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PubMedDate not supplied

A retrospective study of standing gastrocnemius-soleus stretching versus night splinting in the treatment of plantar fasciitis.

Plantar fasciitis is the most common cause of heel pain, yet the conservative treatment of plantar fasciitis is not standardized. This open retrospective study compared the effects of standing gastrocnemius-soleus stretching to a prefabricated night splint. One hundred and sixty patients with unilateral or bilateral plantar fasciitis were evaluated and treated according to the standard regimen in addition to either night splints or stretching. Seventy-one patients performed standing stretching of the gastrocnemius-soleus complex. Eighty-nine patients utilized the prefabricated night splint without standing stretching. The night splint treatment group had a significantly shorter recovery time (p < .001), fewer follow-up visits to recovery (p < .001), and fewer total additional interventions (p = .034) compared to the stretching group. Absolute body weight, body mass index, and age did not have a statistically significant effect on the time to recovery or additional interventions needed. The duration of pain prior to this treatment was a predictive factor and was associated with increased time to recovery and increased number of treatment interventions. Its was concluded that early treatment in a standardized four-tiered treatment approach, including the night splint without standing stretching of the gastrocnemius-soleus complex, speeds time to recovery.

Fasciitis↗

PubMed2000

Evaluation of the Herbst Mandibular Advancement Splint in the management of patients with sleep-related breathing disorders.

Sleep-related breathing disorders such as snoring and obstructive sleep apnoea syndrome are the cause of significant social disruption and hypersomnolence. Several intraoral appliances for the treatment of these disorders have been described, especially where nasal continuous positive airway pressure is poorly tolerated. Mandibular Advancement Splints, such as the Herbst splint used in this study can also be offered to patients with mild to moderate sleep apnoea and simple snorers. The success and compliance rate noted in the literature are quite diverse. Few side-effects have been reported. We therefore undertook this study to assess: (1) the compliance; (2) the effectiveness; and (3) the side-effects in the long- and short-term. All patients for whom a Herbst splint had been prescribed in the last 18 months were sent a postal questionnaire regarding the above mentioned issues. In all, 179 questionnaires were posted and on analysis of the 132 returned it was noted that 82% of splints were worn and 88% of patients found the device to be effective. The long-term side-effects were minimal. In addition objective assessment on 10 patients with and without a jaw-retaining device was also obtained. We conclude that the Herbst Mandibular Advancement Splint is a justifiable option in selected subjects with sleep-related breathing disorders.

Female↗

PubMed1998

Effects of a bite-raising splint on the duration of the chewing cycle and the EMG activities of masticatory muscles during chewing in freely moving rabbits.

Metal bite-raising splints of 0.5 mm thickness were attached to the upper molar teeth on both sides of the jaw in rabbits. The effects of these splints on masticatory behaviour during the chewing of soft food (bread) by freely moving rabbits were investigated. We recorded electromyograms (EMGs) of the masseter and digastric muscles. The animals exhibited prolongation of the chewing cycle, decreased EMG activity of the masseter muscle and increased EMG activity of the digastric muscle during chewing after introduction of the bite-raising splints. The effects of the splints on the activities of masticatory muscles were abolished by bilateral sectioning of the maxillary and inferior alveolar nerves. It seems likely that afferents from oral sensory receptors were responsible for the changes in masticatory behaviour after the introduction of the occlusal splint.

Animals↗

PubMed2000

Evaluation of the effect of a stabilization splint on occlusal force in patients with masticatory muscle disorders.

The purpose of this study was to evaluate the effect of stabilization splint therapy on occlusal force in patients with masticatory muscle disorders (MD). Six female patients with myalgia or myofascial pain participated in this study. The occlusal points and load on the dental arch in maximum clenching was measured using the computerized system with Dental Prescale(R) before and after the use of the splint. There were no significant changes in the number of occlusal points, mean occlusal pressure, and asymmetry in occlusal balance between before and after the use of the splint. However, there were significant differences in the extent of the area of occlusion and in the integrated occlusal loads. The integrated occlusal load converged to the normal level with the use of the splint. From the results of this study, it is suggested that the use of the stabilization splint has the effect of normalizing the occlusal force.

Adolescent↗

PubMed2001

The short-term effect of stabilization-type splints on the local asymmetry of masseter muscle sites.

