Tuesday, October 6, 2015
Recurring foot pain caused by plantar fasciitis can limit mobility and make even walking a painful task. The typical approach to reducing this inflammation pain is to stay off your feet, but there are better solutions. Clinical studies show that when a night splint is used with Accommodator insoles, patients see faster recovery and significant heel pain relief.1
Plantar fasciitis is defined as painful inflammation of the plantar fascia. The plantar fascia is the thick band of tissue running across the bottom of the foot that connects the heel to the toes. Plantar fasciitis causes sharp, stabbing pain that is usually the worst first thing in the morning when first stepping out of bed.
The Accommodator insole supports the arch so it cannot collapse or "flatten" during normal daytime standing, walking or running. When the arch collapses, the faciae, which tie the forefoot to the heel, are stretched, aggravating the plantar fasciitis pain. The FREEDOM Plantar Fasciitis Night Splint helps reduce severe heel pain by stretching the plantar fascia, foot and calf muscles that relax while sleeping, so patients are able to get out of bed with less pain. . The combination of a night splint and these insoles not only reduces pain, but also helps resolve the plantar fasciitis.
 The Prospective Evaluation of Invasive and Noninvasive Treatment Protocols for Plantar Fasciitis. Awbrey BJ, Bernardone JJ, Connolly TJ. Rehabilitation R&D Progress Reports. The Use of Night Splints for Treatment of Recalcitrant Plantar Fasciitis. Wapner KL, Sharkey PF. Foot Ankle; 12(3): 135-6.
Low trunk tone, especially in younger children, creates huge issues in being able to perform functional activities. The weight of the head is such that many are unable to even sit unsupported let alone begin to enjoy function and their surrounding environment.
TLSO’s have been around for a long time however the single biggest issue has always been around comfort for the user. Whilst functionally they perform well, if a product is not comfortable then the user simply refuses to wear it and all benefit is lost.
The Restorative Medical Safe Spine is made of softer more conforming materials making it comfortable to wear unlike a moulded thermoplastic device. It is easy to don and doff and the materials wick moisture from the skin keeping the user cool.
The Safe Spine is suitable to be worn all day however many users choose to wear it just when performing activities where additional trunk support is desirable. Places/ times when this works well include; using a corner seat, using a standing frame, using a walking frame, in a car seat, horse riding, cycling to name just a few.
By using the Safe Spine to support the torso you are then able to use less lateral brackets and bracing, and less carer hands on support. Supporting the torso independently, and providing gentle spinal extension allows the user greater energy to use arms, hands and practise independent head control.
Safe Spine’s can be customised to the individual user with cut outs for feeding tubes and custom heights and widths to suit individual shapes and sizes.
The Environmental Impact Report
Author - Andy O’Sullivan
The paradigm shift in society to give greater individual choices in our lives is mirrored in the care setting.
This change in the equipment we use to assist in enabling more access to the life around those in a care setting has introduced changed physical forces to what we have traditionally dealt with.
The advent of three and four section electric beds; recliners; Tilt and Recline wheelchairs; and other technologies has delivered a great deal more “living and lifestyle” for persons with disabilities or age related loss of function. Television and computers are accessible, interacting with those around you, being eye to eye with life. No longer the bed bound, body wasting patient of yesteryear.
Whilst medicine and science have played a significant part in prolonging life, it would mean little if we were not given the opportunity to continue to “live” life.
This has been, perhaps, the greatest shift in caring of the modern era. The ability to live your life with the abilities you have.
This entitlement to living your life as richly as possible has put new demands on the support surfaces that are required to give those we care for the safety and security that will enable them to do just that.
As an example - If we just look at the bed surface and the use of the elevated bed head, then we see that products and solutions for supine lying may not be enough when the tangential forces of friction and shear are added to the pressure.
Before the advent of this enabling technology if you had pressure issues you would be nursed flat, turned regularly and had skin tension reliefs often by onsite staff. Enter the new technology and cost/care models and the picture blurs somewhat. Yet we still see mattress manufacturers focus on the single dimensional forces and talk about average pressures.
The Environmental Impact Report© (EIR©) is a document that sets out to give a structured process to the evaluation of environmental influencing factors with relations to pressure care.
