August 2012

Cover Story

Digging in to prevent ACL injuries in volleyball

Landing and change of direction in volleyball can put players at risk of anterior cruciate ligament (ACL) injury. Few ACL prevention studies have focused on volleyball, but players can benefit from screening and intervention programs that have been shown to be effective in other sports.

By Joanne L. Parsons, MSc, PT, CAT(C)

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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

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Editor Message

Out on a limb: Might as well jump

One of the biggest challenges in sports injury prevention is that the sheer number of potential injuries makes it prohibitive to screen for all of them. But what if there was a single test that could be used to screen for all lower extremity injuries? It’s not as farfetched as you might think.

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Out on a limb: Olympic inspiration

Images from the London Olympics were everywhere in late July and early August—on our televisions, our radios, our computer screens, and our smart phones. Flags were flown, national anthems played, and countries ranked by medal count. In so many ways, the Olympics are about the achievements of individual nations. But a closer look reveals a more complex picture.

Jordana Bieze Foster, Editor

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Special Report

CONFERENCE COVERAGE: Orthotics Technology Forum 2012

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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.

By Jordana Bieze Foster

Sponsored by an educational grant from…

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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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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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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Digital design of an internal lattice structure for orthotic additive manufacturing. (Photo courtesy of Chris Lewis Jones/Delcam.)
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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Finding fashion options that accommodate AFOs

Practitioners know patients who feel that ankle foot orthoses (AFOs) hinder their sartorial style are less likely to be compliant, but many clinicians feel ill-equipped to give fashion advice. That’s when the expertise of a stylist, seamstress, or personal shopper can come in handy.

By Shalmali Pal

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Plantar fasciitis: Unique challenges in basketball

Not only do basketball players have many of the same risk factors for plantar fasciitis as the general population, they also have the added challenge of a grueling season and very little opportunity to rest. That means practitioners have had to be creative when it comes to treatment.

By P.K. Daniel

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Figure 1: Toe-in gait has been shown to reduce knee pain and improve knee function for indi- viduals with knee osteoarthritis after six weeks of training.9
Gait retraining improves symptoms of knee OA

A number of different gait modifications have been demonstrated to significantly reduce the knee adduction moment in patients with knee osteoarthritis (OA). Now research suggests gait retraining can also help reduce the pain associated with knee OA and improve function.

By Pete B. Shull, PhD

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Diabetic limb salvage: Surgeon’s perspective

When preventive measures have been exhausted, various surgical approaches can be employed to provide each diabetic patient with a functional, biomechanically sound foot that is free of infection, while minimizing the risk of future lower limb complications.

By Gabriel V. Gambardella, DPM, and Peter A. Blume, DPM, FACFAS

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MS and gait: Assessment facilitates opportunity

Significant progress has been made in quantifying gait impairment in patients with multiple sclerosis, but clinician-friendly assessment techniques that are sensitive to mild levels of impairment are needed to facilitate early intervention and in turn improve patient outcomes.

By Douglas A. Wajda and Jacob J. Sosnoff, PhD

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Load cells enhance study of prosthetic foot rollover

A new technology, the load cell, can be used to assess rollover characteristics of prosthetic feet in a variety of walking envi­ronments. Load cell analysis can help identify premature foot-flat and dead spots and determine the effects of energy stor­age and return designs on amputee gait.

By Edward S. Neumann, PhD, PE, CP, FAAOP; Justin Brink, MSE, EI; Kartheek Yalamanchili, MSE, EI; and Joon S. Lee, PhD

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Idiopathic toe walking: Insights on intervention

As researchers explore the possibility that idiopathic toe walking has an underlying neurologic cause, clinicians continue to refine treatment strategies to keep ITW patients off their toes. Orthotic devices play a key role, with lower-profile devices growing in popularity.

By Emily Delzell

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Gait alterations associated with diabetic neuropathy

Inconsistent findings from laboratory stud­­ies have made it difficult to deter­mine which gait alterations are specific to diabetic peripheral neuropathy and which also affect diabetic patients with­out neuropathy. Body-worn sensor tech­nol­ogy may help clarify the distinctions.

By Tahir Khan, DPM, and Ron Guberman, DPM, DABPS

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Acute stretching debate approaches a consensus

Experts still disagree about whether stretch­­ing prior to athletic activity can prevent injury and, if so, whether those ben­e­fits offset any negative performance effects. But they do tend to agree that some form of stretching is probably a good idea for most athletes.

By Cary Groner

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OA bracing: Longer use does not impair strength

Dose-response research refutes the com­mon perception that increasing brace wear time leads to muscle atrophy in patients with knee osteoarthritis. In fact, longer bracing duration appears to im­prove hamstring strength as well as in­creas­ing patients’ physical activity levels.

