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- ATHLETES AND INJURIES: The global question of prevention
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- SPECIAL SECTION: Teachings from the East
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- CONFERENCE COVERAGE: Orthotics Technology Forum 2012
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Category Archives: Feature Article
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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