May 2012

Cover Story


Healing in the dark: Night use of orthoses

Night splinting for plantar fasciitis gets the lion’s share of attention, but lower extrem­ity practitioners are also seeing positive results with night use of orthoses for conditions ranging from cerebral palsy to AIDS.

By Larry Hand

Editor Message


Out On a Limb: Class act

When I was in journalism school in Los Angeles, securing a spot in the reporting class taught by Pulitzer Prize-winning LA Times writer George Ramos was a coup. It was also terrifying.

Jordana Bieze Foster, Editor

Special Report

Download the original article as a PDF (357kb)

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

Sponsored by an educational grant from…

 


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 ...
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 ...
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.
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 ...
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.
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.
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.
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 ...
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.

Departments


Active Stance: Minimalist footwear: A risky switch for runners?
For the majority of evolutionary history, runners were either barefoot or wore minimalist footwear lacking the cushioning of today’s running shoes. Barefoot or minimally shod runners demonstrate differences1 in kinematics and impact forces compared with those wearing modern running shoes, ...
Preventing hamstring injuries on the gridiron
Hamstring injuries that occur during sprinting are a significant concern in football, not just because of the frequency with which they occur, but also because they are notoriously difficult to rehabilitate, which underscores the need for effective prevention through targeted ...
Selection of amputation level in diabetic patients
Not all patients with diabetes and not all ulcerated limbs are amenable to salvage. When salvage is not an option, amputa­tion can help improve patient function, but a number of factors should be considered when deciding how much of the ...
Peroneal latency’s role in inversion ankle sprain
A delay in the activation of the peroneus longus and peroneus brevis muscles is thought to contribute to the risk of inver­sion ankle sprain. New research suggests that ankle taping, in addition to providing mechanical stability, also helps reduce this ...
Patient race contributes to burden of knee OA
Evidence suggests that the prevalence and symptom severity of knee osteo­arthritis are greater in African-American pa­tients, underscoring the need for lower extremity practitioners to implement effec­tive strategies for disease prevention and management in this patient population. By Kelli D. Allen, PhD

News


In the Moment: Knee OA

By Emily Delzel

Weight watching: Ten percent gain or loss affects symptoms

Education about weight loss—including why it’s important and how to achieve it—should be “front and center” of any clinical encounter involving patients with knee osteoarthritis (OA), said a researcher who recently published findings on the effects of weight change over time on OA-related pain and functional limitations.

Hatha yoga outperforms traditional exercise for relief of OA-related pain

A study e-published in April by the Journal of Alternative and Complementary Medicine suggests hatha yoga is superior to therapeutic exercises in reducing osteoarthritis-related walking pain. Investigators from Ebnezar Orthopedic Center in Bangalore, India, randomized 250 outpatients with radiographic knee OA…

Patellofemoral cartilage damage tends to be medial, even in most valgus knees

Medial cartilage damage, not lateral damage, is the more prevalent pattern of cartilage morphology in patellofemoral knee osteoarthritis in all but the most severely involved knees, according to research from Boston University School of Medicine.

In the Moment: Sports medicine

By Emily Delzell

Direction change: Backward running may reduce PF pain

Backward running involves lower patellofemoral joint compression forces than forward running and is a viable strategy for rehabilitation of patellofemoral pain syndrome in runners, allowing them to continue exercise without increasing these forces, according to UK research e-published in April in the Journal of Biomechanics.

Physical examination outperforms MRI for diagnosing Achilles tendon rupture

A retrospective analysis e-published in April in Clinical Orthopaedics and Related Research found physical examination is superior to magnetic resonance imaging (MRI) for diagnosis of acute Achilles tendon ruptures. Investigators at Thomas Jefferson University Hospital in Philadelphia compared 66 patients…

Rigid footwear affects jump landing mechanics in female soccer players

Interactions between gender and footwear type affect landing mechanics in soccer players, according to research e-published in April in the Scandinavian Journal of Medicine & Science in Sports. Investigators at Duke University in Durham, NC, conducted motion analysis on 28…

In the Moment: Surgery

By Samantha Rosenblum and Jordana Bieze Foster

Flying can be trying: Most hip implants trigger security delays

Researchers in Baltimore reported that patients who have undergone total hip arthroplasty may experience greater inconvenience than other passengers when going through airport security.

