Category Archives: Feature Article

Featured Issue Article

February 2015

Peripheral neuropathy in Lyme disease patients

Reported cases of Lyme disease have been rising steadily over the past 30 years, but its diagnosis can be challenging. Left untreated, patients with Lyme disease can go on to develop neurological symptoms, including those that are characteristic of peripheral neuropathy.

By Greg Gargiulo Continue reading

February 2015

An eccentric approach to hamstring injuries

The effectiveness of eccentric training for the prevention and rehabilitation of hamstring strains has been established in the medical literature. The next step is to identify an eccentric hamstring exercise that addresses the limitations of existing…

By Karl F. Orishimo, MS, CSCS, and Takumi Fukunaga, DPT, ATC, CSCS Continue reading

February 2015

Chronic ankle instability: effects on quality of life

Patient-reported outcomes can be used to monitor health-related quality of life in patients with chronic ankle instability, and lower extremity practitioners can design rehabilitation approaches to specifically target physical impairments that are known to contribute to quality of life.

By Megan N. Houston, PhD, ATC, and Matthew C. Hoch PhD, ATC Continue reading

February 2015

Knee OA brace experts revisit persistent issues

Systematic reviews and meta-analyses show that bracing for knee osteoarthritis (OA) is associated with significant benefits with regard to pain and function. But links to disease progression remain elusive, and the challenges of patient compliance are becoming even more complicated.

By Larry Hand Continue reading

February 2015

Achilles rehab: focusing on insertional tendinosis

Research supports eccentric strengthening for treatment of midportion Achilles tendinopathy, but a new study suggests the same approach…

By Lisa H. Jain, DPT, OCS; Kevin J. McCarthy, MD; Michael Williams, PT, OCS; Marie Barron, PT, OCS; Nick Bird, MPT; Brian Blackwell, PT, OCS; G. Andrew Murphy, MD; David R. Richards, MD; Susan Ishikawa, MD; and Margaret Kedia, PhD, DPT Continue reading

January 2015

Sensory-targeted ankle rehabilitation strategies

Current treatments for chronic ankle instability (CAI) may be ineffective in reducing its development and recurrence. To help address this issue, the authors have proposed a new treatment paradigm based on …

By Patrick O. McKeon, PhD, ATC, CSCS, and Erik A. Wikstrom, PhD, ATC, FACSM Continue reading

January 2015

Knee OA as a long-term consequence of injury

A knee injury can have painful and disabling long-term repercussions, such as the early onset of knee osteoarthritis (OA) or accelerated knee OA. Injury prevention and effective interventions may help …

By Jeffrey B. Driban, PhD, ATC, CSCS; Brian Pietrosimone, PhD, ATC; Nicole M. Cattano, PhD, ATC; Matthew S. Harkey, MS, ATC; and Brittney A. Luc, MS, ATC Continue reading

January 2015

Implications of reduced stride length in running

Decreasing stride length during running has been shown to result in biomechanical changes that are associated with reduced loading of biological tissues and, by extension, also may reduce the …

By Melissa A. Thompson, PhD, and Kristine M. Hoffman, DPM Continue reading

January 2015

Clinical utility of the FMS and its component tasks

Although some research has found that using the composite score for the seven component tasks of the Functional Movement Screen is a reliable way to predict risk of injury in athletes, other studies …

By Erin Hartigan, PT, DPT, OCS, PhD, ATC; Nicole Chimera, PhD, ATC, CSCS; and Sarah Lamberton, NSCA-CPT Continue reading

January 2015

Effects of unstable shoes: Many questions remain

Current research suggests that relatively small but statistically significant changes are associated in the short term with the use of unstable shoes. However, it is unclear if those changes are clinically meaningful, or whether long-term use would yield greater or diminished results.

By Jacob Gardner, PhD Continue reading

November 2014

Eccentric interventions for Achilles tendinopathy

Multiple descriptive studies have demonstrated the clinical benefits of eccentric exercise interventions in patients with Achilles tendinopathy, but researchers have not yet identified the cause-and-effect mechanisms leading to decreased pain or increased function.

