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Posterior Night Splint

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161. Achilles Tendon Enthesopathy

through their range of motion for about 1 min when rising after extended periods of rest. Night splints may also be prescribed to provide passive stretch during sleep and help prevent contractures. Standing Gastrocnemius Stretch VIDEO Heel lifts should be used temporarily to decrease tendon stress during weight bearing and relieve pain. Even if the pain is only in one heel, heel lifts should be used bilaterally to prevent gait disturbance and possible secondary (compensatory) hip and or low back pain (...) , DPM, Temple University School of Podiatric Medicine Click here for Patient Education NOTE: This is the Professional Version. CONSUMERS: Topic Resources Achilles tendon enthesopathy is pain at the insertion of the Achilles tendon at the posterosuperior aspect of the calcaneus. Diagnosis is clinical. Treatment is with stretching, splinting, and heel lifts. (See also .) The cause of Achilles tendon enthesopathy is chronic traction of the Achilles tendon on the calcaneus. Contracted or shortened calf

2013 Merck Manual (19th Edition)

162. Overview of Fractures, Dislocations, and Sprains

are immobilized initially with a splint until most of the swelling resolves. How to Apply Fiberglass Splints VIDEO How to Apply a Posterior Ankle Splint VIDEO How to Apply a Long Arm Splint VIDEO How to Apply a Sugar Tong Ankle Splint VIDEO How to Apply a Thumb Spica Splint VIDEO How to Apply an Ulnar Gutter Splint VIDEO How to Apply a Short Leg Cast VIDEO How to Apply a Shoulder Sling and Swathe and Shoulder Immobilizer VIDEO How to do a Short Arm Cast VIDEO How to Apply a Volar Arm Splint VIDEO Joint (...) in millimeters or bone width percentage. Angulation is the angle of the distal fragment measured from the proximal fragment. Displacement and angulation may occur in the ventral-dorsal plane, lateral-medial plane, or both. Treatment Treatment of associated injuries Reduction as indicated, splinting, and analgesia RICE (rest, ice, compression, and elevation) or PRICE (including protection with a splint or cast) as indicated Usually immobilization Sometimes surgery Initial treatment Serious associated problems

2013 Merck Manual (19th Edition)

163. Effectiveness of Manual Therapy Combined With Standard Treatment in the Management of Plantar Fasciitis

bearing. The pain intensity can be very high and this can cause functional limitations and reduce quality of life. Despite the high prevalence of the PF, treatment is controversial and not supported by extensive research. Review of the previous studies on various treatments, mentioned steroid injections, shock waves, night splint, orthotics, heel padding and stretching exercises. Limitation of ankle dorsi flexion is a common finding and thought to be a contributing factor to the development (...) therapy in frequency of 1 MHz, power of 1.5 watts per centimeter-squared, pulses of 50% for 5 minutes. The study group will receive the same treatment and a number of manual techniques that include antero-posterior (AP) mobilization for talocrural joint in two variations (weight baring and non-weight baring) to improve the range of dorsi flexion, subtalar joint mobilization to improve range of eversion and mid-tarsal mobilization to improve pronation / supination of the forefoot. Each technique

2011 Clinical Trials

164. Plantar fascia

and night stretch splinting being applied to the / unit. Function [ ] The effect of dorsiflexing the toes on arch height (A). The windlass mechanism (B). The plantar fascia contributes to support of arch of the foot by acting as a tie-rod, where it undergoes tension when the foot bears weight. One model estimated it carries as much as 14% of the total load of the foot. In an experiment using , it was found that failure of the plantar fascia averaged at loads of 1189 ± 244 (121 ± 24 or 267 ± 55 (...) an aponeurosis as: (i) a white, flattened or ribbon-like tendinous expansion, serving mainly to connect a muscle with the parts that it moves, (ii) a term formerly applied to certain fasciae. Further, it defines the plantar aponeurosis as bands of radiating toward the bases of the toes from the medial process of the tuber calcanei (posterior half of the calcaneus). The plantar fascia is made up of predominantly longitudinally oriented fibers. There are three distinct structural components: the medial

2012 Wikipedia

165. Upper limb surgery in tetraplegia

is worn by day and at night the patient wears a semi-firm splint that keeps the arm in maximal extension. With the emergence of the one step procedures for the hand, the post-operative rehabilitation programmes became even more important, since early movement is essential. Patients are mobilised 24 hrs post-operatively, with protective splints. The regimen takes approximately 12 weeks, before the hand is allowed to be fully loaded. Patients are not required to stay as an in-patient for the entire (...) splints. In the early 1940s, a surgeon called Sterling Bunnell (1882–1957) was probably one of the first to refer to the reconstruction of gripping function for the tetraplegic hand. He described surgeries of combining tenodeses and tendon transfers to restore hand function. He also advocated transferring the m. brachioradialis to the wrist extensors when these muscles are paralyzed. In the 1950s, understanding of the tenodesis effect (See ) influenced the development of surgical techniques