ACL reconstruction delays increase risk of meniscal, chondral injuries

Research from the University of Hong Kong provides further evidence that delaying anterior cruciate ligament surgery increases the risk of meniscal injury and articular cartilage lesions, both of which are associated with increased long-term risk of knee osteoarthritis. Investigators analyzed…

Study finds no decrease in BMI after ankle surgery despite functional gains

Overweight and obese patients with end-stage ankle arthritis may think that having surgery will inspire them to lose weight, but research from the University of British Columbia suggests that in reality this doesn’t happen. Investigators retrospectively assessed 145 patients who…

Market Mechanics


Orthofix inks agreement to sell Breg to private equity firm for $140 million
Lewisville, TX-based Orthofix International signed an agreement on April 24 to sell Breg, its sports medicine business, to Chicago-based Water Street Healthcare Partners, a strategic private equity firm focused on the healthcare industry. Water Street is expected to close on the ...
Preliminary research supports use of advanced wound care product
The AutoloGel System, made by Gaithersburg, MD-based Cytomedix, shows efficacy for healing chronic wounds, according to three posters presented at the Symposium on Advanced Wound Care (SAWC), held in Atlanta in April. The system uses an individual’s own blood to ...
Arthritis Foundation recognizes on-the-move orthopedic surgeon
At its April Women on the Move Luncheon in New York City the Arthritis Foundation honored Alexis Chiang Colvin, MD, assistant professor of sports medicine in the Leni and Peter W. May Department of Orthopaedic Surgery at Mount Sinai School ...
Cyclist with CMT begins ride across US on elliptical bike to benefit foundation
Last month Andreas Johansson, a Swedish cyclist with Charcot-Marie-Tooth disease (CMT) began a nearly 6000-mile cross-country journey on an ElliptiGo 8C elliptical bike that will take him from New York City to Seattle and then down to his finishing point ...
Biomedix earns best company nod
Minnesota Business magazine has named Saint Paul, MN-based BioMedix one of its “100 Best Companies to Work For,” a list that recognizes businesses that make an impact and set a standard of excellence for others to follow. BioMedix, a medical device ...
ABC announces changes for assistants
The American Board for Certification in Orthotics, Prosthetics, and Pedorthics (ABC) announced last month that requirements for its certified orthotic/ prosthetic assistant designation will change as of January 1, 2013. Individuals seeking ABC assistant certification have until September 30 to complete ...
DM Systems goes green, reduces environmental impact, saves dollars
Evanston, IL-based DM Systems made a series of environmental efforts in 2011, including upgrading its lighting to reduce carbon dioxide emissions and implementing a bicycle-friendly commuter policy for employees, according to its first environmental sustainability report, released last month. DM, which ...
Rehab center demos new exoskeleton that helps paralyzed patients walk again
In April, Rancho Los Amigos National Rehabilitation Center in Downey, CA, debuted the ReWalk exoskeleton robot, which can help people with lower-limb paralysis walk again. As the crowd of spinal cord injury patients, their families, and press watched, 36-year-old Agnes Fejerdy ...
Trigger point author speaks at June events
Author and continuing education instructor Valerie DeLaune will lecture on trigger points at two June conferences. DeLaune has written books on trigger point therapy for foot, ankle, leg, and knee pain and for repetitive strain injuries. She is scheduled to speak ...
Nonprofit group partners with Allard
In April the Charcot-Marie-Tooth Association (CMTA) announced a new patient-focused partnership with orthotic device manufacturers and distributors Allard International, based in Helsingborg, Sweden, and Allard USA, based in Rockaway, NJ. The partnership embodies the philanthropic spirit of the Allard companies and ...
AOPA annual meeting set for September
The American Orthotic & Prosthetic Association will hold its 95th National Assembly and New England Chapter Combined Meeting September 6-9 in Boston, MA. Practitioners can attend spe­­ci­alty sessions to earn up to 30 continuing education credits and view the latest technology ...
Zimmer launches app for OA patients
Warsaw, IN-based Zimmer has developed Arthritis 411, an iPad application designed to help individuals with knee and hip osteoarthritis learn more about their condition and treatment options. The app offers a library of simple animations and videos as well as information ...
PT course focuses on kinesiology tape
Boise, ID-based Spider Tech will work with Canadian digital education development company Collarborans to offer educational courses for physical therapists interested in learning more about the company’s precut, apply-by-the-numbers kinesiology tape. Toronto-based Collaborans offers interactive digital education and seminars for healthcare ...
Bike-a-thon supports disabled kids
Edward Glaser, DPM, of Lyles, TN-based Sole Supports has partnered with Charles C. Southerland, DPM, professor in the School of Podiatric Medicine at Barry University in Miami, FL, to support the Yucatan Crippled Children’s Project, the medical mission Southerland founded ...

