Category Archives: Special Section

July 2013

High-tech path leads to the future of improved orthotic prescription

One of the most-talked-about images from the 2013 Orthotics Technology Forum (OTF) depicted 11 custom foot orthoses made by 11 experienced orthotists and podiatrists for a single patient. All 11 practitioners had been given the same information about the patient’s condition, yet all 11 orthoses were distinctly different.

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July 2013

3D printing: The shape of things to come

The Orthotics Technology Forum presentation given by Ben Boyer, CPed, was as much about what the speaker was wearing as what he was saying. Boyer, who is the lab manager at Kintec in Vancouver, Canada, wore a product he thinks may represent part of the future of orthotic design and manufacture—orthoses he’d printed with a hobbyist-level desktop 3D printer.

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July 2013

Lean manufacturing transforms orthotic fabrication

The need to replace entrenched processes and thinking with fluid, fast-moving orthotic design and manufacture that minimizes errors and maximizes resources was highlighted by several speakers at the Orthotics Technology Forum, including Jarret Eschenburg, CPed, director of operations at Coral Springs, FL-based SureFit, a subsidiary of Hanger.

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May 2013

Clinicians come to aid of marathon victims

Lower extremity practitioners were among the first responders after two explosions ravaged the Boston Marathon last month, and are continuing to help heal the hundreds of victims who lost limbs or experienced other traumatic lower extremity injuries.

By Emily Delzell

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March 2013

CEREBRAL PALSY: Dynamic devices facilitate compliance, outcomes in children with cerebral palsy

Brace wear time, not torque, is key – Dynamic orthoses offer an effective alternative to static devices for management of tip-toe gait and knee flexion contracture in children with cerebral palsy (CP), particularly because the dynamic devices are associated with greater compliance, according to separate studies from Sweden and France.

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March 2013

OSTEOARTHRITIS: Knee braces and wedged insoles both alter gait in patients with knee OA

A Taiwanese study offers more evidence that offloading knee braces and wedged foot orthoses are both associated with significant biomechanical improvements in patients with knee osteoarthritis (OA).

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March 2013

SPORTS MEDICINE: Proximal rocker bar on shoe can relieve tension on Achilles tendon in runners

A rocker bar proximally positioned on a running shoe can relieve tension on the Achilles tendon as well as reduce the force required of the calf muscles during walking and slow running, according to research from the Netherlands.

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March 2013

DIABETES: More results support use of foot orthoses to significantly decrease plantar pressures

Swedes also find low ulceration rate – Research from Sweden and Egypt provides more evidence that foot orthoses can significantly decrease plantar pressures in patients with diabetes, theoretically reducing the risk of foot ulcers and lower extremity amputation.

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March 2013

FLAT FOOT: Arch structure in children with talipes planovalgus improves with shoe inserts

Orthotic management of pediatric talipes planovalgus starting at an early age is associated with significant improvement in weightbearing arch structure, according to research from Saga University in Japan.

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March 2013

OFFLOADING: Walkers’ effect on proximal biomechanics varies depending on design characteristics

Tibial inclination appears significant – Orthotic walkers have significant effects on proximal joint mechanics during gait, the extent of which appear to depend on individual device design, according to research from the University of Central Lancashire in the UK.

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March 2013

PEDIATRICS: In hyperpronators, functional scoliosis responds to distal orthotic treatment

What appears to be idiopathic scoliosis may actually be functional scoliosis that can be effectively treated with foot orthoses in children who are hyperpronators, according to research from Chungnam National University in Daejeon, South Korea.

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March 2013

STROKE: Eight weeks of early AFO use significantly enhances benefits of stroke rehabilitation

Functional balance test scores rise – Use of an ankle foot orthosis (AFO) within six weeks of stroke results in better balance outcomes and earlier independent ambulation than if AFO use is delayed, according to research from the Netherlands.

