figure 10 from an opposed side;

Figure 12 is a schematic exploded view of the mounting wrap of Figures 10 and 11;

Figure 13 shows the embodiment of Figures 10 and 11 in a different view;

Figure 14 shows a kit of parts in accordance with an embodiment of the present invention; Figures 15 and 16 show, respectively in schematic plan view and schematic side view an alternative configuration of thermal module for the apparatus of Figures 1 to 14; and

Figures 17 and 18 show alternative, preferred embodiments of thermal composite pad, for use with the apparatus of Figures 1 to 16. Turning to Figure 1, this shows a therapeutic apparatus generally at 100, for the treatment of a body by application of heat /cooling and/or pressure. The example shown in Figure 1 is suitable for the right foreleg of a horse (not shown) . The apparatus 100 comprises a mounting wrap 120, for securing the apparatus to the leg of a horse. The wrap comprises three straps 122, 124 and 126 for wrapping around the leg in use. The straps are each able to detachably engage the other side 128 of the wrap by means of hook and loop fasteners (not shown} , which are adjustable to accommodate differently sized legs.

The apparatus is shown in Figure 1 from above - ie showing the side that does not contact the body in use. A first pouch 130 houses a detachable controller module 140, a second pouch 150 accommodates a thermoelectric module 160, for providing a cooling and/or heating effect and a third pouch 170 houses a battery pack module 180 for providing electrical power to the controller and the module 160. The pockets only partially cover their respective contents .

In use the wrap is attached to a body part, in this case the leg of a horse. Figure 1 shows a side of the apparatus that faces away from the body part.

When the apparatus is attached to the body part a composite thermal regulation pad makes contact with the skin and applies a controlled, regulated temperature to the body part as will be described below.

Figure 2 is a sectional view taken through lines A-A' of Figure 1, and shows the pouch 150 and the thermoelectric module 160 beneath. The module 160 comprises a housing 200 within which are located Peltier devices 210, only one of which is shown in this drawing. A plurality of heat sink elements 220 extend upwardly from the Peltier cell into a cavity 230 within the housing 200. The pouch and upper side of the wrap 120 are formed from a thermally insulating and protective material, such as neoprene. An active face 210a of the Peltier device 210 is in contact with a flexible, thermally regulating composite pad 240 comprising a highly conductive layer 242, preferably of multi-layer graphite, which is closes to the Peltier device, and a medical-grade skin-facing layer 244, which is of silicone rubber.

The pad 240 is resiliently deformable and may flex in three dimensions for an intimate contact with a body part.

A thermal insulation layer 246 insulates the graphite conductive layer 242 from the ambient conditions. This is important if the Peltier devices are to operate efficiently.

Within the wrap 120 is located an inflatable bladder 248 as a compression portion for pressing the pad 240 against the body part. The bladder is connected to a pump {not shown} in the control module by tubes and valves (not shown) . The bladder 248 can be inflated to increase and/or maintain pressure on the body part during use. This is important particularly when a swelling of the body part may begin to reduce after the wrap has been applied.

The inflatable bladder 248 is an example of what might be termed an active compression portion. However, in a simpler version of the apparatus {not shown) the wrap itself can be made to exert compression, for example by virtue of its elasticity, though this may require the reapplication of the wrap, for example when a swelling has reduced, in order to maintain appropriate compression. This might be termed a passive compression portion.

Figure 3 is a perspective view of the thermoelectric module 160 in its housing 200. The module 160 is shown mounted on the pad 240, but the pouch and wrap are omitted for clarity. The module 160 is generally rectangular and the housing is of durable plastics material, having a cover 202. Towards one end of the body is a fan 300 which, in use, is arranged to draw ambient air into the casing through an air inlet 320 for cooling the heat sink elements 220 of the Peltier devices, as will be described below. Turning to Figure 4, this shows the module 160 with cover removed. There are four Peltier devices in this example. Each has a set of heat sink elements 220, comprising aluminium rods 222 extending upwardly from a top surface of the Peltier device. In use, when the lower, body-facing sides of the Peltier devices become cooled from the effect of an applied voltage, the temperature of the upper sides rises correspondingly. The fan blows cooling air, drawn from an inlet 320 (see Figure 3) of the housing 200, over the heat sink elements 220 in the direction of arrows F, to encourage the heat energy to dissipate. Without this the efficiency of the Peltier devices would become impaired rapidly. The rods 222 of the heat sink elements are taller the further away they are from the fan, to ensure that cool air reaches them, and not only air that has been previously heated by contact with closer rods. This ensures that each Peltier device is able to operate with substantially equal efficiency. The housing 200 also includes integrally moulded baffles 204 arranged to direct cooling air into the spaces between the rods 222. Other arrangements of the heat sinks could be used to optimise the cooling. Heated air is exhausted through outlets 322 on the housing 200 {See Figure 3) .