By Cheryl L. Hubley-Kozey, PhD, and Gillian Hatfield Murdock, PT, MSc

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In the Moment: Footcare

By Emily Delzell

Less and less limb loss: But uphill battle still awaits, experts say

Lower extremity amputation (LEA) rates in the US continue to fall, according to an analysis published in July that confirms earlier research demonstrating a steady decline beginning in the 1990s.

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Amputation, reulceration rates fall after two years of orthotic therapy

Orthotic therapy in patients with diabetes and a history of foot ulcers was associated with dramatic decreases in reulceration and amputation rates, according to data from Spanish researchers at the Universidad Complutense de Madrid.

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Removable plug insoles significantly reduce pressure, as do arch supports

Researchers from Taiwan confirmed that insoles with removable plugs reduce forefoot plantar pressures in patients with diabetic neuropathy, and those pressures are further reduced by adding arch support.

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Photo courtesy of the University of Iowa.
Clubfoot conversion: Nearly all surgeons adopt Ponseti method

The shift away from aggressive surgery to correct clubfoot in now all but complete, according to research published in July in the Journal of Pediatric Orthopaedics (JPO). The study shows the Ponseti me­thod is now the treatment of choice for the vast majority of practitioners and that increased understanding of the technique has resulted in better outcomes.

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Selective plantar fascia release assists healing of recalcitrant forefoot ulcers

Korean surgeons have developed an alternative to Achilles tendon lengthening for reducing plantar pressure and promoting wound healing in patients with diabetic foot ulcers.

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Study finds noise-enhanced insoles reduce gait variability in older adults

A subsensory level of mechanical noise delivered directly to the foot soles of healthy older adults during walking has the potential to normalize gait variability and possibly reduce the risk of falls, according to research published in July in Gait & Posture.

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Market Mechanics

APMA announces 2013 abstract awards

The American Podiatric Medical Association (APMA) announced the winners of its 2013 APMA Annual Scientific Meeting Abstract Competition on July 24 at its annual meeting, held in Las Vegas. APMA presented awards to first-, second-, and third-place winners in five … Continue reading

UNO opens $6M biomechanics building

The University of Nebraska at Omaha (UNO) will hold the official ribbon-cutting ceremony for its new $6-million biomechanics research facility on September 5 during the annual meeting of the American Society of Biomechanics. The 23,000-square-foot building houses research efforts led … Continue reading

Toenail topical shows efficacy in trials

A topical antifungal manufactured by Palo Alto, CA-based Ancor Pharmaceuticals clears nails and fungal infection in people with onychomycosis, according to data presented in July at the 2013 American Podiatric Medical Association Annual Scientific Meeting held in Las Vegas. Max … Continue reading

FDA clears Empi Phoenix stimulator

The Empi Phoenix, a neuromuscular electrical stimulator designed to supplement physical therapy before or after surgery for total knee replacement or anterior cruciate ligament repair, has received 510(k) clearance from the Food and Drug Administration, according to a July statement … Continue reading

Center expands sports injury surveillance

The Datalys Center for Sports Injury Research and Prevention in Indianapolis announced in July that its data collection is expanding beyond college sports to include national youth, high school, and amateur sports programs. The National Collegiate Athletic Association (NCAA), the … Continue reading

EPA endorses socks’ fungicidal effects

The Environmental Protection Agency granted public health claim approval in July to Richmond, VA-based Cupron for the antifungal properties of its new copper-infused diabetic socks. The PRO Therapy System socks kill 99.9% of Trichophyton mentagrophytes (athlete’s foot fungus) after 12 … Continue reading

Motion lab targets assistive technology

Cleveland State University (CSU) opened the doors in July to its new Parker Hannifin Motion and Control Lab, where the research focus is assistive technology. Lab scientists are working on computerized “smart” prosthetic limbs that react like natural limbs and … Continue reading

Orthocare Innovations wins tech honor

R&D Magazine highlighted its picks for the year’s best technology in July, naming Oklahoma City-based Orthocare Innovations’ microprocessor foot-ankle system to its list of the 100 most technologically significant products introduced in the last year. Other winners of this year’s … Continue reading

VA verifies DM Systems’ vet-owner status, an arm of the US Department of Veterans Affairs (VA), certified Evanston, IL-based DM Systems in July as a veteran-owned small business. DM Systems president and owner Denis Drennan, MD, is a Vietnam veteran who won the Bronze Star … Continue reading

Midwest O&P chapter makes donation

The Midwest Chapter of the American Academy of Orthotists and Prosthetists made its annual donation in July to the Orthotic & Prosthetic Activities Foundation’s Dale Yasukawa Scholarship. The $1000 donation will help sustain the scholarship of an O&P student at … Continue reading