The EIR© deals only with the extrinsic forces and should not be used simply by itself but sits alongside the use of pressure care assessment scales such as Waterlow (http://www.judy-waterlow.co.uk) and Braden (http://www.bradenscale.com) which deal more with the intrinsic aspects of pressure care.
Based on this and our own experience we decided that we would allow for a framework where independent solutions are to be found that were not dictated by a previous clinical bias or technology solution simply because it was available or had history in the site or facility.
Click here to view the full report Environmental Impact Report
If you are uncomfortable in bed your sleep will be compromised.
We use 24 hour positioning to ensure we do not fall into dangerous postures during the many hours spent in bed. Whilst the benefits of proper positioning during sleep are well documented this must not be done at the compromise of comfort, there has to be a happy medium that increases positioning but in a way that is manageable, comfortable and safe for both the user and caregiver.
Sleep systems that are too rigid and unforgiving will often be left unused if bedtime becomes a struggle between user and caregiver, where the user simply does not want to be strapped into a hard, unforgiving surface for hours – and why would they?
Compliance is the number #1 issue with Sleep Systems and the main reason they become unused is “comfort”. Either the user is not comfortable in the system or the caregiver is not “comfortable” with putting the user into the system.
Snooooooze has changed all that! The Snooooooze Flexible Sleep System was designed in conjunction with Caregivers, End Users and Therapists to come up with a system that is functional, supportive and comfortable.
Each flexible component is made with a mix of chipped memory foam contained in an outer Dartex cover. The memory foam conforms to body contours and is soft and comfortable in bed. The Dartex cover is also soft and is easy to wipe down and keep clean.
The Snooooooze System is modular and you choose the pieces/shapes you need to support your individually required positioning. A little or a lot, the choice is yours.
For more information please click here.
Tom Watts, 16, has been taking on the world of extreme sports thanks to his Lycra orthoses supplied by DM Orthotics.
Tom suffered a stroke at the age of eleven which impaired the function and movement down his left side, preventing him from continuing to enjoy contact sports such as rugby. Now aided with DM Orthotics’ Dorsiflex Sock and more recently the DMO Glove, Tom is taking on Extreme Sports like climbing and mountain biking.
Tom was determined to get active again and tried a number of rigid carbon fibre splints for his foot before his physiotherapist recommended DM Orthotics’ Lycra version. Tom explains,
“I got through about three different types of carbon fibre splints, but because I was so active, I kept breaking them. They just didn’t last, or weren’t flexible enough to allow me to do the things I wanted to do.”
The Dorsiflex Sock works using a number of strategically placed Lycra panels which create forces to re-align the foot’s position, providing active dorsiflexion (lifting the foot up during walking and running).
Martin Matthews, Managing Director at D M Orthotics explains,
“The new positioning stimulates the body’s neuro-sensory system and effectively, re-programmes the brain so that the muscles work in a new bio-mechanical state. There are a number of benefits to this including increased proprioception but most importantly it encourages muscle movement and usage.”
Tom says of the Dorsiflex Sock,
“The Dorsiflex Sock is great. Because it is made from Lycra it is really easy to put on. It’s so much more comfortable, nice and light and doesn’t rub. I don’t have to keep changing it over either like I did with the carbon fibre splints. I can just put it on in the morning and leave it on all day.”
Tom has been able to take part in a lot more activities that require a lot of leg movement with the Dorsiflex Sock and joined the Club of Extreme Sports at his local leisure centre.
“I can do a lot more running using the sock. I go to an Extreme Sports club - I do wall climbing, mountain biking, rocketball. The Dorsiflex Sock has definitely allowed me to do a lot more of these things.”
And there are also other aesthetic benefits, something which is important as Tom points out,
“The other great thing is that you can choose your own colours. Mine looks like a regular sports sock which is great in the summer, when people see it, they think it’s just a sports sock – it doesn’t draw the same sort of attention as a rigid brace.”
As a wheelchair user you will know that the ability to move your torso, stretch, reach and being able use your arms to their fullest extent has a huge impact on how you approach and can achieve everyday tasks.
Function starts with stabilising the pelvis, spine and shoulders.