Figure 5 shows the module 160 in cross section taken along lines B-B' of Figure 4, and with the pad 240 removed for clarity. The four Peltier devices are labelled 210a, 210b, 210c and 210d.

Figure 6 shows the module 160 in a side view. Figure 7 shows the module 160 in plan, with the cover 202 removed .

Figure 8 shows the module 160 in plan with the cover 202 in place .

Figure 9 shows the module 160 in plan with a decorative cover 202a attached thereto.

The pad 240 extends the effective area of the Peltier devices and can be tailored to suit the geometry of the body part to be treated. The pad must be flexible, in order to maintain a close contact with the body part, and yet must also have good thermal conductivity, so that the thermal effects being applied by the Peltier devices are substantially uniformly applied across the treatment area. In addition, as the pad makes contact with the skin, it must include a skin-facing surface of a material that is medically suitable. To meet these needs, the embodiment described has a conductive layer 242 comprising multi-layer graphite material and a skin-facing layer 244 of silicone rubber. The conductive layer could, as an alternative, be made from metallic material, such as copper. The conductive layer 242 and the skin-facing layer are separate layers that are bonded together. However, in an alternative embodiment (not shown) the functions of these two layers could be realised by coating one type of material with the other.

The protective neoprene wrap must also provide thermal insulation from the ambient conditions, as this affects the efficiency of the Peltier devices and hence of the apparatus as a whole.

Each of the controller, thermoelectric module and battery pack is removable, making electrical connections when inserted in its respective pouch. The controller can optionally communicate with the thermoelectric module wirelessly. This allows that the controller can be detached from the apparatus and operated remotely. The fact that the modules can all be removed means that they can be supplied with a set of different mounting wraps, each being optimised for a different body part, such as different limbs, different parts of limbs, specific muscle groups, joints and so on. The above-described apparatus has modules 140, 160 and 180 that can easily be inserted or removed from their respective pouches. When the thermoelectric module 160 is inserted into the pouch, the permanently attached thermal pad 240 is first inserted though an aperture in the wrap, so that the skin facing layer 244 of the pad 240 is positioned to face the skin of the human or animal body to which is will be applied. The module housing 200 remains on the other side of the wrap to the pad 240.

The removable modules are retained securely in place by magnetic mounting pads or brackets. Other forms of contact fastener could be used.

Once the modules 140, 160 and 180 have been inserted into the pouches, connecting cables (not shown) , that connect the battery module to the control module and the control module to the thermoelectric module, are connected. The device is then ready to be used in a thermally regulated treatment of a body part .

In the example described above the thermal pad is held against the body part by fixing the wrap 120 to the body part and then regulating the pressure in the inflatable bladder 248 so as to maintain the pad against the body part, for example as a swelling in the body part reduces.

The apparatus may be supplied as a kit, in which a set of modules 140, 160 and 180 are provided along with one or more wraps 120 having differing geometries, for application to different body parts, such as different muscles or j oints .

Alternatively, the apparatus may be supplied pre-configured so that the end user may not remove, replace or reconfigure some or all of the parts, thereby reducing the risk of inadvertent misuse or incorrect assembly.

In an alternative embodiment (not shown} the thermoelectric module 160 and pad 240 are connected to the control module and/ or the battery module by a longer cable, allowing the module and pad to take the form of a hand-held applicator, such as a mitt, for applying he heating and/or cooling effect by hand.

In a still further alternative embodiment the modules can be permanently, or semi-permanently embedded in a wrap or harness. This approach is favoured where there is a risk of them becoming inadvertently detached from the wrap, for example if the apparatus were being used to treat an animal, such as a horse.

The embodiments described above provide a versatile, easy to use apparatus for the thermal treatment of a body part by heat and/or cold and/or pressure. The effective area of one or more Peltier devices can be increased and can be matched to the desired area of treatment using the thermally regulating pad which, because of its multi-layer structure, is sufficiently thermally conductive, flexible, hardwearing and hygienic. The controller applies user-determined, or pre-set programmes to provide heating and/or cooling, which may include cycles of either or both. One or more temperature sensors (not shown) are utilised to provide feedback to the controller so that the temperature at the operational site on the body can be monitored closely. Similarly, the pressure in the inflatable bladder is monitored by one or more pressure sensors (not shown) to maintain an appropriate pressure.

Turning to Figure 10, this shows, generally at 400, an alternative embodiment of therapeutic apparatus in which the elements are numbered in correspondence with their counterparts shown in Figure 1. However, with this embodiment, the mounting wrap 120 is shaped differently, for easy application to a body part. In particular, the wrap 120 has a pull tab 414 located at an opposed end to the three tabs 122, 124 and 126 which are present also in the Figure 1 embodiment. The shape of the wrap 120 is also different, being generally more arcuate in outline. A wrap cover unit 420 contains the modules 140, 160 and 180.

