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May 2017

Stepping Up: Orthotic devices help patients boost physical activity levels

Improved mobility with ankle foot orthoses and other devices can help patients experience the multiple health benefits of increased physical activity. But aggressive activity goals— including the oft-cited target of 10,000 steps per day— may still be problematic for some device users.

By Larry Hand Continue reading

May 2017

National Biomechanics Day thrills kids worldwide

National Biomechanics Day continued to build momentum in its second year, as scientists from Delaware to New Zealand got a jump on recruiting the next generation of biomechanists by demonstrating a wide range of applications—not to mention just how much fun the field can be.

By Hank Black Continue reading

May 2017

Stress fractures: Lessons from military research

Lower extremity stress fractures are not limited to members of the armed forces, but have been studied extensively in military populations. That body of evidence has important implications for stress fracture prevention and management in runners, other athletes, and even nonathletes.

By Baris K. Gun, DO; Andrew C. McCoy, DPM; Kevin C. Wang, BS; and Brian R. Waterman, MD Continue reading

May 2017

Somatosensory deficits following ACL surgery

Research suggests light touch sensation in the foot and ankle may be negatively affected several years after anterior cruciate ligament (ACL) reconstruction—a finding consistent with studies that have reported decreased somatosensation in patients with other lower extremity conditions.

By Matthew Hoch, PhD, LAT; Steven Morrison, PhD; and Johanna Hoch, PhD, LAT Continue reading

May 2017

Unique orthotic strategies for low-volume footwear

The low-volume shoes worn by cyclists, figure skaters, and others can make orthotic management of these patients challenging. So, lower extremity practitioners have had to develop creative strategies for achieving the desired biomechanical effects while working within a limited space.

By Jill R. Dorson Continue reading

April 2017

From prints to prison: Forensic podiatry and gait analysis gain ground

Increasingly, lower extremity experts are being called on to assist with crime scene investigations by analyzing footprints, shoe prints, and the gait patterns of shadowy figures on security videos. For members of this fledgling field, as Sherlock Holmes famously said, the game is afoot.

By Shalmali Pal Continue reading

April 2017

Protocol helps improve TKA outcomes, cut costs

A multidisciplinary joint replacement program is improving patient outcomes, decreasing complications, and shortening hospital stays, which helps to lessen clinical anguish following total knee arthroplasty as well as the financial burden on patients and the healthcare system.

By Katie Mullen, SPT; Jon R. Cook, PT, DPT; Meghan Warren, PT, MPH, PhD; and Tarang Jain, PT, PhD, DPT Continue reading

April 2017

Metatarsal morphology and injury risk in runners

Although it has not been shown to be a risk factor for stress fracture in traditional running, the presence of Morton’s foot (a second metatarsal longer than the first) alters running mechanics in ways that may exacerbate the risks of forefoot injury associated with alternative running styles.

By Brian E Stoltenberg, DPT, OCS, CSCS; and Donald L Goss, PT, PhD, OCS, ATC Continue reading

April 2017

The troublesome triad of diabetic ulcer healing

Uncontrolled deformity, deep infection, and ischemia-hypoxia make up the troublesome triad of confounders associated with healing challenges in patients with diabetic foot ulcers. Clinical examination and intervention in nonhealing patients should focus on these three elements.

By Anna Maria M. Tan, DPM; Michael B. Strauss, MD; and Lientra Q. Lu, BS    Continue reading

March 2017

April LER Issue Flipbook is live!

Check out the latest issue of LER as a digital flipbook. Continue reading

March 2017

Knee OA in amputees: Biomechanical and technological considerations

The risk of knee osteoarthritis in the intact limb of longtime unilateral amputees is much higher than in non­amputees, and the range of potential contri­buting factors is even more complex. Optimizing prosthetic fit and function, in addition to more conventional OA interventions, can help address gait issues that contri­bute to knee joint degeneration.

By Emily Delzell Continue reading

March 2017

Rocker-bottom footwear: effects on balance, gait

Footwear with rocker soles are best known for helping to redistribute plantar pressures during gait in patients with diabetes, but research suggests they also have clinically relevant effects on balance and gait that can be beneficial for some populations but potentially dangerous for others.

By Greg Gargiulo Continue reading

March 2017

Chronic ankle instability and self-reported function

Using patient-reported outcome tools can give lower extremity clinicians insight into the disability experienced by patients with chronic ankle instability. A combination of instruments may be necessary, as different assessments may capture different aspects of the condition.

