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Tech Papers

 

COLD THERAPY

Name: Cold Steerage
Author: Mack D. Rubley, PhD, ATC
Source: BioMechanics December 2002
Summary: Harnessing the healing power of cryotherapy — Given the many variables that determine cold therapy effectiveness, practitioners should realize that no single protocol will be ideal for all patients. Understanding the factors that determine the effectiveness of cryotherapy will facilitate earlier exercise and complete rehabilitation.

 

Name: Corflex Cryotherm Wrap Study
Author: Marie Pellegrini, MSN, RN, C “Manager, Occupational Health”
Summary: Due to the concerted efforts of the staff at Notre Dame Center for Occupational Health, Occupational Therapy and Physical Therapy, we have successfully completed the Corflex Cryotherm Wrap pilot study. The results supported Cryotherm Wrap use, demonstrating excellent compliance rates, patient satisfaction with product use, and reported efforts of improved tolerance to work and other activities.

 

Name: Superficial Heat and Cold – How to Maximize the Benefits
Author: Matthew P. Kaul, MD and Stanley A. Herring, MD
Source: The Physician and Sportsmedicine December 1994
Summary: The wide array of superficial heat and cold modalities offers physicians many options for treating sports-related injuries. Appropriate application of heat and cold therapies can reduce the impact of an injury by relieving pain, reducing swelling, and encouraging rehabilitation.

 

CERVICAL / SPINE

Name: Braces: Low Back Bracing for Post-operative Surgery of the Lumbar Spine
Author: Saul Bernstein, MD
Source: BioMechanics January 1997
Summary: Bracing can provide significant benefits in the course of treatment post-operatively. Post-operative bracing can provide protection and pain relief.

 

Name: Quantitative EMG Analysis of Disc Unloader Brace
Author: Vijay Vad, MD. , Assistant Professor of Rehabilitation Medicine
Summary: The purpose of this study was to determine if the Disc Unloader brace was effective in reducing intradiscal pressure. There is a strong correlation between lumbar paraspinal activity and intradiscal pressure. We used ten healthy volunteers to measure lumbar paraspinal activity at L5 using a quantitative EMG system. After doing reliability and reproducibility testing which showed margin of error of 7%, ten volunteers were measured for quantitative EMG activity at the L5 paraspinal level in full lumbar flexion without the Disc Unloader brace three times and averaged. The same quantitative EMG testing was done in full flexion with the Disc Unloader brace on at the L5 paraspinal level three times and averaged. For five of the ten patients, we performed the test first with the Disc Unloader brace on whereas for the rest of the five, the test was performed first without the brace on. There were 7 females and 3 males with average age of 39 (range 26-46). The average area under the curve score was 173 ± 27.1 microvolts at the L5 paraspinal for the ten healthy subjects without the Disc Unloader brace on. The average area under the curve score was 102 ± 19.6 microvolts at the L5 paraspinal for ten healthy subjects with the Disc Unloader brace on. There was a statistically significant (p<0.05) reduction in quantitative paraspinal activity of 41% with the Disc Unloader brace on. We conclude that the Disc Unloader brace is effective in reducing quantitative EMG lumbar paraspinal myoelectric activity and therefore intradiscal pressures.   Name: Brace Yourself: An Old Remedy For Back Pain Makes Comeback
Author: Tara Paker-Pope
Source: WSJ January 2004
Summary: With the evidence that most medical procedures for back pain are largely ineffective, patients are finding relief from a surprisingly simple treatment.

 

UPPER EXTREMITY

Name: Boxer Splint Memo to Healthcare Providers
Author: Douglas Goumas, MD
Summary: The Boxer Splint is a very versatile lightweight metacarpal fracture brace. Some of the key points to consider are: it saves time, eliminates one of the hardest casts to roll and is customizable.

 

Name: Casting & Splinting for Acute & Chronic Cubital Tunnel Syndrome
Author: Richard DeRosa, O.T.C.
Source: Orthopedic Associates of Hartford, Hartford Connecticut
Summary: When looking at casting and splinting, we basically think of the fixation and stabilization of fractures. With the ever-growing world of sports medicine and occupational therapy, we are finding countless uses for these very special products. For example, the use of fiberglass casting material allows for innovative and functional uses that the plaster would never allow. The casting and splinting for cubital tunnel syndrome are an area where practices (like mine) have found considerable success.

