Category Archives: Feature Article

Featured Issue Article

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

August 2014

Patient Perspective: The long struggle to get a knee back in the game

It happened about two years ago while I was playing a friendly game of basketball with my teenage sons and friends. I was 49 years old and never felt like slowing down. Like most guys, while playing ball, we would imitate our favorite players.

By Joseph Hayward Continue reading

August 2014

AFO tuning: Balancing function and satisfaction

Tuning of ankle foot orthoses (AFOs) and AFO-footwear combinations can significantly improve gait in patients with neuromuscular impairments. Even so, some pa- t­ients still prefer their untuned devices, which has led researchers and clinicians to reexamine their approach to intervention.

By Cary Groner Continue reading

August 2014

Return of strength after Achilles tendon surgery

Despite excellent subjective outcomes following Achilles tendon repair, significant plantar flexion and dorsiflexion strength deficits often persist. However, modern trends in postoperative rehabilitation represent a progression toward a more functional strength recovery.

By David A. Porter, MD, PhD, Kirk Cleland, MD, and Angela M. Rund, MEd, ATC Continue reading

August 2014

Flexible flatfoot: Foot orthoses and outcomes

Many studies have shown an effect of foot orthoses on biomechanical function in patients with flexible flatfoot, but few studies have focused on patient-centered outcomes. There is a need to investigate the effect of foot orthoses on pain and fatigue in these individuals over time.

By Sarah A. Curran, PhD Continue reading

August 2014

Running shoe mass: Can feet tell any difference?

Research suggests that when trying on athletic shoes in a retail store, an individual’s perceptions of shoe mass primarily come from handling the shoes and less (if at all) from test-wearing them. In addition, the foot’s perception of shoe mass does not appear to improve with practice.

By Joel G. Greenya, BS, Stephen J. Slade, BS, Christopher L. Kliethermes, PhD, and David S. Senchina, PhD Continue reading

August 2014

Dynamic compression for recovery in athletes

US Olympic Committee researchers have found that peristaltic pulse compression of the lower extremities may provide a means of enhancing the rheological properties of the lower extremities without resorting to extreme temperatures, expensive body work, or stretching.

By William A Sands, PhD, FACSM, CSCS Continue reading

July 2014

Functional movement tests and injury risk in athletes

Efficient, low-cost, field-ready functional movement tests may be useful in preparticipation physicals to identify and provide preventive treatment for individuals with an elevated risk of injury, as well as aiding return-to-sport…

By Kathryn Schwartzkopf-Phifer, PT, DPT, OCS, CSCS, and Kyle Kiesel, PT, PhD, ATC Continue reading

July 2014

Studies explore statin use for lower limb indications

A growing body of research suggests that statins may help improve not just cardiovascular outcomes but also those associated with lower extremity conditions such as peripheral arterial disease and knee…

By Larry Hand Continue reading

July 2014

Revisiting the status quo for AFO strap placement

Conventional wisdom says dorsal straps for ankle foot orthoses should be positioned at a certain angle to resist heel rise. Now preliminary research from Georgia Tech is calling that practice into question…

By P.K. Daniel Continue reading