2012 Wikipedia

166. Diabetic neuropathy

are affected to a greater degree than shorter ones because nerve conduction velocity is slowed in proportion to a nerve's length. In this syndrome, decreased sensation and loss of reflexes occurs first in the toes on each foot, then extends upward. It is usually described as a glove-stocking distribution of numbness, sensory loss, and night time pain. The pain can feel like burning, pricking sensation, achy or dull. A pins and needles sensation is common. Loss of , the sense of where a limb is in space (...) from low frequency electrical stimulation to relieve , improve mobility, relieve neuropathic pain, reduce , and heal resistant foot . , posture training, and teaching these patients the basic principles of off-loading can help prevent and/or stabilize foot complications such as foot ulcers. Off-loading techniques can include the use of (e.g. crutches) or foot splints. Gait re-training would also be beneficial for individuals who have lost limbs, due to diabetic neuropathy, and now wear a . Exercise

2012 Wikipedia

167. Temporomandibular joint disorder

also have a diagnostic role if it demonstrates excessive occlusal wear after a period of wearing it each night. This may confirm the presence of sleep bruxism if it was in doubt. Soft splints are occasionally reported to worsen discomfort related to TMD. Specific types of occlusal splint are discussed below. A stabilization splint is a hard acrylic splint that forces the teeth to meet in an "ideal" relationship for the muscles of mastication and the TMJs. It is claimed that this technique reduces (...) , these factors are poorly understood, and there is disagreement as to their relative importance. There are many treatments available, although there is a general lack of evidence for any treatment in TMD, and no widely accepted treatment protocol. Common treatments include provision of occlusal splints, psychosocial interventions like , physical therapy, and or others. Most sources agree that no irreversible treatment should be carried out for TMD. About 20% to 30% of the adult population are affected

2012 Wikipedia

168. Obstructive sleep apnea

Signs and symptoms [ ] Common symptoms of OSA include unexplained daytime sleepiness, restless sleep, and loud (with periods of silence followed by gasps). Less common symptoms are morning ; insomnia; trouble concentrating; mood changes such as , and ; forgetfulness; increased heart rate and/or ; decreased sex drive; unexplained weight gain; increased urination and/or ; frequent heartburn or ; and heavy night sweats. Whereas the vast majority of patients with obstructive sleep apnea exhibit snoring (...) symptoms similarly to CPAP. Oral appliances or splints are often preferred but may not be as effective as CPAP. This device is a mouthguard similar to those used in sports to protect the teeth. It is designed to hold the lower jaw slightly down and forward relative to the natural, relaxed position. This position holds the tongue farther away from the back of the airway and may be enough to relieve apnea or improve breathing. Many people benefit from sleeping at a 30-degree elevation of the upper body

2012 Wikipedia

169. Conservative Treatment of Patients With Temporomandibular Disorders

, patients will have maxillary and mandibular polyvinyl siloxane impressions made. Interocclusal records will be made with a fast setting silicone using a metal tray. A commercial laboratory will then wax and heat process a clear acrylic resin splint attempting to capture the mandibular cusp tips in the occlusal plan of the splint. The splint will be adjusted to provide uniform posterior centric occlusal stops followed by evaluation for canine guidance. The splint will then be polished and home care (...) instruction provided. Patients will be instructed to wear the splint at night and two hours per day. Sham Comparator: Sham AMCT & Self Care This protocol will attempt to follow all of the procedures of the actual AMCT protocol except no thrust will be delivered. Self-care only participants successfully completing the 6 month assessment will be given the option for RIST or AMCT for one month. Other: Sham AMCT This protocol will attempt to follow all of the procedures of the actual AMCT protocol except

2009 Clinical Trials

170. The Pillar Procedure: for the treatment of obstructive sleep apnoea and snoring

of respiratory events, which tend to higher during REM sleep)(Cistulli & Grunstein 2005; Shochat & Pillar 2003). Continuous positive airways pressure (CPAP) is the most widely used treatment option for OSA and is considered to be the “gold standard” treatment. CPAP involves the delivery of positive air at a predetermined pressure through either a nose or full-face mask. The device is worn throughout the night and the continuous air pressure acts as a pneumatic splint, keeping the airway open. Variations (...) , and between 205,000 and 410,000 females, in Australia. Current treatment options for obstructive sleep apnoea include lifestyle modifications (eg weight loss), invasive surgical procedures or the “gold standard”, continuous positive airways pressure. Continuous positive airways pressure involves the delivery of positive air at a predetermined pressure through either a nose or full-face mask, worn throughout the night. Continuous positive airways pressure only treats the symptoms of obstructive sleep

