Category Archives: Feature Article

Featured Issue Article

September 2012

Effects of minimalist shoes on running gait

Research suggests that when transitioning to a minimalist running shoe, foot strike pat­tern is key to preventing lower extrem­ity injuries. A transitional minimalist shoe, with slightly thicker and softer soles, may help prevent certain injuries in some runners.

By Everett B. Lohman III, DSc, PT, OCS

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September 2012

Knee OA interventions: A look at value for money

Even if an intervention results in a positive clinical outcome in patients with knee oste­o­­arthritis, another important factor to consider is whether that treatment’s benefits justify its costs. Increasingly, cost effectiveness studies are comparing OA interventions to determine value.

By Daniel Pinto, PT, PhD

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September 2012

Clinical assessment of ankle joint laxity

Ankle joint laxity can be a complicating factor in patients with acute ankle sprains or chronic instability, and testing for excessive laxity can help practitioners choose an appropriate method of treatment. However, not all tests for ankle joint laxity are created equal.

By Theodore Croy, PhD, PT, OCS, and Jay Hertel, PhD, ATC, FNATA

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August 2012

Load cells enhance study of prosthetic foot rollover

A new technology, the load cell, can be used to assess rollover characteristics of prosthetic feet in a variety of walking envi­ronments. Load cell analysis can help identify premature foot-flat and dead spots and determine the effects of energy stor­age and return designs on amputee gait.

By Edward S. Neumann, PhD, PE, CP, FAAOP; Justin Brink, MSE, EI; Kartheek Yalamanchili, MSE, EI; and Joon S. Lee, PhD

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August 2012

Idiopathic toe walking: Insights on intervention

As researchers explore the possibility that idiopathic toe walking has an underlying neurologic cause, clinicians continue to refine treatment strategies to keep ITW patients off their toes. Orthotic devices play a key role, with lower-profile devices growing in popularity.

By Emily Delzell

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August 2012

Gait alterations associated with diabetic neuropathy

Inconsistent findings from laboratory stud­­ies have made it difficult to deter­mine which gait alterations are specific to diabetic peripheral neuropathy and which also affect diabetic patients with­out neuropathy. Body-worn sensor tech­nol­ogy may help clarify the distinctions.

By Tahir Khan, DPM, and Ron Guberman, DPM, DABPS

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August 2012

Acute stretching debate approaches a consensus

Experts still disagree about whether stretch­­ing prior to athletic activity can prevent injury and, if so, whether those ben­e­fits offset any negative performance effects. But they do tend to agree that some form of stretching is probably a good idea for most athletes.

By Cary Groner

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August 2012

OA bracing: Longer use does not impair strength

Dose-response research refutes the com­mon perception that increasing brace wear time leads to muscle atrophy in patients with knee osteoarthritis. In fact, longer bracing duration appears to im­prove hamstring strength as well as in­creas­ing patients’ physical activity levels.

By Cheryl L. Hubley-Kozey, PhD, and Gillian Hatfield Murdock, PT, MSc

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July 2012

Pediatric obesity weighs on growing bones, joints

Exercise is the standard prescription for obesity. But alterations to joint biome­chan­ics, gait, and anatomical structure in overweight children and teens mean that physical activity comes with its own risks, which practitioners must factor into any clinical recommendations.

By Christina Hall Nettles

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July 2012

Development of the arch: Functional implications

Contrary to the conclusions of early research, recent studies suggest that arch height does indeed affect lower extremity function. The biomechanics associated with different arch heights may provide a basis for treatment and prevention of related injuries.

By Thomas C. Michaud, DC

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July 2012

The evidence for use of gauntlet-style AFOs

Gauntlet-style ankle foot orthoses offer an alternative to a larger rigid therm­oplastic AFO for foot and ankle pathol­ogies requir­ing more stability or im­mo­bili­za­tion than a foot orthosis provides. Materials, trim lines, and fabrication techniques can vary to meet different patients’ needs.

By Holly Tuchscherer Olszewski MS, CPO 

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July 2012

Dialysis treatment takes toll on diabetic foot care

A convergence of comorbidities means diabetic patients on dialysis have an even higher risk of foot ulcers and amputation than those without renal disease. The potential for preventing these complica­tions at dialysis centers is too often underappreciated by practitioners.

By Larry Hand

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July 2012

ACL reconstruction and risk of knee OA, part 2

This two-part series examines the link between ACL injury and the later development of osteoarthritis (OA) and how surgery may strengthen or weaken that link. This second installment explores meniscal damage, proprioception, and what MRI can add to the discussion.

