September 2009

Cover Story

Running shoes and injury risk: Rethinking the importance of cushioning and pronation

In spite of advancements in research and subsequent modifications to running footwear design, rates of running-related injuries have not decreased. That may be because researchers and designers have been focusing on the wrong variables.

By Joseph Hamill, PhD, and Gillian Weir, PhD Continue reading

Clinician-patient communication: How personal connections can improve outcomes

Increasingly, lower extremity practitioners are realizing the clinical importance of patient communication. They’re also starting to realize that effective communication requires more than just using the right words.

By Hank Black Continue reading

Health literacy: the challenge of making clinical information accessible to patients

Healthcare education materials for patients are consistently written at a reading level too advanced for a significant number of people–a trend that affects all aspects of lower extremity care and can adversely affect clinical outcomes.

By Hank Black Continue reading

3D printing: An overview of lower extremity applications

The world of 3D printing has opened up new possibilities in every area of healthcare, including that of lower extremity medicine. 3D printing—sometimes called additive manufacturing—has already led to major changes in healthcare, but experts say…

By Shannon Lee Continue reading

Going for the cold: Cryotherapy and physical performance

Cryotherapy applied to a joint may not necessarily have the same effects on balance and physical performance that have been demonstrated in applications involving muscle.

By Emily E. Williams, ATC, and Giampietro L. Vairo, PhD, ATC Continue reading

Obesity and O&P: Optimizing outcomes

Few patient populations have more to gain from orthotic and prosthetic therapy. But no other group of patients poses a bigger clinical challenge. By Cary Groner

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Editor Message

Out on a limb: Of opioids and outcomes

Recent efforts to reduce utilization of opioid pain medications for lower extremity joint injuries and surgical rehabilitation have mostly focused on reducing the risk of addiction. But there’s another important reason to be concerned about the use of opioids in these patients—and other popular pain medications as well.

By Jordana Bieze Foster, Editor Continue reading

Out on a limb: Brains, sprains, & the NFL

National Football League (NFL) players say they worry more about lower extremity injuries than concussions. But a growing body of evidence suggests the latter injury actually increases the likelihood of the former.

By Jordana Bieze Foster, Editor Continue reading

Out on a limb: Reading lessons

The Internet and social media have transformed health advocates’ ability to disseminate educational information, which has the potential to substantially improve outcomes across all healthcare disciplines.

By Jordana Bieze Foster Continue reading

3D printing: An overview of lower extremity applications

The world of 3D printing has opened up new possibilities in every area of healthcare, including that of lower extremity medicine. 3D printing—sometimes called additive manufacturing—has already led to major changes in healthcare, but experts say…

By Shannon Lee Continue reading

Out on a limb: Seeing upside in O&P

“You are what your record says you are.” Hall of Fame football coach Bill Parcells said it first, and it’s a saying that applies to many aspects of life. But when it comes to prescribing orthotic and prosthetic devices, clinicians know that the numbers don’t always tell the whole story.

Jordana Bieze Foster, Editor Continue reading

Out on a limb: Getting a leg up

by Jordana Bieze Foster

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Hemophilia, ankle pain, and orthotic management

The ankle is a frequent site of arthropathy  in patients with hemophilia, but orthotic devices and orthopedic shoes can help relieve this pain. New research suggests that…

By David Oleson, PT, PCS; Katherine Stribling, PT, DPT, PCS; Jamie Beckwith, PT, DPT; Laura Fox, PT, DPT, PCS; Felicity Case, PT, DPT, PCS; Nancy Durben, MSPT, PCS; and Michael Recht, MD, PhD      Continue reading

Soft braces: Experts hunt for potential mechanisms

Soft braces are not designed to change lower extremity alignment or joint forces, but research suggests they may influence knee and ankle biomechanics in other ways, including by enhancing proprioception. This line of investigation could open the door to new therapeutic opportunities.

