She has cerebral palsy  This graphic shows her unable to balance with an inturnally rotated left leg.

This is the same girl 30 minutes later

   wearing

Crampbusters

The Crampbuster Story

      From Acorn toSapling

 

Bouyed by this response I tried it with a group of hemiplegic people who were members of a stroke group in Canberra. There were a variety of positive responses.

The lady who organised the club was a Physiotherapist whose husband had suffered from many strokes and was bedbound and cared for in a nursing home. Both arms and his left leg were very stiff and he wailed whenever the staff approached to move him. The hand loops were applied and soon gave him relief from the stiffness and pain in his arms.

His wife asked me to try and make something similar for the foot. [figure5] This inhibited the rigidity in his left leg. He no longer wailed when being moved. He wore them 24hours a day and no longer wailed when staff approached.                                                  

                                       Figure 5 

 

 

 

 

 

 

 

 

 

 

 

 

During the following week I considered whether this device might help the bright lady who, as well as having pain in her arm, had severe pain in her leg both day and night, especially when walking. She was able to wear it inside her shoe. 

I was delighted when she reported a reduction in pain, especially in the internal rotator of the hip, She had been walking with an internally rotated hip, stiff knee and weightbearing through her right great toe. Because of this she wore a built up shoe. 

The device helped inhibit the increased tone and she began to get a little knee flexion when walking. She progressed to wearing normal shoes. Her heel remained 1/2" from weightbearing. Adduction of the hip was now possible which reduced the scoliosis of the spine while walking. Compare figures 6 and 7.

                                                                               figure 6                                 figure 7

 

Graeme Collins my assistant asked me to explain what was causing her pain. I replied that it was sort of like cramp. He asked if I would make a pair for his wife who had suffered agonising night cramps for many years and these occurred several times a week.

Although I did not consider that they would be at all helpful, I am not one to knock anyone's ideas. To my astonishment he kept reporting "No cramps last night" for two weeks. It was then that I asked if she would consider not wearing them for a week. She only lasted a few days before she asked if she could resume wearing them because the cramps were so bad. WOW!

This began a flurry of excitement. We began a trial of these devices which were given the name of "Cramp Busters". We eventually found fifty severe cramp sufferers to try them. A report of this study was published in letter form in the Medical Journal of Australia on the 7th of June 1993, with the help of Dr John Egan, MB BS.

 

It is difficult for therapists, patients and parents to comprehend that crampbusters have an effect on the whole limb, and not just the hands and feet. They feel that because they are worn on the hands and feet that the effects should be confined to that area. This is not the case.

 

I worked as a sole Occupational Therapist at the Goulburn Base Hospital [ a country hospital in Australia] and without the fantastic support the staff, little of this could have been achieved. My special thanks must go to Graeme Collins who has been involved every step of the way, and was my first "sounding board". I am also indebted to the therapists who have refered patients, given support and shown interest.

The device illustrated in figures 3 and 4 had a few problems! It was difficult to describe how it was to be put on, and rather clumsy. The new design, figures 8 and 9 was successfully tried, obtaining the same effect.  

                              Figure 8                                       Figure 9 

 

Cramp - The  hospital staff would let me know when there was a patient suffering cramp. It was almost always cramp of the lower limbs, but there was a group of medical patients [who recieved medication via a nebuliser] some of whom suffered cramps in the upper as well as lower limbs.

This hand device became known as a Hand Cramp Buster, figure 9. Other people who often suffer cramps are those with Parkinson's Disease and Multiple Sclerosis

I considered that crampbusters worked because they minimally spaced the fingers and toes.

In 1994 a young hockey player [the goal keeper] was referred because she was getting severe cramp of the hands while wearing the large gloves which spread the fingers. [How could this be!] She was provided with figure 9. type hand cramp busters that she wore inside the gloves and this prevented further cramp.

My notion that crampbusters worked because of digit spacing- flew straight out of the window !

Charles, has worn crampbusters on his hands and feet for several years and is now aged 14. He has cerebral palsy, which causes a left hemiparesis. He originally started to wear them because his ankle/foot orthosis hurt and he would not wear it. After wearing a foot crampbuster for two weeks he could hop on his left foot. If he calls to see me I know whether he wearing the crampbuster or not because his leg internally rotates when he is not wearing it, even though his heel remains down.The parents have reported that the surgery that was to be done on hisarm and leg is no longer required.

Charles has now worn a hand crampbuster for several years. Figure 10. shows Charles' hand before treatment and figure 11. shows him wearing a figure 9. crampbuster. Figure 12. shows a modified crampbuster worn with a "Joclyn" splint. 

Figure 10.                                                        Figure 11.                                    Figure 12.