Aqualeg opens its first facility in the US

European company Aqualeg opened its first US facility on July 30 in Rock Hill, SC, naming Michael Burton general manager. The company, based in Nantes, France, is scheduled to introduce its hybrid cover that can be adapted to compatible existing … Continue reading

Delcam succeeds with US-based forum

Delcam’s 2013 Orthotics Technology Forum, held in the US for the first time in May at the Georgia Institute of Technology in Atlanta, showcased new and upcoming technologies and processes designed to assist practitioners in the prescription, design, and manufacture … Continue reading

ComfortFit updates online ordering

Roselle, NJ-based ComfortFit Orthotics has added new online ordering capabilities. Customers can now view complete information on all new orders as well as three years of account history, order noncustom products online, and query lab staff about orders, products, materials, … Continue reading

PEL announces new owners, retirements

Cleveland, OH-based PEL Supply Company announced on August 1 that the company has been purchased by PEL LLC, a private organization led by Michael A. Sotak, who also assumes the positions of president and CEO. Sotak spent the past six … Continue reading

Orthofeet launches shoe line at APMA

Northvale, NJ-based Orthofeet partnered with former National Football League quarterback Randall Cunningham to introduce its latest footwear collection at this year’s annual meeting of the American Podiatric Medical Association (APMA), held in Las Vegas in late July. The Performance collection … Continue reading

US sprinter will debut prosthetic running foot at Paralympic games

US Paralympic track and field athlete Richard Browne will compete in the London games wearing Freedom Innovations’ Catapult Running Foot, a high-tech prosthetic designed to maximize energy return. Browne is slated to compete in the 100-m dash and the high … Continue reading

DJO Surgical inks deal with researchers to develop osseointegrated prosthesis

San Diego-based DJO Global’s surgical business unit signed a deal in July with the University of Utah, Salt Lake City, to develop an alternative to traditional socket technology, a percutaneous osseointegrated prosthesis (POP) for above the knee amputees. The POP … Continue reading

Napa Valley hosts foot pathology event

Napa, CA-based ProLab Orthotics and the College of Podiatric Medicine, Western University of Health Sciences, Pomona, CA, will hold “Solutions to Foot Pathology” in the Napa Valley  October 19-21. During the seminar, which coincides with the annual grape harvest, faculty … Continue reading

Superfeet opens UK operations center

Ferndale, WA-based Superfeet Worldwide assumed direct responsibility in July for all its European distribution through a new operations center in Edinburgh, Scotland. Superfeet will also begin distributing its products and systems directly to retailers in the UK and Ireland. The … Continue reading

Gait and foot function seminars scheduled

Boston-based Tekscan is slated to host three gait and foot function analysis seminars this fall on plantar pressure mapping technology. Seminars are scheduled for September 15-16, Washington DC; October 13-14, Fort Worth, TX; and November 17-18, Toron­to, Canada. For more … Continue reading

Texas podiatric foundation awards grants

Commerce City, CO-based Mile High Orthotics Lab helped fund the first annual scholarship grants awarded June 30 by the Texas Podiatric Medical Foundation at its state meeting in Galveston. The recipients of the grants, which were open to Texas residents … Continue reading

i-FAB-PG publishes consensus on PMD

An international scientific group has published its final consensus document on plantar pressure measurement devices. The Pedobarographic Group of the International Foot and Ankle Biomechanics (i-FAB-PG) released the paper in July, presenting the group’s consensus on the definition and standardization … Continue reading

Pennsylvania sets licensure standards

In July Pennsylvania Gov. Tom Corbett approved HB 48, which amends the Pennsylvania Medical Practices Act of 1985 to provide for licensure of prosthetists, orthotists, pedorthists, and orthotic fitters. The new law sets standards of professional conduct and requires practitioners … Continue reading


Hames Air Brace

Hames Orthotech introduces the Hames Air Brace for treating plantar fasciitis and Achilles tendinitis. Designed to be worn in a shoe, the brace allows for heel pain treatment during ambulation. With each step, the heel is cushioned by a U-shaped … Continue reading

New Injinji Toesocks

Injinji offers two new performance socks. Performance Midweight Toesocks, Injinji’s most padded toesock, are engineered for sensitive feet and individuals who prefer maximum cushioning. The padded toesocks offer light compression for a snug fit and a honeycomb design for optimal … Continue reading

Boost Compression Socks

Total Vein Systems, a Houston-based medical supply company, recently introduced Boost, its new line of Athletic Compression Therapy. Boost socks are designed to increase blood circulation and enhance oxygen delivery to working and recovering muscles to acceler­ate recuperation and reduce … Continue reading