Patients with temporomandibular disorders (TMD) may present with a cluster of joint and muscle disorders characterized primarily by pain, joint sounds and irregular or deviating jaw function. Maxillary stabilization-type splints represent the best standard therapy, so the purpose of this study was to evaluate changes in local cross-sectional dimensions (LCSD) of masseter muscle sites associated with short-term application of 'splint therapy' using the diagnostic approach of high-resolution gray-scale ultrasonography. The study included 29 patients who had signs and symptoms of temporomandibular disorders. Ultrasonographic investigation was performed with a linear (B-scan) 7.5 MHz small-part transducer to visualize the antero-superior, antero-inferior, medio-superior, medio-inferior, postero-superior and postero-inferior sites of the masseter muscle. To assess local muscle asymmetry patterns and to evaluate the respective effect of occluding splints, the 'absolute asymmetry index (AAI)' was used, with the mean maximum muscle diameter of the respective right and left sides calculated from three consecutive measurements before and after splint therapy. Comparing the pre-treatment with the 2-month follow-up values revealed a significant decrease in the overall mean asymmetry indices at the anterior (P < 0.01), medial (P < 0.05) and posterior (P < 0.05) muscle sites. There was no significant change in LCSDs at the various muscle sites (P > 0.05). The results of this study suggest stabilization-type splints to be effective in reducing local muscle asymmetries. Further studies are warranted to evaluate muscle-site specific effects in patient and non-patient groups and to relate these effects to pre-treatment variables like bite force, preferred chewing side, facial morphology and occlusion.

Adult↗

PubMedDate not supplied

An alternative splinting and rehabilitation protocol for metacarpophalangeal joint arthroplasty in patients with rheumatoid arthritis.

This prospective study was completed to establish results obtained using a static splinting regimen as an alternative to the dynamic extension splint. Fifteen patients with rheumatoid arthritis, who had undergone metacarpophalangeal (MCP) joint arthroplasties and a postoperative rehabilitation program of alternating MCP joint flexion and extension static splints, were assessed pre-operatively and reviewed postoperatively. Total active arc of MCP joint motion and ulnar deviation were measured, and an activities-of-daily-living questionnaire was completed by each patient at 19 months (mean) postoperatively. Mean total active arc of MCP joint motion showed statistical improvement from 21.6 degrees (range, 5 degrees-60 degrees) pre-operatively to 47.2 degrees (range, 15 degrees-84 degrees) postoperatively. The little finger gained the most improvement, with a 50.2 degree arc, showing that this regimen does not compromise flexion gains at this joint. Ulnar deviation improved from a mean of 30.4 degrees (range, 5 degrees-65 degrees) pre-operatively to 9.7 degrees (range, 0 degrees-30 degrees) postoperatively. These initial results reinforce the clinical impression that this alternating static splint regimen can be used as an effective alternative to the dynamic extension splint.

Activities of Daily Living↗

PubMed2000

Results after surgery for severe Dupuytren's contracture: does a dynamic extension splint influence outcome?

Seventy-six consecutive patients were operated on for advanced Dupuytren's contracture and the results evaluated after nine months with special reference to the use of a dynamic extension splint. The patients were separated into three groups: those in whom the splint was used according to our guidelines (n = 15); those in whom the splint was used, but inadequately (n = 15); and those who did not require splinting (n = 24). Our results nine months postoperatively were similar to those of other studies in showing that the fifth proximal interphalangeal joint constituted the greatest problem. Comparison of the three groups indicated that splinting the way we used it did not influence the natural course of the disease after operation.

Dupuytren Contracture↗

PubMed1994

Influence of stabilization occlusal splint on craniocervical relationships. Part I: Cephalometric analysis.

This study was conducted in order to determine the effect of an occlusal splint on craniocervical relationships, in subjects with muscle spasms in the sternocleidomastoid and trapezius muscles. A full-arch maxillary stabilization occlusal splint was made for each of the 15 subjects. Two lateral craniocervical radiographs were taken for each subject, with and without an occlusal splint. Cephalometric analysis showed that the splint caused a significant extension of the head on the cervical spine. There was also a significant decrease in the cervical spine lordosis in the first, second and third cervical segment. These cervical changes could be a compensation mechanism caused by the extension of the cranium on the upper cervical spine. The change in the curvature implies that it is necessary to periodically evaluate the changes occurring in the craniocervical relationships after the occlusal splint has been inserted.