Products


Ultra High-5 Ankle Brace
Breg has released a new ankle brace named the Ultra High-5, which features a lightweight, semi-rigid, heat-moldable shell designed for anti-rotation and anti-inversion to help patients or athletes recover from high or low ankle injuries. This brace moves with the ...
Children’s AFO Socks
KeepingPace offers SuperMax Children’s AFO Socks, incorporating 92% CoolMax polyester to wick moisture away from the foot when worn under ankle foot orthoses. Construction features 2% Lycra content to ensure stretch and eliminate bunching. A 6% exterior plated nylon content ...
Triton VS Foot For Active Users
Developed with input from amputees, Otto Bock’s new 1C61 Triton VS (Vertical Shock) prosthetic foot combines the function of the Triton foot with additional vertical shock and rotation compliance and is suitable for everyday use as well as an active ...
Total Support Siesta Shoe
Spenco Medical Corporation has unveiled its first full shoe, the Total Support Siesta, as part of its spring 2012 footwear line. The slip-on Siesta features the same footbed contour as the Total Support insole, with a metatarsal bump to offload ...
Air-Gel Ankle Brace
Elite Orthopaedics introduces the Advantage Air-Gel Ankle Brace. The brace, designed for patients in acute to active phases of ankle recovery and rehabilitation, is available in a universal size to either the left or right ankle and may be dispensed ...
ProMed Ankle Brace
New from Active Innovations, a division of Active Ankle Systems, the ProMed brace provides the comfort and mobility of a lace-up with added support for controlling both the heel and the forefoot, starting with its Y-shaped vertical stabilization straps. Total ...
Poly/Lycra Knee Casting Sleeve
The STS Company of Mill Valley, CA, announces the re-introduction of a new and improved polyester/ Lycra Knee/KAFO Casting Sleeve. The new casting material provides a more detailed, accurate, and precise negative lower extremity mold for custom knee braces or ...
DDP Yoga Exercise Program
DDPYoga is designed by Diamond Dallas Page (DDP), a three-time professional wrestling heavyweight champion who entered the ring at 35, an age when most pro athletes are in retirement. DDPYoga is a hybrid workout that incorporates some traditional yoga movements ...
Original Levy Dynamic AFO
Levy & Rappel has finally introduced the Original Levy Dynamic AFO. This biomechanically correct and dynamic ankle foot orthosis is fully custom manufactured from the practitioner’s cast and delivered in seven days. A Tamarack ankle joints (dorsiflexion assist or free ...
Reflective PattStrap
Fabrifoam Products introduces an improved version of its Reflective PattStrap with continuous reflective stripes for increased visibility and greater leg-hugging power. This multi-purpose strap can be used to treat iliotibial band syndrome (ITBS), patellar tendinitis, Osgood-Schlatter disease, chondromalacia, and for ...
Universal Plantar Fasciitis Support
The Universal Plantar Fasciitis Support from Corflex is designed to provide pressure and continuous support to help reduce the pain caused by plantar fasciitis. The 1½” elastic tension strap applies pressure over the medial calcaneal tubercle and plantar fascia. This ...
Ultraviolet Shoe Deodorizer
Using UV technology, the shUVee Ultraviolet Shoe Deodorizer is proven to destroy odor causing germs and bacteria, including MRSA (Methicillin Resistant Staphylococcus Aureus), and T. Rubruna, the parent strain of the fungus commonly known as athlete’s foot. The deodorizer is ...