Category Archives: Feature Article

Featured Issue Article

January 2010

Active Stance: A controlled-stress approach to PTTD

Controlled stress would seem to be the ideal environment for orthotic management of PTTD. How could that be accomplished? By Frank Caruso, CO

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January 2010

Whole body vibration: Neuro-rehab applications

It’s popular with professional athletes and Hollywood celebrities. But WBV also has very real clinical potential for patients with neurological disorders. By Kurt Jackson, PT, PhD, GCS and Harold Merriman, PT, PhD, CLT

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January 2010

Effective compression therapy starts with you

Practitioners themselves may be to blame for not ensuring that stockings are fit properly and that patients know how to wear them correctly. By Linda Weber

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January 2010

Diabetes: Offloading difficult wounds. Part 2

The second article in this two-part series addresses preventing recurrence and management of Charcot foot and foot amputations. By Robert J. Snyder, DPM, FACFAS, CWS, and Karen K. Lanier, CPed, LPed

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December 2009

PFPS gender gap inspires researchers

Although the mechanisms behind patellofemoral pain syndrome (PFPS), like those of anterior cruciate ligament (ACL) injuries, are still somewhat elusive, research is shedding new light on the role gender plays in the onset of this chronic overuse condition.

By Linda Weber

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December 2009

Heel pain relief: Expanding the playbook

The science of treating plantar fasciitis in athletes is evolving to consider the unusual demands these patients put on their feet. Although clinicians continue to rely on conservative management with rest, ice, anti-inflammatory medications, taping, and orthoses, some are embracing new approaches that seem counterintuitive but offer evidence of improved outcomes.

by Cary Groner

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December 2009

Lower extremity O&P warms to CAD-CAM

With a start-up cost of many tens of thousands of dollars and a steep learning curve, it’s no surprise that many O&P practitioners have been slow to transition to computer-aided design and computer-aided manufacturing (CAD-CAM).

By L.W. Barnes

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December 2009

Ankle sprain research focuses on teens

Epidemiological studies confirm what coaches, trainers, parents, and student athletes already know—that ankle sprains are the most common musculoskeletal injury among high school athletes. A study in the August issue of the American Journal of Sports Medicine bears that out, with recurrent ankle injuries accounting for 28.3% of recurrent traumatic sports injuries in teen athletes.

by Linda Weber

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December 2009

CPO seeks central fab: Finding a match

Charles Kuffel, CPO, of Blaine, MN, knows his limitations. If the clinician and father of four is going to keep his referrals happy, get products to his patients on time and have a life outside the office, it means outsourcing some orthotic orders to a central fabricator.

By L.W. Barnes

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December 2009

For those about to rock, we caution you

Shoes with rocker-bottom soles have long been used to alleviate plantar pressures in diabetes patients and others susceptible to forefoot pain or ulceration. The soles move the apex of the toe rocker behind the metatarsal heads, reducing pressure as the patient’s weight transfers forward over the ball of the foot.

by Cary Groner

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December 2009

Shear Madness: Beyond plantar pressure

Clinicians have known for many years that uneven plantar pressures, combined with the loss of sensitivity caused by peripheral neuropathy, are associated with foot ulcers in diabetes patients. Ulcers often occur in different areas than peak pressures do, however. Shear forces, caused by pressure differentials in the foot, may be more to blame than plantar pressures per se.

by Cary Groner

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December 2009

Drop foot mechanics outweigh etiology

Conditions associated with drop foot are as varied as post-stroke hemiplegia, brain or spinal cord injury, and neuromuscular disorders including multiple sclerosis (MS). Patients with drop foot are unable to use the dorsiflexor muscles to lift the foot clear of the ground during the gait’s swing phase, nor can they control plantar flexion during heel strike. The result is an awkward, unstable gait and a tendency to trip when the toes brush the ground.

by Cary Groner

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December 2009

Finding—and breaking—the ACL-OA link

In recent years, scientific studies have shown that anterior cruciate ligament (ACL) injury in athletes can lead to later osteoarthritis in a large proportion of cases. In fact, some studies have documented osteoarthritis rates of 50% to 100% in former athletes who have experienced ACL injury, when followed for 15 to 20 years.

By Barbara Boughton

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December 2009

The Home Stretch: Paths to pain relief

Stretching and splinting have long been treatment strategies for plantar fasciitis. However, new research and ongoing clinical experience are calling into question older methodologies and providing evidence for some new approaches.

by Cary Groner

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December 2009

Underuse, overuse both can lead to PTTD

Ongoing research into posterior tibial tendon dysfunction (PTTD) has revealed risk factors that include female sex, increasing age, overweight, unsupportive footwear, and even metabolic syndromes such as diabetes. Although typically associated with older, inactive patients, PTTD is also seen more rarely in young athletes.

by Cary Groner

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December 2009

CP gait studies document AFO efficacy

Clinicians who treat ambulatory cerebral palsy patients rely heavily on ankle-foot orthoses, which are the most effective treatment option for improving gait mechanics. But because CP encompasses such a wide range of symptoms, selecting the most appropriate corrective brace for a patient’s specific gait abnormality or abnormalities can present clinical challenges. Recent studies that shed light on ankle-foot orthoses’ impact on gait are characteristic of crucial ongoing research.

By Linda Weber

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December 2009

Sport-specific advances benefit all amputees

Whether it’s rock climbing, triathalons, cycling, running or the high jump, advances in prosthetic design have made high-caliber athletic competition a reality for some amputees. One such athlete testified in the September issue of Prosthetics and Orthotics International, “Snowboarding with the new prosthesis is like it was before the amputation!”

by Barbara Boughton

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December 2009

Early, active ACL rehab maximizes ROM

Achieving full range of motion is a key outcome of any rehabilitation program after ACL reconstruction. But what are the ingredients of a rehabilitation program that produces the best outcomes in terms of ROM?

By Barbara Boughton

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November 2009

Managing turf toe in football players

Grade 1 and 2 turf toe hyperextension injuries have good outcomes when treated non-operatively, but the optimal treatment for grade 3 is unclear.

By Seth C. Gamradt, MD, and Robert H. Brophy, MD

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November 2009

Kinematics of PTTD dictate management

Researchers are only starting to examine how orthotic management of PTTD affects foot and ankle kinematics.

By Jeff Houck, PT, PhD, Christopher G. Neville, PT, MS, and Adolph Flemister, MD

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November 2009

Feedback-based rehab could lower risk of OA

Feedback-based gait retraining may help reduce rates of loading by improving joint kinematics and proprioception.

By Jody L. Riskowski, PhD

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November 2009

Diabetes: Offloading difficult wounds

If foot pressures are to be reduced, healing to progress, and prevention of ulceration to be a realistic
goal, offloading is imperative. Part one of two.

By Robert J. Snyder, DPM, FACFAS, CWS, and Karen K. Lanier, CPed

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November 2009

Achilles tendinopathy: A four-part approach

Treatment program includes patient education, deep friction massage, eccentric exercise, and Mulligan taping.

By Russell Woodman, FSOM,OCS,MCTA, DPT, and Juan C. Garbalosa, PhD, PT

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October 2009

Practice Tactics: Assess, then exceed patient expectations

As patients pay more for healthcare, they will expect more from the patient experience. The most successful practices will be those that are best able to meet — and exceed — those expectations.

By Jason Kraus

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October 2009

Controlling drop foot: Beyond standard AFOs

The basic goal is to improve toe clearance during swing and provide stability during stance, but new orthotic technologies do much more.

By Jeremy Farley, CPO/L

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