Adult↗

PubMed1994

Influence of stabilization occlusal splint on craniocervical relationships. Part II: Electromyographic analysis.

The aim of this study was to determine the effect of stabilization occlusal splints on electromyographic (EMG) activity of sternocleidomastoid and trapezius muscles in subjects with spasm in the mentioned muscles. A full-arch maxillary stabilization occlusal splint was made for each of the 15 subjects. In the sternocleidomastoid muscle, tonic and saliva swallowing EMG activity decreased significantly with the splint, whereas maximal clenching activity did not change. In the trapezius muscle, no significant changes were observed with the occlusal splint. The different pattern in both muscles during tonic and swallowing EMG activity with the splint is attributed to differences in the synaptic inputs to the respective motoneuron pools, suggesting that a differential modulation of the motor neuron pools may exist of both muscles, of peripheral and/or central origin.

Adult↗

PubMed1997

Effect of occlusal splint on masticatory movement in healthy individuals.

To investigate the effects of wearing an occlusal splint on masticatory movements in healthy individuals, twelve healthy individuals were examined. A full maxillary stabilization splint made of heat-cured acrylic resin was fabricated for, and worn by, each individual for 24 hours. Masticatory movement was measured before and after the 24-hour period using a 3-D mandibular movement analyzing system. While the duration of a masticatory cycle+ did not change, the occlusal time significantly decreased after use of the splint. The lateral displacement of the opening phase to the balancing-side area also decreased after use of the splint, showing a vertical pattern of the opening path. Measurement in more healthy individuals and patients should help clarify the therapeutic mechanism of the splint in the treatment of temporomandibular disorders.

Adult↗

PubMed1989

Effect of hand splints on stereotypic hand behavior of girls with Rett syndrome: a replication study.

The purposes of this study were to replicate a recent report of the positive effects of hand splinting on the stereotypic hand movement of children with Rett syndrome and to evaluate the generality of these results to a different setting. Two 5-year-old girls diagnosed with early Stage-III Rett syndrome were introduced to hand splints in accordance with the multiple-baseline design used in the Naganuma and Billingsley study. Splint wear ranged from 30 to 50 days for the two subjects. Data were analyzed as a percentage of time and as actual time in minutes. Unlike the previous study, in which a decrease in hand-wringing behavior was noted, neither subject in our study demonstrated a decrease in stereotypic hand behavior or a subsequent increase in independent feeding skills when wearing the splints. There was also no evidence of increased hand wringing following withdrawal of the splints. The differences in ages of the subjects and different functional levels (stages) may have been contributing factors to the conflicting results and should be considered in managing this group of children.

Child, Preschool↗

PubMed1989

Basic principles of splinting the hand.

This article presents the basic principles needed in the fabrication of static and dynamic splints. The principles are defined, and examples are used as illustrations. The biomechanics of dynamic splinting are described, with special attention given to low-profile dynamic splinting. Several low-profile dynamic splints are described, with current indications presented in case studies with supporting documentation for appropriate splinting protocols.

Adult↗

PubMedDate not supplied

Have you tried the sandwich splint? A method of preventing hand deformities in children.

The prevention of contractures of the burned hand is an arduous problem in the young pediatric burn patient. Difficulty in applying splints, along with the time-consuming fabrication of complex splints, led to the development of the "sandwich" splint. This easily produced splint provides a means of preventing and treating hand deformities in this patient age group. Positive results have been noted with the use of this splint in conjunction with the patient's usual active physical therapy program.

Burns↗

PubMedDate not supplied

Analysis of materials for splinting of the thermally injured patient.

Good results have been achieved in the treatment of patients with burns with new splinting materials and proper splinting techniques. This article focuses on the thermoplastic splinting materials Clinic and Spectrum (Northcoast Medical Inc., San Jose, Calif.) and the comparable thermoplastic products Polyform (Smith & Nephew Rolyan, Inc., Menomonee Falls, Wis.) and Orthoplast (Johnson & Johnson Orthopedics, New Brunswick, N.J.). Qualities such as self-bonding, recyclability, and rigidity were tested for these materials. Splint rigidity was measured by a calibrated hook scale and determined by the force per pound needed to bend the material 20 degrees. Spectrum and Clinic products were judged more economical and, we contend, they are therefore better choices for splinting the thermally injured patient.