Nodule 140, the control module, comprises a removable controller 140a and a control receptacle 140b. the controller can be removed and can be used to control the apparatus wirelessly. When it is in its receptacle 140b the controller 14a can be charged from the battery pack 180.

The battery pack 180 also contains batteries (not shown) that are themselves removable, so that they can be replaced . The tab 414 is angled with respect to the rest of the wrap so that it projects beyond an edge 120a of the wrap, ie at least partly transverse to a longitudinal extent of the wrap. In this case, as will be seen in the following figures, edge 120a is a top edge in use. However this need not be the case. The direction of extent of the tab is represented by arrow T and it has components Tl transverse to the longitudinal axis of the wrap, and also component T2 that extends longitudinally with respect to the wrap.

Beneath the thermomodule 160, and the wrap 120, the flexible thermally conductive pad 240 can be seen in broken lines. The wrap cover unit 420 has a tab portion 422 that can be lifted to allow insertion of the pad 240, as will be described later.

Figure 11 shows the wrap 120 from the opposite side to that shown in Figure 10. Contact fastener pads 416, such as hook and eye pads, are located on each of the tabs 122, 124 and 126. These are for contacting and securing to the opposite surface of the wrap to hold it in position on the body part .

Figure 12 shows schematically an exploded view of the apparatus of Figures 10 and 11. From front to back, the individual layers are as follows: Firstly, on an outwardly facing side, is the wrap cover unit shown, in this drawing, with the modules 140, 160 and 180 removed. The wrap cover unit includes magnetic mounting portions 422 for the control module and the battery pack module 180. An aperture 424 in the wrap cover unit 420 is for receiving the thermoelectric module 160 with pad 240 attached (not shown) .

In this embodiment the modules are mounted magnetically on the wrap cover unit 420, facing away from the patient.

The flap 422 can be opened to assist in inserting the pad 240. The next layer is a first neoprene layer 430, which has a separable slit portion 430s at an upper edge for opening to allow insertion of the pad 240. Similarly the inflatable bladder 248 has a separable slit portion 248s and finally a skin-side neoprene layer 440 has a separable slit portion 440s. The slit portions are to allow the pad 240 to be readily arranged on a skin-facing side of the wrap 400.

The wrap cover 420 is, in the assembled product, stitched to the neoprene layer 430, which is stitched to the bladder 248 and second neoprene layer 440.

Figure 13 shows schematically the application of the apparatus to a body part, represented as 412 in the drawing. The wrap is placed around the body part 412 and the opposed ends are pulled over and around the body part towards each other in the directions indicated by arrows PI and P2. The pull tab 414, being angled away from the main body of the wrap, allows the user to pull the wrap tightly into position, so that the contact fastener pads 416 can contact the other side of the wrap 120, without requiring the user to let go. Figure 14 shows a kit of parts comprising a set of components that could be supplied to a user, or to a medical practitioner, as a muscle, joint or ligament treatment apparatus, for the treatment of various muscles or joints using a thermal effect.

The kit comprises a control module 140, comprising a separable controller unit 14a and a controller receptacle 14b, and a battery module 180, a thermal module 160 and integrally attached flexible treatment pad 240, large and small joint or ligament treatment wraps 450 and 460 respectively, an ankle support wrap 470 and small, medium and large muscle wraps 480, 490 and 500 respectively. The thermal module 160 and pad 240 can be combined with the different wraps 450-500 depending on which area of the body is to be treated. The battery pack and controller may be affixed to the wrap, or alternatively may be located remotely therefrom. This modularity provides a versatile apparatus for the treatment of a range of conditions affecting for example, but not limited to: muscles, joints and ligaments.

In the embodiments described above, the thermal module, battery module and controller module are all mounted together on the same wrap. However, the thermal module could be mounted separately from the other modules, for example in cases where, because of the nature of the body part to be treated, there is too little space to house all of the modules. In such cases, one or more of the modules could be housed in a separate mounting wrap. For example, the control and battery modules could be housed in or mounted upon a first wrap and the thermal module could be housed in a second, or treatment, wrap which could also include the thermal pad and the compression portion. Suitable connections or power, control and air (for a bladder) would link the two wraps.

The kit of parts may include a common first wrap for the control and battery modules and a plurality of treatment wraps for accommodating the thermal module, dependent upon the specific body part to be treated.

The first wrap could, for example, be arranged to be mounted around a waist of a user.

