April 2018

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Cover Story


Limb Salvage or Amputation of the Diabetic Foot?

The decision often hinges on how a given inter­vention will affect the patient’s quality of life. How, then, to define optimal QoL for your patient, and to agree on the means to achieve it? As clinicians well know, diabetes puts patients at risk of foot ulcers that can lead to poor outcomes, evidenced by the 40% 5-year mortality in patients with newly diagnosed diabetic foot ulcers (DFUs).

By Cary Groner

Guest Editorial


When considering amputation, consider the whole patient

It is likely that someone close to you has faced a major health decision. After the choices and medical advice have been considered, a very personal factor came into play, and the words were spoken: “I don’t want to be a burden.”

Feature Articles


Making the most of resistance training in the management of knee osteoarthritis

Most physical therapists maintain that resistance training is beneficial to patients with knee osteoarthritis, but evidence from trials that have been designed with consistency is lacking. Experts discuss how to create an effective regimen given this information vacuum.

By Jill R. Dorson

Gait therapy in osteoarthritis of the hip: An assessment

Although clinicians and researchers have been gathering data for the use of gait therapy in patients with knee OA for some time, its use in hip OA is less far along, but shows promise. Does correcting for gait abnormalities have a role in the treatment of hip osteoarthritis (OA)?

By Nicole Wetsman

Does athletes’ divided attention affect mechanics associated with ACL injury?

We might be falling short in our efforts to prevent ACL injury by allowing athletes to focus on how they are moving during screening. Almost 8 million athletes participate in high school sports each year in the United States, and an additional 490,000 compete at the intercollegiate level.

By Sarah Marie Tighe, SPT, and Thomas Gus Almonroeder, PT, DPT, PhD

The future is now— Implications of 3D technology for orthoses

2018 is shaping up as a breakthrough year for 3D printing in orthoses, as the industry moves from promise to reality. Experts agree: Three-dimensional printing will deliver custom clinical products, designed for individual patients at an affordable price.

By Keith Loria

From the Literature


Treatment for post-stroke spastic equinovarus and plantar flexor spasticity

Spasticity occurs in 20% to 40% of stroke patients. Two new studies add to the body of evidence supporting the use of botulinum toxin type A (BT-A) injections for post-stroke spasticity: the first looked at the ideal timing of injections for plantar flexor spasticity, and the second looked at ultrasound-guided injections for spastic equinovarus.

Crossover prosthetic design

Prosthetic feet are typically optimized for a narrow range of activities, meaning active prosthetic users may need more than 1 prosthesis to fully participate in activities with varying degrees of impact. Modern energy-storing feet (ESF) support users’ ability to walk at differing speeds, as well as support static standing, but they can limit aerobic activities and running speeds. Running-specific feet (RSF), while ideal for running and sprinting, do not support ...

Post-operative complications after Achilles tendon rupture repair

Achilles tendon rupture (ATR) is one of the most common injuries resulting from sports and exercise activities. Its resulting functional deficits can last more than 2 years from the original injury. While traditionally it has been an injury seen more among men, prevalence among women has been increasing, most likely due to increased participation in recreational sports.

Low-cost trans-femoral prosthesis uses plantar insole sensors

Indian researchers have designed a trans-femoral prothesis with plantar insole sensors that they found allow users to achieve near able-bodied gait kinematics. The passive prosthesis uses a magneto-rheological (MR) damping system with electronic control based on plantar insole feedback

Supportive footwear for children with CMT

The effect of footwear on gait and balance of children and adolescents with Charcot-Marie-Tooth (CMT) disease is of interest to parents and clinicians. Children with CMT, which causes progressive damage to peripheral nerves, particularly the feet and ankles, often have gait difficulties due to muscle weakness, including problems with balance, resulting in falls.