By Stephanie Kramer Continue reading

SEBT scores and injury risk in collegiate athletes

Anterior-direction Star Excursion Balance Test performance may most appropriately discriminate between collegiate athletes who are and are not at risk for lower extremity injury, though…

By Mikel R. Stiffler-Joachim, MS; David R. Bell, ATC, PhD; and Bryan C. Heiderscheit, PT, PhD Continue reading

Surgery and ulcer healing in patients with equinus

Achilles tendon lengthening and gastrocnemius recession both increase ankle joint dorsiflexion and reduce plantar forefoot pressures in patients with diabetes and equinus deformity, but experts continue to debate which is best for managing forefoot ulcers and minimizing reulceration.

By Barbara Boughton Continue reading

Management of athletes with early-stage PTTD

Posterior tibial tendon dysfunction (PTTD), known also as tibialis posterior tendon dysfunction, is one of the leading causes of acquired flatfoot in adults, but the…

By By Frank Layman, PT, DPT, EdD, MT; and April Wilson, PTA, BS, CI, CKTP, IASTM Continue reading

Support for dry needling builds among clinicians

Dry needling is gaining momentum as an alternative therapy for myofascial pain, and is supported by a small but growing body of research as well as anecdotal evidence. But the training and expertise required to perform the procedure has become a topic of debate.

By P.K. Daniel Continue reading

Chronic ankle instability, gait, and muscle activity

New research suggests lower extremity clinicians should consider implementing gait training in combination with targeted strengthening of the peroneus longus and gluteus medius muscles to help restore normal gait patterns in patients with chronic ankle instability.

By Rachel Koldenhoven, MEd, ATC Continue reading

Reducing postoperative thromboembolism risk

Preventing deep venous thrombosis and pulmonary embolism after lower extremity surgery can involve pharmaceutical therapies or mechanical interventions. The type of prophylaxis used depends on the type of surgery, pre-existing risk factors, and patient preference.

By Barbara Boughton Continue reading

Step-rate manipulation and foot-strike pattern

In distance runners, step-rate manipulation of at least 10% above a runner’s preferred rate may be an effective clinical gait retraining method to decrease the severity of foot inclination angle at heel strike and…

By Darrell J. Allen, PT, DPT, MS, SCS, CSCS; Hollie Heisler, PT, DPT; and Jennifer Mooney, PT, DPT  Continue reading

Knee OA, biomechanics, and progression to TKA

The frontal and sagittal plane gait bio­mechanics associated with progression to total joint replacement in patients with knee osteoarthritis, particularly variables related to sustained loading, may be promising…

By Cheryl Hubley-Kozey, PhD, and Gillian Hatfield, PT, PhD Continue reading

Tibial stress fractures: an evidence-based approach

Study findings suggest that increased loading rates and tibial acceleration are associated with an increased risk of sustaining a tibial stress fracture. Interventions directed at reducing these impact…

By CPT Jamie B. Morris, DPT, OCS, CSCS, and LTC Donald L. Goss, PT, PhD, OCS, ATC Continue reading

Fifth met fractures and osteoporosis in women

Given that older women are at increased risk for osteoporosis, an increased incidence of fifth metatarsal fractures with increasing age in women suggests that such injuries could serve as an early point of entry into osteoporosis treatment and fracture prevention.

By David Beck, MD, Justin Kane, MD, and David Pedowitz, MD    Continue reading

Cryotherapy and muscle recovery after exercise

Research utilizing contrast-enhanced ultrasound suggests that, although cryo­therapy effectively decreases the pain associated with exercise-related muscle damage, those symptomatic effects are not associated with decreased blood flow in the affected skeletal muscle.

By Noelle M. Selkow, PhD, ATC, and Susan A. Saliba, PhD, MPT, ATC Continue reading

Surface EMG: A how-to guide for practitioners

With evidence-based protocols in hand, practitioners can feel more comfortable clinically integrating surface electromyography (sEMG) assessment, creating more sophisticated sEMG treatment protocols, and demonstrating the effectiveness of interventions.

By Rachelle Bordlee, sDPT, and Christopher Kevin Wong, PT, PhD Continue reading

3D printing: An overview of lower extremity applications

The world of 3D printing has opened up new possibilities in every area of healthcare, including that of lower extremity medicine. 3D printing—sometimes called additive manufacturing—has already led to major changes in healthcare, but experts say…

By Shannon Lee Continue reading

Internal vs external focus: Effects on motor learning

A growing body of research is demonstrating that the focus of actions or movements is critical to how well athletes and patients respond to feedback from instructors or clinicians, and one of the central issues is the distinction between internal focus and external focus.