Burns↗

PubMed1991

Influence of an occlusal splint on integrated electromyography of the masseter muscles.

In order to examine the effect of an occlusal splint on the integrated electromyography (EMG) of the masticatory muscles, EMG of bilateral masseter muscles of 23 patients with temporomandibular joint disturbance syndrome (TMJDS), with and without an occlusal splint, was measured and integrated on line during maximum clenching. It was found that the integrated myoelectrical value of the masseter muscle on the involved and non-involved side was reduced with the occlusal splint. The absolute difference between integrated myoelectrical values in the left and right masseter muscles was reduced with an occlusal splint, but the relative difference remained virtually unchanged. These results indicate that the occlusal splint can decrease masseter muscle activity and thus exert a therapeutic effect.

Adult↗

PubMed1995

Effects of occlusal splints on the asymmetry of masticatory muscle activity during maximal clenching.

The effects of stabilization splints on the electromyographic activity patterns of the masseter and anterior temporal muscles during maximal clenching in healthy subjects and subjects with different types of stomatognathic dysfunction syndrome were investigated. No marked effect of splints on the asymmetry of muscle activity during bilateral clenching was revealed immediately after splint insertion. During unilateral clenching in the intercuspal position (ICP), the relative asymmetry index (rAI) of the masseter muscles, detecting the imbalance of left and right muscular activity, was significantly increased. The use of splints suppressed the asymmetry of masseter muscle activity during unilateral clenching. This result suggests that the use of a splint is a method of suppressing clench-caused aggravation of stomatognathic dysfunction in the presence of an imbalance between left and right muscle activities.

Adult↗

PubMed1995

The temporal/masseter co-contraction: an electromyographic and clinical evaluation of short-term stabilization splint therapy in myogenous CMD patients.

The short-term effect (3-6 weeks) of the use of a stabilization splint was investigated in a group of 35 myogenous craniomandibular disorder patients. The patients were clinically examined and surface EMG recordings of the temporal and masseter muscles were made during clenching in the intercuspal position (ICP), immediately after the insertion of the splint (SSP), and after at least 3 weeks of splint treatment (SSP 3). With the use of the error variance of the activity index changes in EMG activity were investigated. Three groups of patients were then recognized. One group showed a decrease in temporal muscle activity during splint treatment. Another group did not show any significant change during splint treatment. The third group showed an increase of temporal muscle activity. In general, significant reductions in the amount of static pain were found. In the group with a significant reduction of temporal muscle activity (n = 15) there was a greater decrease in the amount of static pain (P < 0.05) than in the group (n = 4) with a significant increase of temporal muscle activity. The results may indicate that the temporal muscle plays an important role in the perception of static pain in the masticatory system.

Adolescent↗

PubMed1976

Influence of splints and temporary crowns upon electric and thermal pulp-testing procedures.

The influence of different splints and temporary crowns upon the reliability of electric and thermal pulp-testing procedures was examined in 10 patients with vital maxillary central incisors and 10 patients with vital maxillary central incisors and 10 patients with unilateral pulp necrosis of a central incisor. The pulp-testing procedures were: (1) Bofors Pulp Tester, (2) Siemens Sirotest, (3) heated guttapercha, (4) ice, and (5) carbon dioxide snow (Odontotest). The splints or temporary crowns were: (1) silver cap splint, (2) acrylic cap splint, (3) Hawley orthodontic plate, (4) Saur's arch bar, (5) orthodontic bands, (6) stainless steel crown, and (7) stainless steel crown with labial surface removed. A reliable electrometric pulp response could only be elicited if the pulp tester was applied directly upon enamel and preferably upon the incisal edge. In this instance metal splints or partial steel crowns applied to the tooth had no effect on the pain threshold. A false positive reaction in case of pulp necrosis was only elicited when the electrode was placed directly upon metal which contacted neighboring vital teeth. The use of ice and heated guttapercha appeared to be of limited value, due to inconsistent pulp responses. Carbon dioxide snow gave a reliable response, unless applied on the incisal edge.

Adult↗