July 2012

Cover Story


The sprinter's advantage: Thinking outside the blocks
The sprinter’s advantage: Thinking outside the blocks
Researchers at The Pennsylvania State University have identified structural char­ac­teristics that distinguish the foot and ankle mechanics of trained sprinters from nonsprinters. Are similar underlying vari­ables responsible for the reductions in mobility that affect older adults? By Stephen J. Piazza, PhD

Publisher’s Memo


Publisher’s memo: Embracing change
Publisher’s memo: Embracing change
As a father of four, I knew the day would come when one of them would be moving on. As my wife and I watched our eldest son walk across the stage to receive his high school diploma, I was reminded of how fast life moves and how important it is to have a strong ...

Editor Message


Out on a limb: Power in practice
Out on a limb: Power in practice
Healthcare researchers don’t get a lot of instant gratification. Typically it takes years for a study’s findings to have an impact on clinical practice, and often that doesn’t happen until those findings have been replicated by additional studies.

Departments


Pediatric obesity weighs on growing bones, joints
Pediatric obesity weighs on growing bones, joints
Exercise is the standard prescription for obesity. But alterations to joint biome­chan­ics, gait, and anatomical structure in overweight children and teens mean that physical activity comes with its own risks, which practitioners must factor into any clinical recommendations. By Christina Hall Nettles
Development of the arch: Functional implications
Development of the arch: Functional implications
Contrary to the conclusions of early research, recent studies suggest that arch height does indeed affect lower extremity function. The biomechanics associated with different arch heights may provide a basis for treatment and prevention of related injuries. By Thomas C. Michaud, DC
The evidence for use of gauntlet-style AFOs
The evidence for use of gauntlet-style AFOs
Gauntlet-style ankle foot orthoses offer an alternative to a larger rigid therm­oplastic AFO for foot and ankle pathol­ogies requir­ing more stability or im­mo­bili­za­tion than a foot orthosis provides. Materials, trim lines, and fabrication techniques can vary to meet different patients’ needs. By Holly Tuchscherer Olszewski MS, CPO 
Dialysis treatment takes toll on diabetic foot care
Dialysis treatment takes toll on diabetic foot care
A convergence of comorbidities means diabetic patients on dialysis have an even higher risk of foot ulcers and amputation than those without renal disease. The potential for preventing these complica­tions at dialysis centers is too often underappreciated by practitioners. By Larry Hand
ACL reconstruction and risk of knee OA, part 2
ACL reconstruction and risk of knee OA, part 2
This two-part series examines the link between ACL injury and the later development of osteoarthritis (OA) and how surgery may strengthen or weaken that link. This second installment explores meniscal damage, proprioception, and what MRI can add to the discussion. By Cary Groner

News


In the Moment: Ankle

By Jordana Bieze Foster

Fusion vs replacement: Both improve gait, but well short of normal
Fusion vs replacement: Both improve gait, but well short of normal
Functional outcomes for total ankle re­place­ment (TAR) in patients with end-stage ankle arthritis appear to match or exceed those of ankle fusion, according to research presented in June at the an­nual meeting of the American Ortho­paedic Foot & Ankle Society (AOFAS).
ATFL repair with any of three methods decreases ligament stiffness, strength
Three different methods for repairing the anterior talofibular ligament (ATFL) leave the repaired structure significantly stiffer and weaker than an intact ligament, which may have implications for ankle injury rehabilitation, according to research presented in June at the AOFAS meeting.
Effects on plantar flexor endurance, power linger after gastroc recession
Tasks requiring plantar flexor endurance and push-off power remain difficult for patients long after an otherwise successful gas­tro­cnemius recession for treatment of Achilles tendinopathy, according to findings presented in June at the AOFAS meeting.
Bracing affects plantar pressures and inversion, but not most performance tests
Research presented in June at the annual meeting of the National Athletic Trainers Association shed more light on the biomechanical effects of ankle braces that can help reduce the risk of inversion injury.

In the Moment: Sports medicine

By Jordana Bieze Foster

Concussion conundrum: Chronic postural deficits elude detection
Concussion conundrum: Chronic postural deficits elude detection
Sophisticated laboratory experiments have documented postural control deficits in athletes with a history of concussion, but research presented in June at the annual meeting of the National Athletic Trainers Association (NATA) suggests clinicians may find it difficult to identify similar deficits in concussed athletes once their other symptoms have resolved.
Hip adduction on landing stands out as predictor of future ACL injury risk
Hip adduction on landing is a significant predictor of anterior cruciate ligament (ACL) injury risk, according to a large pros­pective study from the University of North Carolina at Chapel Hill, presented in June at the NATA meeting.
In patients with patellofemoral pain, hip weakness may be result, not cause
A pain-inducing protocol significantly reduces hip extension strength in patients with patello­fem­oral pain (PFP), suggesting that hip weakness associated with the condition may be a result and not a cause, according to research from the University of Wisconsin-Milwaukee presented in June at the NATA meeting.