By Matthew Crill, MS, MBA, PT Continue reading

November 2014

Online tool facilitates use of exercise for knee OA

A pilot study has demonstrated the feasibility and potential success for employing the Internet to deliver targeted individualized exercise routines for patients with knee osteoarthritis, which may help…

By Alison Brooks, MD; Bryan Heiderscheit, PT, PhD; and John E. Beaulieu, PhD Continue reading

November 2014

The Y Balance Test: Assessing the evidence

The Y Balance Test (YBT) is a reliable tool and may be used to predict injury risk. However, clear cut-points have not been sufficiently defined, and more research investigating the mechanics and muscle activation strategies used during the YBT is needed.

By Craig A. Smith, DPT, and Meghan Warren, PT, MPH, PhD Continue reading

November 2014

Exercise in individuals with diabetic neuropathy

Patients with diabetes and peripheral neuropathy can benefit from participation in mild to moderate aerobic, resistance, and balance activities. But they must take precautions to ensure exercise is safe as well…

By Steven Morrison, PhD, and Sheri R. Colberg, PhD Continue reading

November 2014

The role of hip mobility in patellofemoral pain

Findings of an association between hip mobility and patellofemoral pain suggest practitioners may be putting the cart before the horse by implementing strength programs in individuals with PFP without first measuring and addressing deficits in hip extension.

By Sean Roach, PhD, DPT, ATC Continue reading

November 2014

Onychomycosis remains a major clinical challenge

Despite the ongoing development of new treatments, onychomycosis is still an extremely recalcitrant disease with high rates of relapse and reinfection, and the associated physical and cosmetic implications can negatively affect patients’ quality of life and self esteem.

By Greg Gargiulo Continue reading

October 2014

Impact of AFO design on calf circumference

Preliminary research suggests the use of a kinetic return ankle foot orthosis is associated with small but significant short-term increases in calf circumference, which in turn suggests this type of device might reduce or protect against the risk of disuse muscle atrophy.

By Robert H. Meier, CO, BOCO; David C. Ruthsatz, CO, CPA; and Daniel Cipriani, PT, PhD Continue reading

October 2014

Clinicians weigh the pros and cons of social media

There is considerable debate in medical circles as to whether healthcare practitioners should embrace social media, but online aficionados say they welcome the opportunity to exchange information, educate, connect, and potentially attract more patients.

By P.K. Daniel Continue reading

October 2014

Offloading the diabetic foot: Effects of obesity

Increasing body mass index is associated with significantly increased peak plantar pressures regardless of the type of off­loading device used. However, it is possible to decrease plantar pressures in some regions of the foot with the use of offloading devices.

By Andrew J. Meyr, DPM, FACFAS; Kelly Pirozzi, DPM, AACFAS; and Matthew R. Wagoner, DPM Continue reading

October 2014

Functional contributors to outcomes after TKA

The increasing utilization of total knee arthroplasty has led to increased efforts to identify variables that can be modified to help improve postoperative functional outcomes. These risk factors include patient weight, smoking, diabetes, infection, and joint range of motion.

By John Ryan Quinn, MD, and Ran Schwarzkopf, MD, MSc Continue reading

September 2014

Internal vs external focus: Effects on motor learning

A growing body of research is demonstrating that the focus of actions or movements is critical to how well athletes and patients respond to feedback from instructors or clinicians, and one of the central issues is the distinction between internal focus and external focus.

By Cary Groner Continue reading

September 2014

Debating corticosteroid injections for heel pain

Some practitioners find plantar fasciitis patients respond to corticosteroid injection when other treatments have failed, but concerns about complications make others cautious. With evidence-based guidelines in short supply, the decision often comes down to clinical experience.

By Larry Hand Continue reading

September 2014

AFOs and interfaces: The important role of socks

Interface use has long been the subject of study and clinical emphasis in prosthetics, but too little attention has been given to the role of interfaces—padded socks in particular—in protecting the skin and soft tissues from forces experienced during ankle foot orthosis use.

By Harry “J.R.” Brandt Jr, CO, LO, BOCO Continue reading

September 2014

Knee OA, BMI, and pain: A complex relationship

Excess body weight is considered by many experts to be the primary modifiable etiological factor in knee osteo­arthritis (OA) development. However, the relationship among body mass index (BMI), the anatomical manifestations of knee OA, and knee pain is not clear-cut.

By Elizabeth Weiss, PhD Continue reading

September 2014

Compression stockings: Progress and pitfalls

Research supports the use of compression stockings for managing peripheral edema, venous insufficiency, and venous leg ulcers. But, outside the laboratory, issues related to patient compliance and achieving a proper stocking fit remain significant clinical challenges.

By Greg Gargiulo Continue reading