My son is going to get fitted for his first pair of night splints. I know there are different types, and I am wondering what to ask for. Alec's PT said the softer boots do not work as well as the hard ones, as for as stretching goes. He is starting to walk on his tip toes, especially at night. He is 4, and is not a very good sleeper to begin with. He has suffers from restless leg syndrome.

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Dr. Wong has always asked us to get Cascade Softeze 3.5. They are hard plasstic with a soft insert for comfort. They work well for my son.
Our PT has always ordered for Elliott the Cascade DAFO 9.0. I think the difference there is the hinged ankle and the straps that allow you to adjust the amount of stretch
We've had no complaints from the boys wearing them through the night.

Also - I saw something on Jen's site www.hopeforjavier.org that looked like a fun idea for that first night they get the braces if they are showing any concern about them: Boot Party
We have ours made right here in the city so they don't have to be ordered. If they are too hard, then they will put the foam inside of them and Joshua has the choice of close to 100 different patterns to choose from. They will also drill holes all throughout for air if they have sweaty feet at night. They recommend wearing socks under them at night so the air holes may be important. Good luck and I hope Alec enjoys his first pair of 'bedtime boots'!

Naomi
hi we just got back from Dr. Wong and she asked that we order cascade DAFO no hinge for our 21/2 year old. Good luck
I assume that each child may have a different need, which is why there are different DAFO recommendations. Has anyone tried using soccer shin guards at night or other "stuff" to put on the legs in preparing the child for night splints?

Rosalie said:
hi we just got back from Dr. Wong and she asked that we order cascade DAFO no hinge for our 21/2 year old. Good luck
Ok - so I was curious as to why we have the hinged type and it seems like Dr. Wong's group prescribes the unhinged - so I emailed her to ask. (Side note: Isn't she great - I'm not even a patient and no more than 2 hours later I get a response...)
Basically here is the paraphrasing of her response:
Their main goal is to maintain the ankles at resting position during sleep - not to do actual stretching, as the boys should be getting that during their stretching routines in the daytime. She also said they've found if actually stretching the ankles at night the kids don't sleep as well.
She then she included the PT form Cinci, Michelle, on the thread and Michelle added that they also found "with the hinged braces is that the boys ended up pushing back out of them if they provide too much of a stretch....therefore defeating the purpose and also possibly causing muscle damage if they end up working their muscles all night pushing down on the brace instead of relaxing into the stretch"
So it seems as though in our case we are probably ok with the 9.0. As we do provide a little stretch on them (not much - we've found as Dr. Wong noted that if we stretch too much - the boys wake up and complain about the braces in the middle of the night) and they tolerate the minor stretching just fine and don't work out of them as Michelle notes...

So that was a very enlightening bit of email as to why they prefer the one over the other... And I guess (disclaimer ;-) - these are my own thoughts here - with no medical or PT experience to back them up) you can go with the hinged kind and keep it adjusted at 90* which is essentially the same as the non-hinged, but also gives you the flexibility to stretch beyond 90* if you are using your braces in conjunction with your nighlty stretching routine, which we do. We use the braces stretched beyond 90* along with some knee braces to keep his legs straight - then he sits in those while watching TV for a while to give a long stretch to his hamstrings).

Hope this info helps - I found their responses to be very useful.
Thank you so much for the input!! My Dr thought the hinged braces would be better for Alec, but I will be sure to keep an eye on him so he is not trying to push out of them at night.

Does anyone know the best way to break them in? I have heard you just start out a little bit at a time before he wears them all through the night.
What if he has to use the bathroom in the middle of the night?? Can he walk in them if he has to?? The pt says not to let him walk in them because the AFO's are slippery and he may fall.
Xavier has a grip pad on the bottom of his AFO's and he walks in them no problem. (the stick on kind that you can buy for your own shoes in the store, it came on them). We don't have him walk in them regularly, but if he needs to go to the bathroom quickly before he can get them off it's not an issue.

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