A tiny three months old baby with the diagnosis of hypo genisis corpus colosum, was brought to me. She was rigid fisted and blind.The hands were so tightly fisted that the distal phalanx of the middle fingers were displaced sideways at 45 degree angle. The mother had been given splints [figure 18] to be bandaged on for 30 minutes at feed time. It took the mother 30 minutes to put them on, with the baby crying the whole time. The baby had severe reflux, and the stress of this was compounding the problem. As an alternative I tried two pieces of plastazote 19mm tubing with a 6mm hole, with to ends of hat elastic drawn through the centre of each as in figure 19. The elastic was to hold the plastazote in place, by passing it through between the web spaces on either side of the middle finger, knotted then fastened round the wrist as in figure 20. The baby's hands opened up and the rigidity lessened. 

      Figure 18                                                           Figure 19                                               Figure 20

 

 

 
© 2007 Pauline Buck

                                                                

The Crampbuster Story

From Acorn to Sapling

 

.                                    

 

 

In the early 1980's I worked as an Occupational Therapist in Dunedin New Zealand. During this time there was a lady who had suffered from a right sided stroke.She had a very painful right leg,especially at night and while weight bearing. A physiotherapist demonstrated that by taking a piece of foam 4"x 3"x 1 1/2" with three cuts in it, as seen in figure 1. you could inhibit spasms by pulling these "fingers" of foam up firmly between the web spaces of the toes, as in figure 2. This relieved the pain, which allowed her to sleep. I remember the staff and patient lamenting that it was a great pity that it would not fit inside her shoe to relieve pain when she walked.

.                                figure 1                                                       figure 2

 

In 1991 I met a bright lady who had suffered a stroke twelve years previously. She had severe pain in her arm and leg.

Shoulder was so tight that it was difficult to wash under the arm.

Elbow was flexed and rigid and no passive movement was possible. 

Wrist was flexed and no passive movement was possible.

Thumb was in full opposition and adduction and was dislocated at the MCP joint with the fingers tightly flexed over the thumb causing the dislocation.

Fingers so tightly fisted that the hand presented a considerable hygiene problem.

 

At this time I recalled the lady in New Zealand and pondered whether a similar thing might apply to the upper limb. Because the hand was so difficult to open, I tried slipping loops of foam backed velour [figure 3] over the index and ring fingers bringing the end of the strap accross the web space between the thumb and index finger, as in [figure 4]. The results were almost immediate. After the time it took to have a cup of coffee it was possible to passively abduct the shoulder, partially extend the elbow and it was now possible to unravel the hand, and eventually relocate the thumb on the outside of the fist. This relieved a lot of pain caused by the dislocation of the metacarpal phalangeal joint

                      Figure 3                                                            Figure 4.

 

 

 

Increased tone could still be triggered by pain if she bumped her leg, or a too vigouous stretch was placed on shortened muscles in the treatment setting. This often continued until the pain spasm cycle had been broken, with the use of analgesics. At other times she was pain free and walked pain free for the first time in twelve years. She was sleeping better.

 

 

 

Mykalia [who has cerebral palsy]  has been wearing crampbusters since the age of three when she was refered for waking in the night with very painful cramp. It was discovered that the cramp busters reduced the spasm allowing her to put her heels on the ground. She has returned for new crampbusters because she had grown out of them about 6 months ago. Her feet which had been flat, have now returned to heels off the ground and the left leg is internally rotated. This is corrected by wearing  AFO's, however in bare feet figure16. shows how she stands,unable to balance while standing still. Figure 17. shows her improvement 30 minutes later wearing crampbusters.

                figure 16                                                                          figure 17. 

 

 

 

 

Was it possible that it was only nessary to give stimulus to the web spaces on either side of the middle finger, instead of all the web spaces? This was to be born out with changes to other hand devices.

About a week later the plastazote was discarded and replaced with a single loop  [figure 21]  placed around the middle finger, [figure 22] which continued to keep her supple.

      Figure 21.                                                                                      Figure 22.                              Figure 23.

 

 

 

 

 

A single loop was made to go loosely over the middle toe of the baby's foot,and passed round the ankle, then tied with a bow, as in figure 21. The rigidity in the legs reduced and the toe curling disappeared. She was soon doing normal baby knee bends when weight bearing. The mother reports that the toes will start curling again if these loops are left off for more than two hours.                                                                                        Figure 24.         

                                                                  

 

Mathew who is a seven year old has worn crampbusters for several years. He was rigided, fisted and blind. His diagnosis is cerebral palsy severe, visual impairment severe, intelectual disability severe and epilepsy. He is wheelchair bound. After wearing crampbusters for hands and feet his mother reported that he was less rigid and that he cried less. 

Mathew has recently changed to single loop cramp crampbuster with improved results. He has been observed rubbing his face without poking a finger in his eyes. Because Matthew now lives in a hostel, the original single loop models [Figures 21 & 22] were a disaster! Some carers were applying them too tightly, which caused nasty pressure areas. I suppose that it appears crampbusters are not doing anything when applied snug but not tight and it is tempting to pull them tight. For this reason I went back to the two loop variety of the foot crampbusters and designed a hand crampbuster with a single loop from a wrist band, [figure 24]. This is a lot safer for those who cannot communicate.