Category Archives: Cover Story

Cover Story Article

January 2013

The value of walking in children with CP: A matter of perception

The achievement of independent walking is a major focus of rehabilitation for children with cerebral palsy (CP). Even when mobility could be achieved more easily through the use of assistive technologies such as wheelchairs, independent walking is typically pursued as a major rehabilitation goal and other forms of mobility are often discouraged.

By Barbara E. Gibson, BMR(PT), MSc, PhD

Continue reading

November 2012

Genetics: The future of injury prevention

Evidence is linking genetic mutations to Achilles tendon and anterior cruciate ligament injuries as researchers try to connect complex motor control processes to small segments of DNA. But genetic testing is still a long way from becoming a clinical tool.

By Larry Hand

Continue reading

October 2012

London bridges: Clinicians and athletes connect at the 2012 Paralympic Games

There were no medals for the orthotists, prosthetists, and other lower extremity specialists in attendance at the 2012 games in London. But thousands of world-class athletes couldn’t have succeeded without them.

By Emily Delzell

Continue reading

September 2012

Triple threat: The female athlete triad and injury risk

The Triad’s new definition specifies low energy availability, menstrual irregularity, and low bone mineral density as predictors of future health risks, including lower extremity injuries. This broader definition means far more female athletes may be at risk than previously thought, particularly in the high school setting.

By Jill Thein-Nissenbaum, PT, DSc, SCS, ATC

Continue reading

August 2012

Can AFOs help prevent falls?

Studies suggest that ankle foot orthoses can improve balance in some individuals, so it might seem logical that they would also help prevent falls. But the medical literature has yet to reveal a direct con­nection between AFOs and falls risk, and as a result the issue has become a mag­net for debate.

By Cary Groner

Continue reading

July 2012

The sprinter’s advantage: Thinking outside the blocks

Researchers at The Pennsylvania State University have identified structural char­ac­teristics that distinguish the foot and ankle mechanics of trained sprinters from nonsprinters. Are similar underlying vari­ables responsible for the reductions in mobility that affect older adults?

By Stephen J. Piazza, PhD

Continue reading

June 2012

ACL injury and OA risk: Surgery’s complicated role

Given the accumulating evidence linking anterior cruciate ligament injury to early-onset osteoarthritis, one might reason that surgical repair of the injured joint would decrease that risk. But too often that isn’t the case. This two-part series explores the complicated ways, both negative and positive, that surgery can influence OA risk.

By Cary Groner

Continue reading

May 2012

Healing in the dark: Night use of orthoses

Night splinting for plantar fasciitis gets the lion’s share of attention, but lower extrem­ity practitioners are also seeing positive results with night use of orthoses for conditions ranging from cerebral palsy to AIDS.

By Larry Hand

Continue reading

April 2012

Algorithms and views: Whats, whens, and whys of plantar fasciitis care

Published guidelines for management of plantar fasciitis don’t cover every detail of which interventions to try, in what order, and for how long. As a result, every practitioner tends to interpret the gray areas just a little differently.

By Cary Groner

Continue reading

March 2012

Finding a formula for the optimal AFO

Quantitative research from The Nether­lands suggests that for every ankle foot orthosis, there is an optimal stiffness associated with the lowest energy cost of walking for a given set of gait-related impairments. Achieving this optimal device stiffness in practice, however, may require clinicians to rethink conventional ap­proaches to AFO prescription.

By Daan J.J. Bregman, PhD

Continue reading

February 2012

Odd couple: Linking ACL injury and patellofemoral pain

One is an acute injury, the other a chronic condition. But researchers believe it’s no coincidence that anterior cruciate liga­ment injury and patellofemoral pain syn­drome share many of the same risk factors. The next step is to determine if a single intervention can effectively prevent both.

By Cary Groner

Continue reading

January 2012

Breaking pointe: Foot and ankle injuries in dance

Essential to the beauty of dance are the demanding biomechanics of the dancer, particularly at the foot and ankle. Injuries and pain are almost inevitable. But an understanding of the underlying issues—artistic as well as anatomical—can help practitioners keep dancers on their toes for as long as possible.

By Jeffrey A. Russell, PhD, ATC

Continue reading

November 2011

Pretty pathways to pain: Muscle activation in high-heeled shoes

Researchers from New York University have found that wearing high heels increases muscle activation, which can have painful ramifications throughout the kinetic chain. Some individuals, however, seem to adapt to high heels more effectively than others.