By Cary Groner

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June 2012

Diabetic foot infections: Progress meets pitfalls

New evidence-based guidelines on the management of diabetic foot infections reflect significant advances by research­ers and clinicians, but the recent emer­gence of regulatory hurdles has slowed the development of new antibiotic drugs for treating those infections.

By Emily Delzell

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June 2012

Foot strike in runners: Influence on injury risk

Different foot strike patterns are associ­ated with different means of attenuating and redistributing forces during running, which may have implications for injury risk and rehabilitation. Researchers, however, have yet to fully examine and understand those implica­tions.

By Peter Larson, PhD

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June 2012

Minimizing the effects of knee brace migration

Too many knee braces just won’t stay put, which can affect compliance and possibly even device effectiveness. Research on the topic is scarce, but experts say the key to minimiz­ing knee brace migration is making sure the device fits the patient’s anatomy as closely as possible.

By Shalmali Pal

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June 2012

Rehabilitative footwear: Importance of comfort

A growing body of research suggests that footwear comfort can improve movement performance and, in particular, neuromus­cular control of balance. These findings could have significant implications for rehabilitation of older adults and patients with lower extremity disorders.

By M. Owen Papuga, PhD, and Jeanmarie R. Burke, PhD

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June 2012

Effects of ankle bracing on athletic performance

Ankle braces help prevent injury by restrict­ing motion, but those restrictions don’t necessarily result in negative effects on athletic performance. Evidence sug­gests that while agility may be affected with use of an ankle brace, vertical jump and balance skills may not.

By Jatin P. Ambegaonkar, PhD, ATC, OT, CSCS; Nelson Cortes, PhD; and Shruti J. Ambegaonkar, MS, PT

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June 2012

Amputation vs salvage for lower limb tumors

Studies assessing the relative functional benefits of limb salvage and amputation for lower extremity bone and soft tissue tumors have produced inconsistent re­sults, but the range of subjective and objective tests used in those studies may have influenced the findings.

By Lucy Kupersmith, BA, and Jeremy S. Somerson, MD

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May 2012

Active Stance: Minimalist footwear: A risky switch for runners?

For the majority of evolutionary history, runners were either barefoot or wore minimalist footwear lacking the cushioning of today’s running shoes. Barefoot or minimally shod runners demonstrate differences1 in kinematics and impact forces compared with those wearing modern running shoes, and some research suggests barefoot running may confer biomechanical advantages over more cushioned footwear.

By Erik M. Haniuk, BS; LTC Steven J. Svoboda, MD; Karen Y. Peck, MEd, ATC; Kenneth L. Cameron, PhD, MPH, ATC; and LTC Brett D. Owens, MD

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May 2012

Preventing hamstring injuries on the gridiron

Hamstring injuries that occur during sprinting are a significant concern in football, not just because of the frequency with which they occur, but also because they are notoriously difficult to rehabilitate, which underscores the need for effective prevention through targeted exercise programs.

By Charles D. Kenyon, MS, RSCC, and Marcus C.C.W. Elliott, MD

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May 2012

Selection of amputation level in diabetic patients

Not all patients with diabetes and not all ulcerated limbs are amenable to salvage. When salvage is not an option, amputa­tion can help improve patient function, but a number of factors should be considered when deciding how much of the foot—if any—should be retained.

By Cary Groner

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May 2012

Peroneal latency’s role in inversion ankle sprain

A delay in the activation of the peroneus longus and peroneus brevis muscles is thought to contribute to the risk of inver­sion ankle sprain. New research suggests that ankle taping, in addition to providing mechanical stability, also helps reduce this peroneal latency.

By Adam Knight, PhD, and Wendi Weimar, PhD         

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May 2012

Patient race contributes to burden of knee OA

Evidence suggests that the prevalence and symptom severity of knee osteo­arthritis are greater in African-American pa­tients, underscoring the need for lower extremity practitioners to implement effec­tive strategies for disease prevention and management in this patient population.

By Kelli D. Allen, PhD

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April 2012

When foot-ankle issues complicate knee surgery

A patient presenting with both end-stage knee osteoarthritis and a painful foot-ankle deformity is not uncommon, but the medical literature offers practitioners little guidance as to which condition should be managed first or whether they should be addressed simultaneously.

by Michael S. Pinzur, MD, and William Hopkinson, MD

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