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Special Features

Wearable sensors assess relationship between foot problems and frailty

Assessing how foot problems— namely, pain, neuropathy, and deformity— contribute to frailty syndrome has been a challenge for researchers, as transporting frail elders to lab facilities creates its own set of issues. But a recent study from the University of Arizona used wearable sensors to assess the seniors in their “natural” environment and found significant relationships between the number of foot problems and degree of frailty.

Three-year follow-up: Close contact casting vs surgery

In a pre-specified, 3-year extension of a randomized clinical trial of equivalence, close-contact casting maintained equivalence in function compared to surgery in older adults with unstable ankle fracture. Furthermore, no significant differences were reported in quality of life or pain. The authors concluded that the focus of treatment for these patients should be on obtaining and maintaining reduction until union, using the most conservative means possible.

Lower-extremity amputation feared more than death

Both type 1 and type 2 diabetes are known for their life-threatening complications—in particular, blindness from retinopathy, kidney failure, and peripheral neuropathy. For patients with diabetes and foot pathology, amputation is a significant worry. A recent study in Foot & Ankle Specialist sought to understand just how much this population fears lower-extremity amputation (LEA).

Wasp stings: Some really do hurt more than others, and how to counsel patients

As summer approaches and we become more active outdoors, wasps will become more active, too. Two recent studies highlight the pain and danger of the ubiquitous wasp. The first study, from entomologists at the University of Utah, looked at stinger length compared to reported pain and toxicity.1

Flip flops, bare feet, or sports shoes: Which are best and which are worst?

Many have long suspected the answer, but a new study would appear to resolve the question: Are flip flops really that bad for your feet? According to Chen and colleagues from the Department of Biomedical Engineering at The Hong Kong Polytechnic University, flip flops are most likely no better than barefoot when it comes to lower-limb co-contraction and joint contact force in the ankle.

Multidisciplinary views of chronic foot, ankle, and knee-related conditions that curtail activity in otherwise healthy adults

Editor’s note – Welcome to this first installment of a series for the readers of Lower Extremity Review: LER Perspectives. This planned, occasional series is designed to provide multidisciplinary voices to both common and uncommon conditions seen in clinical practice by podiatrists, orthotists and prosthetists, physical therapists, and other clinicians who care for patients with a lower extremity concern.

The goal of the series is to provide a forum for clinicians from an array of specialties to offer perspective on a clinical question or issue.

In this LER Perspective, we asked clinicians in daily practice to identify their most commonly seen foot and ankle and knee conditions that cause previously healthy and active adults to curtail activity. Dr Jay Segel offers the podiatric perspective, Mr Ken Johnson provides the physical therapy perspective, and Dr Kim Ross provides the chiropractic perspective.

Please write to LER with your suggestions for topics that should be covered in a future installment.

–The Editors


Dr. Segel is in private podiatry practice in Martha’s Vineyard, Massachusetts, and Director of Applied Podiatric Biomechanics at Noraxon USA. He is also a podiatric advisor and member of the medical education staff at Orthotic Holdings Inc.

By Jay Segel, DPM

PERSPECTIVE: Physical Therapy

Mr. Johnson is director of outpatient rehabilitation therapy services at Johns Hopkins Rehabilitation Network in Baltimore, Maryland. He has disclosed no relevant relationships.

By Ken Johnson, PT

PERSPECTIVE: Chiropractic Medicine

Dr. Ross is Director of Education Year 1, and associate professor at Canadian Memorial Chiropractic College, in Toronto, Ontario, Canada. He conducts educational sessions on behalf of Orthotic Holdings Inc.

By J. Kim Ross, DC, PhD


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