In this arm, the subjects will receive the intervention of extracorporeal shock wave therapy and general physical therapy 3 times a week for 2 weeks, in total 6 times treatments and will be arrange to take efficacy two assessment on 1 week and 2 weeks after 6 times treatments separately.

In this arm, the subjects will only receive the intervention of general physical therapy 3 times a week for 2 weeks, in total 6 times treatments and will be arrange to take efficacy two assessment on 1 week and 2 weeks after 6 times treatments separately.

Nocturnal Leg Cramps

Extracorporeal shock wave therapy is a mechanical sound wave that generates energy by extremely high-frequency vibration to compress the medium. Low-energy extracorporeal shock waves can be used for cell regeneration and pain control therapy; medium-high energy can be used to treat patients with poor bone healing; high-energy can be used to lithotrite. In recent years, extracorporeal shock waves have been applied on the musculoskeletal diseases, such as: epicondylitis, plantar fasciitis, chronic pelvic pain, chronic heel pain syndrome, lymphedema, burns, pressure sores, calcific tendinitis and myofascial pain syndrome. This treatment is a non-invasive and safe treatment.

Extracorporeal shock wave therapy

The general physical therapies such as: thermotherapy, straight leg raise (SLR), transcutaneous electrical nerve stimulation (TENS) for treatment on calf muscle.

General physical therapy

China Medical University Hospital

Extracorporeal Shock Wave Therapy Treatment for Nocturnal Leg Cramps

Effectiveness of Extracorporeal Shockwave Therapy on the Patients With Nocturnal Leg Cramps - Possible Related to Myofascial Trigger Point in the Gastrocnemius Muscle

Ask participants to describe the frequency of nocturnal leg cramps (NLCs) in the last week. The frequency of occurrence is recorded on an average of several times a day (times/day). The frequency of nocturnal leg cramps (FC) can be used as a tracking and indicator of treatment.

The visual analogue scale or visual analog scale (VAS) is a psychometric response scale which can be used in questionnaires. This tool used to help a person rate the intensity of certain sensations and feelings, such as pain. A straight line of 100mm is actually marked with 0 mm on the far left and 100mm on the far right. Two faces are drawn on both ends. Explain to the patient that 0 mm means no pain and 100 mm means very painful. From the left end The right shift indicates more and more pain. Take a pen and let the patient draw a short line vertically on the line, representing his painful position, and record the measured cm value. In this test, if the score of the subject decreases, it can represent the treatment is helpful for the improvement of the patient's pain.

Pressure pain threshold (PPT) is defined as the minimum force applied which induces pain. This measure has proven to be commonly useful in evaluating tenderness symptom

Range of motion of knee and ankle joint will be limited when the calf muscle with active myofasical trigger point. To record range of motion of knee and ankle joint for tracking the efficacy of treatment.

Muscle tone is the muscle's resistance to passive stretch during resting state. The measuring tool called Myotone will calculate three parameters such as tone, elasticity and stiffness automatically and get a value to represent the muscle tone. If the value decrease, it can represent the treatment is helpful for the subjective muscle relax.

The Pittsburgh sleep quality index (PSQI) is currently the most effective assessment tool for assessing sleep quality and status in adults. It can be used to assess and track changes in sleep quality after treatment. The Pittsburgh Sleep Quality Assessment (PSQI) content includes (1) subjective sleep quality, (2) sleep latency, (3) sleep duration, (4) sleep efficiency, (5) sleep disturbance, (6) daytime function, and (7) the condition of using sleep pills. The score of the item is from 0 to 3 points, and the total score is from 0 to 21 points. The higher the score means the worse the quality of sleep. If the total score is greater than 5 points that means the poor quality of sleep.

Li-Wei Chou

Minister of Rehabilitation

Patients will receive PO magnesium 400 mg, Zofran 4 mgODT, and Tylenol 500 mg in the emergency department. They will then continue with 500 mg Tylenol BID and 400 mg MagOx tablets BID for the next 5 days. Symptom severity scores will be obtained and compared throughout this time as mentioned in the study design.

Patients will receive PO Zofran 4 mgODT, and Tylenol 500 mg in the emergency department. They will then continue with 500 mg Tylenol BID for the next 5 days. Symptom severity scores will be obtained and compared throughout this time as mentioned in the study design.

Concussion Post Syndrome

400 mg Magnesium oxide tablet given once in the ED, and prescribed to take BID for 5 days total after discharge

Magnesium Oxide

500 mg tablets given once in the ED, and prescribed to take BID for 5 days total after discharge.

Acetaminophen

Zofran ODT 4 MG Disintegrating Oral Tablet

Lakeland Regional Healthcare

A Cohort Study Evaluating the Efficacy of PO Magnesium in the Treatment of Acute Traumatic Brain Injury in Adolescents

Using post concussion symptom severity scores, the patient will complete symptom severity scores at specified intervals for comparison in post concussion severity score reduction. Higher scores indicate more severe symptoms, and lower scores indicate less severe symptoms.Post-Concussion Symptom Checklist Rating Mild Mod. Severe Initial 1 Hr. 48 Hr. 120 Hr. Headache 0-6 Nausea 0-6 Vomiting 0-6 Balance Problems 0-6 Dizziness 0-6 Visual Problems 0-6 Fatigue 0-6 Sensitivity to light 0-6 Sensitivity to noise 0-6 Numbness or Tingling 0-6 Pain other than Headache 0-6 Feeling as if "in a fog" 0-6 Feeling Slowed Down 0-6 Difficulty concentrating 0-6 Difficulty remembering 0-6 Drowsiness 0-6 Sleeping less than usual 0-6 Sleeping more than usual 0 1 2 3 4 5 6 Trouble falling asleep 0 1 2 3 4 5 6 More emotional than usual 0-6 Irritability 0-6 Sadness 0-6 Nervousness 0-6 Total Score

Patients who require further treatment in the ED, require further medications, or develop adverse effects to the medications prescribed.

Christopher Trigger

Christopher Trigger, MD, FACEP, CAQSM

Spectrum Health - Lakeland

Michigan State University

Randomized, prospective, cohort study comparing two non-invasive treatments for Mild traumatic brain injury in patients ages 12-18 that present to the Lakeland Health Emergency departments in either St. Joseph, MI or Niles, MI.

Patients will be assigned a 3 digit number given at random and treatment arm will be randomized to day of presentation with treatment determined by even or odd day of the month

mgo/cefaleia

Extracorporeal Shock Wave Therapy Treatment for Nocturnal Leg Cramps

A Cohort Study Evaluating the Efficacy of PO Magnesium in the Treatment of Acute Traumatic Brain Injury in Adolescents

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