Category Archives: Special Section

August 2012

Future of Orthotic Design will focus on practitioners

Foot orthotic laboratories have long been the principal players in the computer aided design and computer aided manufacturing (CAD-CAM) of foot orthoses. But practitioners are gradually starting to play a bigger role in the process—a development that dramatically enhances the potential for clinical creativity but also introduces an extra element of uncertainty.

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August 2012

OPTIMIZING ORTHOTIC MILLING

Computer aided manufacturing is anything but a one-size-fits-all proposition. Customers have a range of variables to choose from, and making the right decision in most cases depends on knowing what type of orthotic material the machine will be asked to handle.

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August 2012

High-tech heel pad tissue analysis: Orthotic implications

The use of technology to improve orthotic design is not limited to CAD-CAM applications, as demonstrated by University of Salford researchers in two presentations at the Orthotics Technology Forum.

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August 2012

Additive manufacturing inches toward prime time

The fledgling field of additive manufacturing is still somewhat fragmented, as evidenced by the fact that the same technology can be described as rapid prototyping or 3D printing. But additive manufacturing’s profile is definitely on the rise, and its advocates are optimistic that lower extremity clinical applications are right around the corner.

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May 2012

STEPS AHEAD: Advances in foot and ankle biomechanics

Foot and ankle experts from across the globe gathered in Sydney, Australia, in April for the third International Foot & Ankle Biomechanics (i-FAB) congress. LER’s exclusive coverage of this event starts with the ever-controversial topic of barefoot running and goes on to examine clinical and scientific progress related to plantar pressures, diabetes, pediatrics, unstable shoes, and osteoarthritis.

By Jordana Bieze Foster

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May 2012

Biomechanist challenges idea that forefoot strike pattern reduces runners’ injury rate

Cites lack of conclusive evidence – Joseph Hamill, PhD, is an avid runner who runs with a natural forefoot strike pattern. But Hamill, professor of kinesiology at the University of Massachusetts Amherst, says he wouldn’t recommend that running technique for most people, despite recent claims that the forefoot strike pattern associated with barefoot running is associated with a lower risk of injury than rearfoot-strike running.

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May 2012

Research links lower extremity symptoms of overuse to kinematics, training habits

Lower extremity kinematics and training habits affect risk of overuse injury in runners, according to research from the University of Tubingen in Germany.

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May 2012

Footwear customized with pressure data fails to reduce diabetic reulceration rates

But ulcer severity may be decreased – In a Dutch randomized controlled trial of 171 high-risk diabetic patients, using plantar pressure measurements to confirm offloading below 200 kPa did not result in lower rates of ulcer recurrence over 18 months compared to standard custom shoes.

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May 2012

Sham debridement matches scalpel for relief of painful plantar calluses

Scalpel debridement of plantar calluses in elderly patients does not reduce plantar pressures and is no more effective than sham treatment for relieving pain, according to an Australian study.

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May 2012

Gait changes associated with footwear may explain foot complaints in children

Studies assess school shoes, flip-flops – Researchers from the University of Sydney in Australia have identified gait changes associated with pediatric footwear that may help explain foot complaints that have been reported in children.

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May 2012

Hand tremor as predictor of calf cramp in CMT patients perplexes researchers

Researchers from the University of Sydney remain perplexed by the emergence of hand tremor as a predictor of calf cramp in children with Charcot-Marie-Tooth disease but theorize that the relationship may involve fatigue.

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May 2012

Factors other than static curve influence rollover shape with rocker-bottom shoes

Data confirm kinetic, EMG changes – The static curve of a rocker-bottom shoe does not correlate strongly with its rollover shape during gait, suggesting that other factors such as material stiffness may also contribute, according to research from the University of Salford in the UK.

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May 2012

Benefits of variable-stiffness footwear may go beyond reducing knee OA risk

Variable-stiffness shoes may have performance benefits for athletes in addition to addressing kinetic risk factors for knee osteoarthritis, according to research from the National University of Singapore.