The pelvis supports the spine and ensures your neck is free to move. If your shoulder girdle is supported then arms are stabilised for fine motor and hand control.
Using a backrest that blocks and supports the pelvis in a slight posterior tilt and allows the spine to retain a functional lumbar curve will increase your upper body range of motion significantly.
You can test this for yourself.....slump down in your chair, collapse your spine down and bend your head forward and see how far you can reach forward, stretch up or twist – it’s not great and it’s also not easy!
By comparison extend your spine upward with a slight arch in your back your pelvis sitting against the back of the chair and try the same reach, stretch and twist, so much easier isn’t it?
The Roho Agility backrest is ideal for users who want to increase their function. The Roho Agility is designed to allow your Therapist to fine tune the angle and seat depth of the backrest whilst you are sitting in the chair. This makes finding your ideal functional position simple and fast without multiple transfers! All this adjustment can also be done with just one allen key.
Roho Agility comes in three different contours, Minimum, Mid, Maximum, this mean you can choose the model most appropriate for you. Roho Agility gives you the structural support you need without limiting your function.
To find out more about the Roho Agility backrests click here....
Click here for Video Links
How people sit is fundamental to their health
The standard sling seat, sling-back, collapsible wheelchair was designed to transport people short distances, for short amounts of time, to assist the person pushing the chair, and to make storage easy.
The chair works for the caregiver, but very poorly for the person in it, particularly if it is used for long periods of time and as the primary seating system for the individual.
When frail elders are properly seated in chairs designed to meet their personal needs improvement in their health is virtually instant.
A PROPERLY DESIGNED FUNCTIONAL CHAIR FOR THE ELDERLY IS A NECESSITY FOR GOOD HEALTH
Benefits of Proper Seating
The chest cavity more easily expands if the person is not slumped forward.
Better positioning improves:
* lung compression
* vascular health
* Pressure distribution
Good positioning can also improve Quality of Life:
* Skin Condition,
* Ability to Care for Self
* Efficient use of limited energy and endurance
* Eye contact
* Socialisation / Talking to each other
* Watching TV
* Self confidence
* Neck / Shoulder pain
* Lower back pain
Prevention of Skin Breakdown
Proper cushions and support prevent skin and tissue breakdown by more evenly re-distributing pressure, thus allowing the individual to be up for longer periods without causing damage.
Improved Comfort and Wheelchair Tolerance
Comfort and physical safety is an important concern of frail elders. The amount of time the person feels able to be up in the chair can be used as a practical indicator of comfort . If the person is uncomfortable in the wheelchair or day chair, they will often ask to go to bed sooner and refuse to become more involved in activities.
Older adults experience more pain due to:
* Chronic illnesses
* Diagnosed or undiagnosed spinal fractures
* muscular atrophy
* Tendon shortening
Often with proper positioning and support, this type of pain can be dramatically reduced. Persons with dementia may not have the verbal or cognitive ability to express their pain in words or even respond appropriately when asked if they are in pain.
However, their behaviour is often a good indicator of pain.
Improved Ability to Care for Self
Correct arm rest length and height allow a wheelchair to get under the table so that at meals the person can be close enough to reach the food and feed themselves.
A level eye gaze allows them to see in the mirror for grooming.
With the proper chair many people can independently wheel themselves from place to place.
Better use of Limited Energy and Endurance
Frail elders often have limited stamina, endurance and energy. When one is not positioned properly energy is required simply to remain upright.
The standard wheelchair wights between 15 - 20kgs, a lightweight chair weighs 10-12kgs and an ultrlight chair can weigh even less 8-9kgs. Choosing a lighter weight chair can save energy for use with other activities. With proper support, the person can relax and focus on other activites such as eating or conversing.
Improved socialization can result from:
*level eye gaze
*ability to move oneself in and out of social situations
*choice in accessing activities
Improved Quality of Life
It goes without saying that if a person is more comfortable, more independent, and has better function, that person will have improved quality of life and self esteem.
When properly seated
*Frail elders may be easier to transfer
*Be able to transfer themselves
*Able to feed or roilet themselves
*May require less repositioning
*Tolerate being up for longer periods
*Have fewer behavioural problems
LIFE IS FOR LIVING, NOT EXISTING