2006 Australia and New Zealand Horizon Scanning Network

172. The effects of knee-ankle-foot orthoses in the treatment of Duchenne muscular dystrophy: review of the literature

and modifications of this type; steel, long-leg, double upright with knee spring lock and adjustable ankle stop; and long leg orthoses. Cointerventions included various active and passive exercise regimes, night splints, the use of walking aids for some boys and the following operative procedures to allow fitting of the orthosis: ilio-tibial band or fascia lata release; tendo Achilles lengthening; tendo Achilles release/tenotomy; hip flexors release; rectus femoris release; sartorius release; posterior tibial (...) in treating spasticity: review of the literature. Crit Rev Phys Rehabil Med 1996;8:111-24. Indexing Status Subject indexing assigned by NLM MeSH Adolescent; Ankle; Child; Contracture /prevention & Foot; Humans; Knee; Male; Muscular Dystrophy, Duchenne /psychology /rehabilitation /surgery; Orthotic Devices; Splints; Treatment Outcome; Walking; control AccessionNumber 12000001537 Date bibliographic record published 31/08/2001 Date abstract record published 31/08/2001 Record Status This is a critical

2000 DARE.

173. Medial-Wedge Insole is Highly Effective in the Treatment of Valgus Knee Osteoarthritis

activities) will be recorded for all patients at entry. In order to assess symptoms, Visual Analog Scale (VAS) will be used for night pain, pain at rest and on movement. Lequesne index score and the WOMAC questionnaire will be applied at baseline and after 8 weeks by a blinded examiner. Antero-posterior conventional X-ray of knees and ankles will be performed under monopodalic load with and without insoles in order to measure femorotibial, talocalcaneal, and talus tilt angles. Femorotibial angle (...) of Medicine related topics: related topics: Arms and Interventions Go to Outcome Measures Go to Primary Outcome Measures : To assess symptoms, Visual Analog Scale (VAS) will be used for night pain, pain at rest and on movement. Lequesne index score and the WOMAC questionnaire will be applied at baseline and after 8 weeks by a blinded examiner. [ Time Frame: 2 years ] Secondary Outcome Measures : Antero-posterior conventional X-ray of knees and ankles were both performed under monopodalic load

2007 Clinical Trials

174. Clinical Evaluation of Placement of Radiofrequency-based Plasma Microdebridement in the Treatment Algorithm for Foot and Ankle Tendinosis and Plantar Fasciosis

treated each year for plantar fasciitis and fasciosis alone.(2) Conservative treatment options for recalcitrant heel pain include rest, stretching, strengthening and massage, progressing to non-steroidal anti-inflammatory drugs (NSAIDs), cox-2 inhibitors, steroid injections or iontophoresis with continued recalcitrance.(3;4) Orthotics, heel cups, night splints and plantar strapping are other conservative options frequently recommended by treating physicians.(4) Patient outcomes and response (...) for patients treated using RF-based plasma microtenotomy was compared to patients undergoing subacromial decompression. Both patient groups demonstrated significant improvement after each respective procedure and longitudinal recovery profiles were statistically similar. Early experience using this procedure for foot and ankle tendons, including the Achilles tendon, posterior tibial tendon, peroneal tendon, and plantar fascia revealed over 90% good to excellent results, reflecting the results shown

2007 Clinical Trials

175. Radial Nerve Lesion (C5-8)

[ ] A department of neurophysiology will be able to arrange nerve conduction studies. High-contrast ultrasound helps to identify the location, severity and cause of the condition. In some cases it may be more useful than nerve conduction studies. MRI scan may help to visualise a lesion such as a ganglion or a lipoma. Management [ ] Lesions from compression such as Saturday night syndrome and simple fractures usually recover spontaneously. General measures to reduce inflammation, such as splints and anti (...) and European Guidelines. You may find one of our more useful. In this article In This Article Radial Nerve Lesion C5-C8 In this article There are three posterior divisions of the brachial plexus that form the posterior cord. The largest and most frequently injured part of both the posterior cord and the brachial plexus is the radial nerve. The segmental origin is C5-C8 but there is also a sensory component from T1. Radial nerve compression or injury may occur at any point along the course of the nerve