Alice Alan Fall Collection

Alice Alan Shoes’ Fall Collection is designed to bring together comfort, style, and fit in ready-to-wear women’s dress shoes that feature a removable orthotic to minimize the stress of wearing heels. Handcrafted in New York City, each pair is made … Continue reading

Pro-Tec Orb Massage Ball

Pro-Tec Athletics introduces The Orb, a deep tissue massage ball. The Orb allows for a multidirectional roll for targeting specific lower extremity areas. The high-density device is designed to reduce muscle fatigue and tightness, promote flexibility, and enhance performance. The … Continue reading

KiddieROCKER Pediatric AFO

Allard USA announces KiddieROCKER, the newest addition to the ToeOFF family of products, for children with more involved pathologies. KiddieROCKER supports the foot-ankle complex while facilitating a more normal range of motion during the developmental years, as well as increased … Continue reading

Tola System Now With Strap

The Tola neuromuscular release system now includes the Tola Strap, making it more effective and easier to use. The Tola Strap allows the user to relax the target muscles and apply pressure to hard-to-reach areas without assistance. The 8-ft adjustable … Continue reading

JMS Swiftwick Compression Socks

JMS Plastics Supply now offers a line of advanced compression socks to minimize the perspiration that builds up in prosthetic liners. The new Swiftwick Valor Compression Socks use a patented bonding process to deliver the natural antiodor and antifungal benefits … Continue reading

New Langer PPT Foams

Langer Biomechanics introduces its new, advanced line of PPT engineered foams, designed to provide practitioners with tools for protecting patients. PPT is versatile, comfortable, durable, and its ability to absorb rapid repetitious shock (attenuation) is almost twice that of other … Continue reading

SportX Odor Eliminator

On the heels of last year’s launch of its Ever-Safe sock line, Ever-Safe now offers a safe and permanent odor eliminator to help keep those socks smelling fresh. SportX technology doesn’t just mask unwanted odors, it inhibits growth of the … Continue reading

Pro Taco Ankle Device

Topical Gear, a company that designs protective gear for female athletes, has released the Pro Taco. A taco-shaped buttress applies topical pressure to the anterior talofibular and calcaneofibular ligaments and two foam buttresses apply pressure to the neuroreceptors in the … Continue reading

DiabeticDefense Topical Products

The PediFix Footcare Company introduces its DiabeticDefense line of topical products for diabetic footcare. These formulas help patients with diabetes care for their feet to minimize dry, rough, cracked skin; wash away fungus and bacteria; and help prevent skin breakdown. … Continue reading

Milsport Heel Rest

Milsport Medical offers its Heel Rest, an ergonomic offloading open wound cavity device for heel pressure ulcers. The ergonomic calf pad fits the contours of the lower leg to completely float the heel and reduce pressure points. The Air-O-Tech low … Continue reading

littleSteps Gait Plate

Introducing the littleSteps Gait Plate for children, a semirigid prefabricated orthosis designed to limit in-toeing gait caused by rotational deformities of the lower limb and to address any associated overpronation. The semirigid shell extends laterally beyond the fourth and fifth … Continue reading

G Brace Gauntlet

Kevin Orthotics announces the release of the Free Motion G Brace (G200) AFO. The custom-molded leather gauntlet orthosis is designed to stabilize the subtalar, talocalcaneal, and midtarsal joints. The absence of a vamp facilitates fitting into patients’ shoes. The articulating … Continue reading

AFX Pro and New AFX

Progressive Health Innovations has rebranded its AFX ankle foot maximizer as the AFX Pro and launched a new AFX product. The two products feature many of the same benefits. With four levels of resistance, the AFX Pro (suggested retail price … Continue reading

Comfort Shoes With Cork

Arcopedico has unveiled a new line of handmade comfort shoes, featuring two recognized styles now with stretch uppers made from Portuguese cork. Springy, light, flexible, sustainable, and water-resistant, cork is a natural fit for the company’s comfort shoe construction. The … Continue reading

pedCAT Imaging System

Foot and ankle specialists can now get a 3D, physiological weight-bearing image with the pedCAT diagnostic imaging device from CurveBeam. The compact pedCAT system uses cone beam computed tomography to produce undistorted, unobstructed images of the foot and ankle. It … Continue reading

AFO-Footwear Combo Device

Buffalo Brace and Jerry Miller Shoes introduce an ankle foot orthosis built right into a custom-molded shoe. The AFO component features a padded collar, thermal molded polypro­pylene frame, and custom removable inserts. The shoe component features include an elongated opening, … Continue reading

Zenvisibles Seamless Liners

Foot Zen by Doctor Specified introduces Zenvisibles—a no-show liner product designed for people who don’t want to wear socks with loafers or pumps but want to avoid the negative consequences of perspiration that can result from not wearing socks. Zenvisibles … Continue reading