In an alternative arrangement, the inherent modularity of the system could be utilised by the manufacturer/supplier alone, and not by the end user. This will allow the creation of various product enclosures but use the same internal cases for the electronics and treatment units. In this embodiment the end user will be supplied with a pre- configured product and will not be able to remove the internal apparatus for use with another wrap.

Turning to Figures 15 and 16, these show respective schematic plan and side views of an alternative configuration of thermoelectric module 1160, which has been found to be more efficient at expelling heat generated by the Peltier cell in some applications.

The module has an electrically powered fan 1300 positioned above a heat sink 1220 and arranged to draw cooling air in through inlets 1320 in the sides of housing 1200, and to expel the air through outlet 1322. A Peltier cell 1210 is located immediately beneath the heat sink: 1220 and in contact with the thermal regulation pad 1240.

Figure 17 shows a preferred embodiment of thermally regulating composite pad 2000. The pad comprises a skin- contacting layer 2100, which may be of PVC material. Next to this is a graphite sheet 2200, above this is a copper sheet or mesh 2300 and above this is an insulating layer 2400. The graphite sheet 2200 is used to carry the thermal effect of the Peltier cell to the area of the patient that is to be treated. In effect this amounts to conducting the thermal energy away from or towards the Peltier cell. Graphite is a good material for achieving this, but it is not so efficient at retaining the effect locally. In order to address this, a sheet or mesh of copper 2300 is interposed between the graphite layer and the insulator. The sheet 2300 helps to maintain the heating or cooling effect in the treatment area. The insulator layer 2400 helps to insulate the pad from the atmosphere.

Figure 18 shows a further preferred embodiment of pad 3000, in which the heat retaining layer 2300 has a sheet of graphite on either side, for even greater local retention of the desired thermal effect.

Whilst endeavouring in the foregoing specification to draw attention to those features of the invention believed to be of particular importance, it should be understood that the applicant claims protection in respect of any patentable feature or combination of features referred to herein, and/or shown in the drawings, whether or not particular emphasis has been placed thereon.

Claims

Therapeutic apparatus for providing a thermal effect to a body, the apparatus comprising a controller, a thermoelectric module and a contact substrate for contacting the body, wherein the contact substrate is a flexible, thermally conductive pad.

Apparatus according to Claim 1, further including a mounting wrap for mounting the apparatus to a body.

Apparatus according to Claim 1 or 2, further comprising a compression portion for maintaining pressure against a body.

Apparatus according to any of Claims 1 to 3, wherein the controller comprises an electronic processor.

Apparatus according to any of the preceding Claims, wherein the apparatus comprises an electronic display for displaying functional information.

Apparatus according to any of the preceding claims 1, wherein the apparatus includes a user interface such as a GUI and/or a key pad.

Apparatus according to any of the preceding claims, wherein the contact substrate comprises a multi-layer pad .

Apparatus according to Claim 7, wherein the pad comprises a main conductive layer.

9. Apparatus according to Claim 7 or 8 wherein the multilayer pad comprises a skin-contacting layer suitable for placing in direct contact with skin of the user.

10. Apparatus according to any of Claims 7 to 9, wherein the pad comprises a protective layer for covering the pad.

11. Apparatus according to any of Claims 7 to 10, wherein the pad comprises a thermally insulating layer for insulating the pad from ambient conditions in use.

12. Apparatus according to Claim 8, wherein the main conductive layer comprises a plurality of layers of conductive material.

13. Apparatus according to Claim 12, wherein the conductive material comprises metallic material.

14. Apparatus according to Claim 12 or 13, wherein the main conductive layer comprises one or more layers of graphite.

15. Apparatus according to any of the preceding claims, wherein the contact substrate comprises at least one layer of thermally conductive material and at least one layer of heat retaining material.

16. Apparatus according to any of the preceding claims, wherein the thermoelectric module comprises a Peltier device.

Apparatus according to Claim 3 , wherein compression portion comprises an inflatable bladde

18. Apparatus according to Claims 2, wherein the mounting wrap comprises one or more pockets for removeably receiving one or more of the components of the apparatus .

19. A method of treatment of a human or animal body, wherein the method comprises contacting a part of the body with an apparatus comprising a controller, a thermoelectric module and a contact substrate comprising a flexible, thermally conductive pad, and forming an intimate contact between the substrate and the body part, and wherein the method comprises providing a thermal effect to the body.

20. A method according to Claim 19, wherein the method comprises attaching the apparatus to the body using a mounting wrap.

21. A method according to Claim 19 or 20, wherein the method comprises maintaining pressure against the body by using a compression portion of the apparatus.

22. A method according to any of Claims 19 to 21, wherein the thermal effect comprises a heating and/or cooling effect.

23. A method according to Claim 21, wherein the method comprises applying pressure to the body part by inflating and/or deflating an inflatable bladder of the compression portion.