Study assesses role of corticosteroid therapy in Achilles tendinopathy

Achilles tendinopathy is the most common overuse injury in sport, and it is common in non-athletes as well. High volume image guided injection and structured rehabilitation (HVIGI+SR) has been shown in repeated studies to provide significant improvement in…

Industry News & Updates


Featured Products


Footwear Designed to Reduce Risk of Falling

Described by the manufacturer as the first-ever footwear scientifically designed to reduce a person’s risk of falling, the Moore Balance Shoe (MBS) by Apex is the latest in OHI’s suite of fall risk therapies. The shoes feature a firm, adjustable heel counter with convenient Velcro strap closure.

FootFlexor for Patients with Foot Drop

Core Products International introduces the FootFlexor, described as a functional and comfortable AFO that allows the foot to perform naturally while walking. Designed to work with most lace-up shoes and boots, the FootFlexor works by incorporating the FootFlexor Wrap, eyelet clips, and a tension cord to help lift the toe during gait.

Biofreeze Soothing Pain Relief Cream

Biofreeze is launching its new Soothing Pain Relief Cream. Biofreeze also offers gel, roll-on, and spray external pain relief products. Research-proven to provide temporary relief from many aches and pains, Biofreeze Soothing Pain Relief Cream also hydrates and moisturizes the skin. Indications include sore muscles and joints, sprains, strains, and bruises.

Fracture Sock to reduce irritation

New from Advantage by Elite Orthopaedics is Fracture Sock, designed to reduce skin irritation while wearing an ankle walker. The latex-free fracture sock is composed of 100% synthetic knit for superior moisture absorption. An improved cross stitch provides better compression, which helps reduce the risk of friction and lessens the risk of sock bunching.

Mastercare Mini Therapy Table

Mastercare AB’s Swedish Back Care System Mastercare Mini is a professional therapy table that can be used to reduce injury risk for runners. The unit strengthens and decompresses the muscles of the back to relieve pressure on the lower extremity joints, as well as the back.

Ankle Stabilizing Orthosis

OPED Medical Inc. (dba Evenup) offers the Vacotalus for stable treatment of the ankle region. The ankle appliance is designed for treating acute ankle injuries, for use in after-care for fractures of the ankle joint, preventing ligament lesions on the ankle joint, and for compensation of ankle joint instability.

ToePro Exercise Platform

HumanLocomotion.org offers the new ToePro Exercise Platform for strengthening specific small muscles of the foot and ankle to improve balance, enhance jump performance, and increase gait velocity. Because the toe and arch muscles provide stability during the pushoff phase while walking, jumping, and…

ETFMx Multi-Frequency Electronic Tuning Fork

O’Brien Medical introduces the ETFMx multi-frequency electronic tuning fork. Building on the success of the ETF128, clinicians can now test sensation with the 3 most used frequencies in medicine, 64, 128 and 256 Hz. The ETFMx is used for diagnosing and…

Revised Pain Science Book

OPTP has added the new “Explain Pain Supercharged” to its collection of pain science books. Written by David Butler and Lorimer Moseley, the book is a revised and enhanced version of the popular book “Explain Pain” released in 2003.

3D Force Sensing Performance Treadmills

AMTI has introduced a new instrumented treadmill: The MOBIUS Treadmill, which is available with an optional incline feature, capable of a 25% gradient. Both models have two independent, 8800N-capacity force platforms, and a newly-designed frame engineered to achieve the…

Cadence Low Volume Insole

Cadence insoles introduces a thinner, low volume design. The Cadence “Low Volume” provides semi-rigid support and low compression set full-length total contact shock absorbing foam for added comfort in the heel and forefoot. Cadence are easily customized with the addition of a wedge, post or lift if needed.

Baby Foot Original Exfoliation Foot Peel & Moisturizing Foot Mask

Baby Foot is described as the Original Foot Peel.” In 1997, Baby Foot was created and formulated in Japan. In 2012, Baby Foot was launched in the US. Baby Foot continues to be a loved foot exfoliation brand.