By Smita Rao, PT, PhD, and Renata Ripa, MA

Continue reading

October 2011

FUTURE SHOCK: Youth sports and osteoarthritis risk

There’s no question that exercise is good for kids. But the trauma asso­ciated with some youth sports can dramatically increase the risk that those kids will develop knee or ankle oste­oarthritis by the time they reach adult­hood. The key next step is to determine what can be done about it.

By Yvonne M. Golightly, PT, PhD, Stephen W. Marshall, PhD, and Dennis J. Caine, PhD

Continue reading

September 2011

Keeping O&P compliance in check

A recent paper suggests that a checklist system can help practitioners educate caregivers about orthotic device use in children with CP, which could improve compliance. But experts differ as to whether such checklists make sense in the complex world of O&P devices.

By Larry Hand

Continue reading

August 2011

Momentous adaptations: Offloading the knee through gait modification

Changing the way people walk can significantly decrease knee external adduction moments, which in turn appears to relieve pain and possibly slow the progression of osteoarthritis. The challenge, however, is finding a gait modification that feels and appears natural to patients.

By Lydia Caldwell, BS, and Joaquin Barrios, PT, DPT, PhD

Continue reading

July 2011

EXERCISE AND NEUROPATHY: Not mutually exclusive

Exercise is a cornerstone of treatment for diabetes, but for years patients with peripheral neuropathy have been dis­couraged from weight-bearing exercise for fear of further increasing ulceration risks. Now new research is turning that advice on its head.

By Cary Groner

Continue reading

June 2011

Powering the Windmill: Lower body mechanics of softball pitching

Injuries in softball pitchers typically occur in the upper extremities, but focusing rehabilitation and prevention efforts on the upper body alone ignores the essential supporting roles played by the pelvis and lower extremities in providing a stable base for the pitching motion.

By Gretchen D. Oliver, PhD, ATC, LAT

Continue reading

May 2011

BATTLES OF ACHILLES: The operative vs nonoperative treatment debate

Early mobilization techniques have revolutionized both surgical and nonsurgical management of Achilles ruptures, but the resulting improved outcomes have ignited a heated discussion among practitioners as to which approach is best.

by Cary Groner

Continue reading

April 2011

Sprain in the Forecast: Epidemiology and risk factors for ankle sprain

Analysis of the epidemiology of ankle sprain has revealed modifiable and non-modifiable risk factors. Understanding these will allow practitioners to help athletes minimize their risk of acute injury and chronic sequelae.

By CPT Brian R. Waterman, MD; Joseph R. Langston, BS; Kenneth L. Cameron, PhD, ATC; LTC Philip J. Belmont, Jr, MD; and LTC Brett D. Owens, MD

Continue reading

March 2011

Upstanding interventions: Falls prevention in O&P

Devices that improve proprioception, balance, and biomechanics can help patients avoid the significant morbidity and mortality associated with falls. But in some cases, a device may actually increase risk. That’s why matching the right intervention to the right patient is essential.

By Cary Groner

Continue reading

February 2011

Head Games: Neurocognitive contributors to noncontact injury

Because movement is controlled by the central nervous system, any type of cognitive disturbance can increase an athlete’s risk of injury. An increasing research focus on these neuropsychological variables could determine the future of rehabilitation and injury prevention.

By Charles Buz Swanik, PhD, ATC

Continue reading

January 2011

THINKING SMALL: Making strides in children’s footwear

It was my first trip to buy shoes for my then-toddler son. He had just started walking with the aid of helping hands, and as I stared out at a sprawling display of shoes inside a high-end children’s shoe department, I felt utterly confounded. Some of the shoes felt soft, others were hard-soled and stiff, many were akin to moccasins. I was assaulted by all manner of colors and patterns and styles, each one different from the next. Massaging my eyes, I wanted to only to leave.

By L.W. Barnes

Continue reading

November 2010

The truth about barefoot running: It’s complicated

One side claims running shoes cause injury; the other side counters that barefoot running comes with its own risks. There are likely elements of truth on both sides. But when it comes to giving your patients advice about barefoot running, experts have more questions than answers.

by Cary Groner

Continue reading

October 2010

Military Medicine: What it means for civilian practitioners

The military – a wellness utopia of active and healthy young adults who must maintain fitness and weight standards to remain in good standing. Personnel medical histories are part of vast military databases that practitioners and researchers use to chart trends and examine the evolution of treatments. Unlike with civilian medicine, patients and their outcomes can be followed through years-long stretches, offering a view that is otherwise hard to come by.

By L.W. Barnes

Continue reading