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November 2012

CONFERENCE COVERAGE: International Clubfoot Symposium

The Ponseti method of clubfoot management has achieved worldwide 
acceptance, but practitioners and researchers are still working to identify the best ways to optimize clinical outcomes while remaining sensitive to issues of cost effectiveness and cultural differences. Clinicians from around … Continue reading

November 2012

Resource-poor areas benefit from global outreach efforts

Treatment of children with clubfoot has evolved considerably in the five years that have elapsed since the inaugural International Clubfoot Symposium, and the benefits of this evolution are particularly evident in resource-poor nations—home to about 80% of the 200,000 children born each year with clubfoot. But practitioners who treat patients in these areas still face financial, cultural, and logistical challenges.

By Emily Delzell

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November 2012

Benefits of Ponseti method extend to older children

Clubfoot correction ideally should be performed during infancy, before children learn to walk, but experts agree that the Ponseti treatment method can also be effective in older children. Speakers at the International Clubfoot Symposium in October presented successful outcomes for Ponseti treatment of neglected clubfoot in patients aged up to 21 years.

By Jordana Bieze Foster

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November 2012

TATT in relapsed clubfeet can affect plantar flexion

Tibialis anterior tendon transfer (TATT) is known to be associated with limited ankle dorsiflexion, but practitioners should be aware that plantar flexion also can be negatively affected, according to research presented in October at the International Clubfoot Symposium.

By Jordana Bieze Foster

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October 2012

Energy efficiency with AFO use varies in cerebral palsy patients

Longer strides lead to increased work
Ankle foot orthoses (AFOs) are regularly prescribed to children with walking disabilities resulting from cerebral palsy, yet the effects of AFOs on energy recovery and work during gait are still unclear.

By Samantha Rosenblum

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October 2012

Biomodel could help researchers optimize clubfoot brace design

Method includes complex rotations
A surrogate biomodel of a child’s lower extremities, in particular the ability to model movement along multiple axes of rotation, could help improve researchers’ biomechanical understanding of bracing for clubfoot.

By Emily Delzell

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October 2012

Juvenile idiopathic arthritis study reveals footcare information gap

Issues involve custom foot orthoses
A Scottish study suggests foot care in children with juvenile idiopathic arthritis (JIA) falls short because of poor access to care and negative perceptions about custom foot orthoses. Experts say those issues may be less prevalent in the US but emphasize the need to educate patients, parents, and referring clinicians about the benefits of lower extremity care.

By Larry Hand

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October 2012

Early ACL surgery could lower risk of associated knee damage

Patterns mirror those seen in adults
Timing of reconstruction surgery after pediatric anterior cruciate ligament (ACL) injuries seems to be related to the prevalence of meniscal and chondral injuries discovered during those surgeries, according to new research published in the September issue of The American Journal of Sports Medicine.

By Cary Groner

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October 2012

Wearing athletic shoes affects some performance measures

Standing long jump distance improves
Research has recently begun to clarify footwear’s effects on gait and functional performance in children, but the broader implications of the findings remain a matter of debate.

By Cary Groner

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October 2012

Dynamic data in obese children may suggest gait compensation

Low force values surprise researchers
An Austrian study exploring the role of genu valgum and flatfoot in obese and normal weight children found obesity was associated with higher peak plantar pres­sures, but lower maximum force while walking, when forces were normalized to body weight.

By Christina Hall Nettles

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October 2012

Experts debate relative benefits of screening feet for risk factors

Most question emphasis on flatfoot
The value of screening programs for pediatric foot problems—primarily flatfoot—was recently challenged in a commentary by Australian podiatrist Angela Evans, PhD, a researcher and lecturer in the Division of Health Sciences at the University of Adelaide.

By Cary Groner

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KID STUFF 2012: Pediatric clinical news update

In our second annual pediatric special section, LER updates you on the latest research and clinical news to help optimize management of your littlest lower extremity patients. Topics include cerebral palsy, clubfoot, juvenile idiopathic arthritis, ACL injury, footwear, obesity, and … Continue reading

CONFERENCE COVERAGE: Orthotics Technology Forum 2012

Orthotic laboratory managers, CAD-CAM technology experts, and lower extremity practitioners convened in Manchester, UK, in July to share ideas and experiences related to the automated design and manufacture of foot orthotic devices. Foot orthotic laboratories have long been the principal … Continue reading