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KID STUFF: Pediatric clinical news update

In this special section, LER updates you on the latest research and clinical news to help optimize management of your littlest lower extremity patients. Topics include pediatric flexible flatfoot, cerebral palsy, ACL injury, clubfoot, Charcot-Marie- Tooth disease, gait patterns in autism, and footwear for early walkers.

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July 2011

New papers revisit, rekindle flexible flatfoot controversy

“Other considerations” spark debate

In January 2010, when LER first covered the controversy, Australian podiatrist and researcher Angela Evans, PhD, had recently published a paper in the Journal of the American Podiatric Medical Association suggesting that children whose feet were flatter than expected, but asymptomatic, should be monitored rather than automatically treated with orthoses.

By Cary Groner

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July 2011

CP experts assess evidence for use of orthotic devices

Despite progress, research gaps remain

The January publication in NeuroRehabili­tation of the recommendations from a consensus conference held in 2008 paints a less-than-perfect picture of the evidence underlying orthotic management of cerebral palsy (CP).

By Larry Hand

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July 2011

ACL injury prevention training focuses on younger athletes

Age-specific protocols are key to success

Training programs aimed at preventing anterior cruciate ligament injuries have been used for many years, but injury rates remain high. Injury prevention experts suggest such programs may be more effective if implemented before children reach the ages associated with highest injury risk and if the programs utilize age-specific protocols.

By Emily Delzell

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July 2011

Not all practitioners embrace soft soles for novice walkers

Barefoot-like isn’t necessarily best

Barefoot is a biomechanics buzzword these days, but not all practitioners believe soft-soled shoes are best for very young children, even if such shoes do approx­imate the barefoot walking experience.

By Shalmali Pal

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July 2011

Charcot-Marie-Tooth patients respond to AFO management

But recognizing device limits is key

Muscle weakness and instability associated with Charcot-Marie-Tooth disease in children can be addressed with ankle foot orthoses, research suggests, but practi­tioners should be aware of the limitations of AFOs in this patient population as well as the ever-present challenge of compliance.

By Shalmali Pal

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July 2011

French study favors Ponseti over compatriots’ technique

Casting simplifies clubfoot management

In a comparative study published in the April/May issue of the Journal of Pediatric Orthopaedics, French researchers found that Ponseti casting compared favorably to French physiotherapy for initial treatment of idiopathic clubfoot.

By Emily Delzell

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July 2011

Early research characterizes gait associated with autism

Results could have clinical implications

Little research has been published about gait patterns in children with autism, but that could be changing. One recently published study, although small, appears to lay the foundation for more focused research and could have clinical implications as well.

By Larry Hand

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CONFERENCE COVERAGE: Custom Orthotic Insoles Technology Forum

Increasing numbers of clinicians and lab owners who have made the leap to digital orthotic technology are seeing meaningful returns on those investments in terms of increased convenience, flexibility, and—importantly—profitability. At the inaugural Custom Orthotic Insoles Technology Forum, held in April at the University of Bath in the U.K., a number of satisfied digital technology converts shared their success stories and underscored the key issues that prospective adopters should consider before taking the plunge themselves.

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June 2011

Custom Orthotic Insoles Technology Forum

Perhaps the most predominant theme echoed by speakers at the conference was the need to understand and carefully weigh the pros and cons of investing in digital technology, as well as the pros and cons of different individual systems, to facilitate decision-making for individual situations.

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June 2011

The future of orthotic technology

Machining orthoses with desktop cryogenics, or using an open-source “3D printer” that not only replicates orthoses but can also replicate itself, may seem unattainably futuristic. But these technologies are on the verge of being ready for prime time, and attendees at the Custom Orthotic Insoles Technology Forum got a sneak peak.

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DEFENSIVE GAME PLANNING: Global insights on sports injury prevention

Multinational all-star teams of sports medicine experts convened in Monaco in April for the World Conference on Prevention of Illness & Injury in Sport, now under the direction of the International Olympic Committee. LER’s exclusive coverage of this event details clinical and scientific progress toward prevention of lower extremity injuries in basketball, soccer, volleyball, running, and ice hockey.

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