 

Name: De Quervain’s management starts with differential diagnosis
Author: Occupational Therapy: Sherry Benisch, OTR, and Sean Melicher, CMT
Source: BioMechanics May 2000
Summary: Quervain’s disease is often confused with carpal tunnel syndrome, arthritis and intersection syndrome. Accurate diagnosis requires skillful use of Finklestein’s test and therapeutic modalities. Once diagnosed, attention to pain-relief modalities, job-site evaluations, and home exercise are essential for recovery.

 

Name: Subcutaneous Anterior Transposition of the Ulnar Nerve For Recurrent Cubital Tunnel Syndrome
Author: Andrew E. Caputo, MD, Hartford CT / H. Kirk Watson, MD, Hartford CT
Summary: We evaluated the effectiveness of subcutaneous anterior transposition of the ulnar nerve for recurrent cases of cubital tunnel syndrome. The current literature universally suggests that submuscular anterior transposition is the standard operative treatment for recurrent cubital tunnel syndrome.

 

Name: A new method of immobilization after traumatic anterior dislocation of the shoulder: a preliminary study.
Author: Eiji Itoi, Yuji Hatakeyama, Tadato Kido, Takeshi Sato, Hiroshi Minagawa, Ikuko Wakabayashi and Moto Kobayashi
Source: Journal of Shoulder & Elbow Surgery October 2003
Summary: Plantar fasciitis is a frequent cause of heel pain in athletes, as well as in persons who are not involved in sports. Stretching, strengthening, correction of training errors and orthotics are essential components in any treatment program. For patients who do not respond to these interventions, posterior night splints can obviate the need for invasive therapies such as corticosteroid injections and surgery.

 

LOWER EXTREMITY

 

Name: Management Options for Plantar Fasciitis
Author: Mark E.Batt, MB, BChir and Jeffrey L. Tanji, MD
Source: The Physician and Sportsmedicine June 1995
Summary: Plantar fasciitis, a common over use injury, is characterized by heel pain that is usually more severe when the patient first arises. Frequent precipitating factors include adverse foot mechanics, training errors, and degenerative changes. Management of plantar fasciitis is a three-part process that involves treating the inflammatory lesion, correcting precipitating factors, and instituting a graduated rehabilitation program. Use of the tension night splint has shown promising results.

 

Name: Night splints: Conservative Management of Plantar Fasciitis
Author: A. Louis Jimenez, DPM, and Robert M. Goecker, DPM
Source: BioMechanics September 1997
Summary: We have noted success with patients who have used night splints, but compliance can be a challenge. Use of a night splint with 5 degrees of dorsiflexion was used on fourteen patients. Eleven of the fourteen using the night splint experienced resolution of recalcitrant plantar fasciitis.

 

Name: The Use of Night Splints for Treatment of Recalcitrant Plantar
Author: Keith Wapner MD and Peter Sharkey MD
Source: American Orthopedic Foot and Ankle Society 1991
Summary: This study reports the results of the use of molded ankle-foot orthosis night splints for the treatment of recalcitrant plantar fasciitis on 14 patients with a total of 18 symptomatic feet. All patients had symptoms for greater than 1 year and had previously undergone treatment with non-steroidal anti-inflammatory medicines, cortisone injections, shoe modifications, and physical therapy without resolution. All patients were provided with custom-molded polypropylene ankle-foot orthoses in 5° of dorsiflexion to be used as a night splint. With continued use of non-steroidal anti-inflammatory medication, Tuli heel cups, Spenco liners, and general stretching exercises, successful resolution occurred in 11 patients in less than 4 months. There were three failures. It is felt that the use of night splints provides a useful, cost-effective adjunct to current therapeutic regimens of plantar fasciitis.

 

Name: Use of Posterior Night Splints in the Treatment of Plantar Fasciitis
Author: Jerry Ryan, M.D. , University of Wisconsin Medical School, Madison, Wisconsin
Source: American Family Physician September 1995
Summary: Plantar fasciitis is a frequent cause of heel pain in athletes, as well as in persons who are not involved in sports. Stretching, strengthening, correction of training errors and orthotics are essential components in any treatment program. For patients who do not respond to these interventions, posterior night splints can obviate the need for invasive therapies such as corticosteroid injections and surgery.