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- CONFERENCE COVERAGE: 2015 ISPO World Congress
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- Orthotic management of CMT: Dynamic solutions for active lifestyles
- CONFERENCE COVERAGE: Orthotics Technology Forum 2014
- ATHLETES AND INJURIES: The global question of prevention
- CONFERENCE COVERAGE: Orthotics Technology Forum 2013
- SPECIAL SECTION: Teachings from the East
- CONFERENCE COVERAGE: International Clubfoot Symposium
- CONFERENCE COVERAGE: Orthotics Technology Forum 2012
- STEPS AHEAD: Advances in foot and ankle biomechanics
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- DEFENSIVE GAME PLAN: Global insights on sports injury prevention
- Recent Advances in Orthotic Therapy
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Category Archives: Feature Article
Arthrodesis remains effective for most patients with end-stage hallux rigidus, but finding an alternative that allows more range of motion can be challenging. Faced with disappointing arthroplasty outcomes, surgeons have had to get creative.
By Cary Groner
In patients with spastic hemiplegic CP, practitioners and researchers tend to focus primarily on the hemiplegic limb. But hemiplegia also leads to impairments in the uninvolved limb, which are important to consider when designing a therapeutic approach.
By Julieanne P. Sees, DO, and Freeman Miller, MD
Excessive rotational traction that occurs at the interface between the shoe and the playing surface, as well as shoe properties such as rotational stiffness, may have the potential to influence the high incidence of lower extremity injuries in athletes.
By Feng Wei, PhD, and Eric G. Meyer, PhD
This two-part series examines trends and techniques in materials development and fabrication. This second installation focuses on technological advances that are likely to affect the structural properties and manufacture of in-shoe foot orthoses.
By Cary Groner
Obese patients are more likely than nonobese individuals to sustain an ankle fracture, particularly a severe ankle fracture. Contributing factors may include increased torque on the ankle or low bone mineral density relative to body weight.
By Christy King, DPM, AACFAS
Evidence suggests that when an athlete stops or tapers his or her training, the resulting effects on endurance, strength, balance, and lower extremity biomechanics may increase the risk of injury. Understanding these effects can help practitioners minimize injury risks.
By Boyi Dai, PhD, and Jason C. Gillette, PhD
This two-part series examines trends in materials development and fabrication. This first installment focuses on how material strength, stiffness, and other variables affect the structural properties and design of orthotic and prosthetic devices.
By Cary Groner
Children’s shoes often are designed to look like adult shoes but lack the same structural components. Perhaps not surprisingly, research has demonstrated that running kinematics and kinetics differ significantly between seemingly similar child and adult shoes.
By Janet S. Dufek, PhD, Dana Forrest, MS, and John A. Mercer, PhD
Interventions to improve postural control in patients with functional ankle instability include strength training, balance training, taping, bracing, and foot orthoses, but further research is needed to determine which therapeutic approaches work best in which patients.
By Janet Simon, MS, ATC, Emily Hall, MS, ATC, and Carrie Docherty, PhD, ATC
Whole body vibration may help improve strength and function in patients with knee osteoarthritis and may even slow disease progression. But contradictory findings, a lack of consensus on optimal parameters, and safety issues have even WBV advocates proceeding with caution.
By Cary Groner
Prevention and treatment of foot ulcers in patients with diabetes requires an understanding of the various factors that contribute to increased risk, including anatomical deformity, poor vascular function, and diminished capacity for healing at a microscopic level.
By Allyson Berglund, DPM, Matthew Juriga, DPM, Aristidis Veves, MD, DSc, and Thanh Dinh, DPM
Research indicates that in diabetic patients with Charcot neuroarthropathy, peripheral bone mineral density decreases over time, which can contribute to risks of hardware failure, loss of correction, delayed union, and nonunion in patients with advanced disease.
By Rachel H. Jung, DPM, MHA, MPH; Robert M. Greenhagen, DPM; Dane K. Wukich, MD; Vassilios Vardaxis, PhD; and Robert M. Yoho, DPM, MS
Two separate studies directly compared valgus knee bracing and wedged foot orthoses for reducing knee adduction moment in patients with osteoarthritis, but came to opposite conclusions. A third study suggests combining the two interventions may be the best solution.
By Barbara Boughton
When treating patients who are going through rehabilitation, clinicians may be overemphasizing gait distance and overlooking the importance of gait speed. Clinical assessment of gait speed is simple and inexpensive but can be a significant indicator of functional recovery.
By Heather Braden, PT, MPT, PhD, GCS
Intramuscular manual therapy, also known as dry needling, is hypothesized to relieve pain by modifying tension in connective tissue. Limited evidence supports the use of IMT for plantar fasciitis, although further research is needed to rule out a placebo effect.
By Brent Harper, PT, DPT, DSc, OCS, FAAOMPT
Despite being upheld by the Supreme Court, the Affordable Care Act remains a subject of debate heading into next month’s presidential election. Meanwhile, government affairs experts are working to determine just how the ACA will affect lower extremity practitioners.
By Shalmali Pal
Research suggests that the ankle’s ability to absorb its share of energy during landing from a jump is altered with the use of an ankle brace. The extent to which this effect might influence risk of injury to other lower extremity joints or soft tissues, however, remains unclear.
By Jacob K. Gardner, MS
There are few high-quality studies and no randomized controlled trials documenting its effectiveness, but debridement—from surgical to larval—remains a mainstay of diabetic ulcer care in many practices, and new twists on conventional techniques continue to evolve.
By Cary Groner
Prehabilitation, particularly in the form of exercise, has the potential to significantly improve preoperative and postoperative outcomes in patients with knee osteoarthritis who are undergoing total knee arthroplasty. Both physiological and psychological outcomes can be positively impacted.
By Carly McKay, PhD, and Harry Prapavessis, PhD
Reducing the shaft height of a removable cast walker, which results in a lighter device and may also help improve postural stability, can help improve compliance in patients at risk for diabetic foot ulcers without compromising the device’s offloading capability.
By Sai Vikas Yalla, PhD, and Ryan T. Crews, MS, CCRP
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