By Adam B. Rosen PhD, ATC; and Cathleen N. Brown PhD, ATC Continue reading

March 2017

Foot posture, orthoses, and patellofemoral pain

Prescription of foot orthoses for runners with patellofemoral pain (PFP) is often based on the premise that individuals with excessive pronation are among those most likely to have a positive response. However, preliminary analyses indicate this may not be the case.

By Thomas Gus Almonroeder, DPT; and John Willson, PT, PhD Continue reading

March 2017

Putting prehab to the test highlights inconsistencies

The growing popularity of prehabilitation contrasts with mixed findings in the lower extremity literature: Specifically, the approach seems to be more effective in patients undergoing anterior cruciate ligament (ACL) reconstruction than those undergoing hip or knee replacement.

By Cary Groner Continue reading

March 2017

March LER Issue Flipbook is live!

Check out the latest issue of LER as a digital flipbook. Continue reading

February 2017

3D PRINTING OF FOOT ORTHOSES: Clinical feasibility and cost-benefit analyses

Several technical issues currently limit the cost effectiveness of 3D-printing custom foot orthoses, but these will likely be addressed in the near future with the emergence of larger and faster 3D printers.

By Steven Hoeffner, PhD; Timothy Pruett; Breanne Przestrzelski, MS; Brian Kaluf, CP; Nikki Hooks, CO; Katelyn Ragland; Shannon Hall; Kyle Walker; Dan Ballard, CPed; and John DesJardins, PhD Continue reading

February 2017

Does history of running protect against knee OA?

Running may increase the risk of knee osteoarthritis (OA) onset or progression for some people, but in many others the knees will be safe during running; in such individuals, the benefits of physical activity can positively affect weight management and other means of reducing OA risk.

By Nicole M. Cattano, PhD, LAT, ATC; and Jeffrey B. Driban, PhD, ATC, CSCS Continue reading

February 2017

Managing O&P patients who are hard on devices

Even patients who obediently wear their O&P devices can pose a clinical challenge if they wear their devices past the point of breakdown. Experts offer suggestions for dealing with patients who are hard on devices—including those who are very large, very active, or very frugal.

By Shalmali Pal Continue reading

February 2017

Basketball shoe trends favor fashion over feet

Several confounding factors make it difficult to determine statistical associations between footwear and injuries in basketball, but attitudes toward shoes among National Basketball Association (NBA) players suggest both positive and negative trends with regard to potential injury risk.

By Will Carroll Continue reading

February 2017

Jump mechanics and risk of patellar tendinopathy

To understand the association between jumping biomechanics and transmission of forces through the patellar tendon, practitioners must have a working knowledge of the anatomy of the knee, as well as the biomechanical factors that determine force transmission through the knee.

By Rob Halle, PT, DPT, OCS, CSCS Continue reading

January 2017

Patellofemoral pain subgroups: A critical first step toward personalized clinical intervention

Researchers from the UK have identified three subgroups of individuals with patellofemoral pain (PFP) that can be determined using simple evidence-based clinical tests—a key first step toward developing targeted treatment strategies as part of the ongoing effort to improve PFP outcomes.

By Jessie Janssen, PhD; James Selfe, DSc; Michael Callaghan, PhD; Chris Sutton, PhD; Paola Dey, PhD; and Jim Richards, PhD Continue reading

January 2017

Influence of mental health on diabetic foot outcomes

As evidence accumulates suggesting negative effects of depression, dementia, and other mental health issues on gait and foot-related outcomes in people with diabetes, researchers are looking at ways to screen for risk factors and psychosocial issues earlier in the continuum of care.

By Hank Black Continue reading

January 2017

The role of hip extensor strength during cutting

Although most clinicians tend to emphasize hip abductor and external rotator muscle  strengthening in injury prevention and rehabilitation, recent research suggests exercises to increase explosive hip extensor strength may be critical for controlling frontal plane motion during cutting tasks.

By Marc Norcross, PhD, ATC, and Sam Johnson, PhD, ATC Continue reading

January 2017

Using wearable sensors to characterize CP gait

Inertial measurement units (IMUs) facilitate the creation of a gait analysis system that is portable and suited for use in the clinic. Research suggests IMUs can be used to measure clinically important gait metrics in children with cerebral palsy, which may improve patient outcomes.

By Mahmoud El-Gohary, PhD; Sean Pearson, BS; Paul Vasilyev, BS; James McNames, PhD; and James Carollo, PhD, PE Continue reading