In the Moment: Knee OA

By Samantha Rosenblum and Jordana Bieze Foster

Arthroscopy attrition: 2002 study changes practice patterns
Arthroscopy attrition: 2002 study changes practice patterns
The number of knee arthroscopy proce­dures performed in patients with osteo­arthritis (OA) has greatly decreased since the 2002 publication of a high profile New England Journal of Medicine study that questioned the procedure’s effectiveness, according to research from the Cleveland Clinic in Cleveland, OH.
Bone bruises associated with ligament injuries may predict chondral damage
The distribution of bone bruises associated with acute knee ligament injury is consistent with long-term patterns of chondral damage, according to research from the University of Kentucky in Lexington presented in June at the annual meeting of the National Athletic Trainers Association.
Soccer training intensity affects levels of biomarker for cartilage degradation
Increased exercise duration is associated with elevated levels of a serum biomarker previously found to be an indicator of cartilage damage, according to research from the University of Kentucky in Lexington presented in June at the annual meeting of the National Athletic Trainers Association.

Market Mechanics


Products


Keeping Pace Children’s Shoes
Keeping Pace Children’s Shoes
The 2012 shoe lines from KeepingPace integrate a wider, deeper heel and toe box for accommodating orthotic devices without being oversized. Designed with input from orthotists and therapeutic footwear designers, all styles offer three adjustable innersoles for a precise fit, ...
Bionic Ankle For AK Users
Bionic Ankle For AK Users
iWalk announces the availability of its new Biom bionic lower limb system for above-knee amputees (Biom AK). The new Biom AK is an ankle system that that works with select microprocessor knees to restore natural motion through personalized bionic technology. ...
Adventure Boots
Adventure Boots
Apis Footwear Company offers the AM5605 and AM5615 Adventure Boots as part of its Mt. Emey Therapeutic Line, suitable for athletic walking or simply improving patients’ general comfort. Designed to accommodate rather than correct, the Adventure Boots are genuine leather ...
Walking Boot Covers
Walking Boot Covers
re:covers walking boot covers solve practical day-to-day issues such as brace wear and tear, skin scrapes, and snagging of compression hose. They also address patients’ very real cosmetic concerns with colors and patterns that disguise the walking boot and showcase ...
Premiere Ankle Braces
Premiere Ankle Braces
Townsend has redefined and expanded its line of custom Premier Ankle Braces to achieve mobility benefits for a wider range of patients. The Standard Premier Ankle Brace includes a tibia shell and ankle joints made from pre-preg carbon fiber with ...
Full-Length KidZerts
Full-Length KidZerts
KidZerts has released a full-length version of its popular three-quarter length insole for kids. Like the three-quarter length version, the full-length insoles feature an ethyl vinyl acetate (EVA) sublayer that molds slowly to the plantar surface of the foot during ...
Total Support Quartet Sandal
Total Support Quartet Sandal
Spenco Medical Corporation introduces a new toe-post sandal style: the Total Support Quartet. The Quartet is designed with a sporty strap that secures the foot in the sandal and offloads pressure from the ball of the foot. The style offers ...
Washable Carter Shoe
Washable Carter Shoe
Dr. Comfort’s new Carter style shoe for men is a machine washable, double-depth diabetic shoe. Made of lightweight stretch Lycra with a two-way Velcro closure for extra flexibility, this shoe is designed to accommodate foot deformities such as bunions or ...
Roland Sandal
Roland Sandal
Oasis Footwear introduces the Roland, a fisherman-style sandal for men. The Roland is approved by PDAC (Medicare’s Pricing, Data Analysis, and Coding) and, when prescribed by a physician, its cost qualifies as a Part B benefit under the Therapeutic Shoe ...
Postoperative Socket System
Postoperative Socket System
The APOPPS (Adjustable Post-Operative Preparatory Prosthetic System) features volume reduction, medial and lateral compression, easy access to bandages, and early weightbearing when using a Universal Frame Outer Socket (UFOS). The three-part adjustable socket system provides postoperative, early, and preparatory prosthetic ...