2008 Mentor

176. Plantar Fasciitis

and give good arch support. Inserts should be worn in both shoes, even if pain is only in one foot. Night splints to keep the ankle dorsiflexed and the toes extended can help to stretch the plantar fascia and may induce faster healing. Corticosteroid injection The evidence for steroid injection shows that it may provide some short-term benefit but the evidence for its effectiveness in the long term is lacking. [ ] Counsel the patient accordingly. The technique A posterior tibial nerve block before (...) by dorsiflexing the toes. There is usually little or no swelling in plantar fasciitis. Referred pain from an S1/S2 lesion should be excluded. Perform the straight leg raising test as for examination of the back. Check the ankle tendon reflex (S1) and calf strength. This is easily performed by asking the patient to walk on toes or stand on one leg and raise the heel off the floor. These tests should be normal. Exclude tarsal tunnel syndrome: the posterior tibial nerve passes under the flexor retinaculum which

2008 Mentor

177. Mononeuropathies

on . Pain in the arm. Paraesthesia in the arm and hand (usually in C8 and T1 distribution). Atrophy of the hand. Weakness of the arm. Rarely, there may be cyanosis or oedema of the arm. Tarsal tunnel syndrome Caused by ankle sprains and fractures, ill-fitting footwear, cysts, ganglia, arthritis, tenosynovitis. Pain in the ankle and the sole of the foot. Paraesthesia on walking. Tibial nerve trunk is tender (posterior to the medial malleolus). Sensory deficit on the foot. Weakness of toe plantar flexion (...) . Radial nerve compression Radial neuropathy usually results from compression against the humerus. Leads to 'Saturday night palsy'. Wrist and finger drop. Variable paraesthesia - look for sensory loss in the dorsal aspect at the root of the thumb. Lateral femoral cutaneous nerve compression Leads to meralgia paraesthetica. Numbness in the lateral aspect of the thigh. Severe pain which restricts activities (reproduced by palpation under the anterior superior iliac spine). Paraesthesia

2008 Mentor

178. Heel Pain

and or orthopaedic specialist clinic should be considered. Additional therapy may be required - eg, orthotic devices, night splints to maintain an extended length of the plantar fascia during sleep, a limited number of corticosteroid injections, cast immobilisation for 4-6 weeks, or the use of a fixed ankle walker-type device to immobilise the foot during activity. If necessary, further treatment, such as surgical plantar fasciotomy, may be required. In most cases, removal of a plantar heel spur does not provide (...) with plantar fasciitis often have increased heel pain with their first steps in the morning or when they stand up after prolonged sitting. There is usually tenderness at the calcaneal tuberosity and pain is increased with passive dorsiflexion of the toes. Achilles tendonitis is associated with posterior heel pain. There is often increased pain with running, jumping, or making quick turns. There is pain and tenderness over the insertion of the Achilles tendon. There is often an increase in pain

2008 Mentor

179. Orthopaedic Problems in Childhood

) - this is caused by a tight posterior hip capsule; it usually resolves by the age of 2 years. Exclude rickets; consider night splint or osteotomy if the condition is severe. Genu valgum (being knock-kneed) - this is usually benign and normally resolves by the age of 5-8 years; surgery may be appropriate if the condition is persistent by age 10 years. Leg length discrepancy - usually due to growth asymmetry; treatment options include surgical correction of the longer or shorter leg, or inhibition of growth (...) calcaneal lengthening is an effective procedure for the correction of mild-to-moderate deformity. In non-ambulatory children with severe deformity there is a high relapse rate and surgery is unlikely to be helpful. - various abnormalities of the tibia, fibula and bones of the foot form a composite abnormality, also known as club foot. Treatment options include manipulation, casting, splinting and surgery [ ] . Hypermobile - flexible flat feet are common in neonates and young children [ ] . The condition

2008 Mentor

180. Bite plates and stabilization splints in mandibular dysfunction. A clinical and electromyographic comparison. (Abstract)

Bite plates and stabilization splints in mandibular dysfunction. A clinical and electromyographic comparison. Twenty patients with mandibular dysfunction, all women, aged 17-41 years, were randomized for treatment with either a bite plate with a frontal plateau or a full-coverage stabilization splint. The occlusal appliances were used at night for 6 weeks to compare clinical and electromyographic effects (EMGs). Integrated EMGs were recorded bilaterally from the anterior and posterior parts (...) of the temporal muscle and the masseter muscle in the rest position and during gentle and maximal biting before and after treatment without the appliances in situ. Initially recorded EMG activity in the temporal muscle was correlated to signs of dysfunction in the rest position. Compared with previously investigated healthy subjects, the patients had lower EMG activity in the anterior part of the temporal muscle and in the masseter muscle during maximal biting. Use of occlusal appliances at night for 6 weeks

1985 Acta odontologica Scandinavica Controlled trial quality: uncertain

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