By Cary Groner Continue reading

Debating corticosteroid injections for heel pain

Some practitioners find plantar fasciitis patients respond to corticosteroid injection when other treatments have failed, but concerns about complications make others cautious. With evidence-based guidelines in short supply, the decision often comes down to clinical experience.

By Larry Hand Continue reading

AFOs and interfaces: The important role of socks

Interface use has long been the subject of study and clinical emphasis in prosthetics, but too little attention has been given to the role of interfaces—padded socks in particular—in protecting the skin and soft tissues from forces experienced during ankle foot orthosis use.

By Harry “J.R.” Brandt Jr, CO, LO, BOCO Continue reading

Knee OA, BMI, and pain: A complex relationship

Excess body weight is considered by many experts to be the primary modifiable etiological factor in knee osteo­arthritis (OA) development. However, the relationship among body mass index (BMI), the anatomical manifestations of knee OA, and knee pain is not clear-cut.

By Elizabeth Weiss, PhD Continue reading

Compression stockings: Progress and pitfalls

Research supports the use of compression stockings for managing peripheral edema, venous insufficiency, and venous leg ulcers. But, outside the laboratory, issues related to patient compliance and achieving a proper stocking fit remain significant clinical challenges.

By Greg Gargiulo Continue reading

Diabetes: Pressure data guide offloading efforts

Pinpoint problem areas, compare orthotic devices and improve consistency in fabrication.
By Georgeanne Botek, DPM, and Tammy M. Owings, DEng.

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Stroke: The evidence for orthotic treatment

The literature on use of AFOs for stroke management could—and should—change your practice. By Stefania Fatone, PhD, BPO(Hons)

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Fifth met stress fracture: Load-based risk factors

Male gender, athletic task, foot type, and shoe design may all contribute to lateral forefoot loading.
By Robin M. Queen, PhD, and James A. Nunley II, MD

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Ankle balance training targets recurrent injury

Reducing sprain recurrence in turn reduces the risk of chronic ankle instability and osteoarthritis. By Erik A. Wikstrom, PhD, ATC, and Mitchell L. Cordova, PhD, ATC

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Orthotics: Management of functional flat foot

Optimal arch height may depend on whether the goal is to control motion or dynamic balance.
By Stephen D. Perry, PhD, E. Anne Cunningham, Msc, CPed, and Kelly M. Goodwin, BSc

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Achilles prophecy: Early heel rise linked to later outcomes

Single-leg standing heel-rise test performance one year after Achilles tendon rupture is associated with the long-term recovery of ankle biomechanics, according to research from Gothenburg, Sweden. The findings may have implications for rehab­ilitation after Achilles injury, particularly with regard to relatively demanding activities such as jumping.

By Katie Bell Continue reading

Online education helps reduce injuries in trail runners despite poor compliance

An online program designed to educate trail runners about injury prevention is associated with a significant decrease in running-related injury rate, even if runners don’t significantly change their preventive behaviors, according to research from the Netherlands.

By Jordana Bieze Foster Continue reading

Navicular injury in college football players slashes odds of NFL success

National Football League (NFL) prospects with a history of navicular injury are significantly less likely to be successful at the professional level than those without such an injury history, according to research that underscores the importance of restoring gait and function after a navicular stress injury in athletes.

By Jordana Bieze Foster Continue reading

OA accelerants: 4 factors help hasten disease progression

Age and body mass index (BMI)—as well as their interactions with glucose concentration and static femorotibial alignment—contribute to increased risk of accelerated knee osteoarthritis (OA), according to research from Tufts University School of Medicine in Boston that could have implications for early diagnosis and intervention in this population.

By Chris Klingenberg Continue reading

Study suggests strawberry consumption can benefit obese adults with knee OA

The old adage about an apple a day keeping the doctor away may need to be expanded to include other fruits, in light of new findings that a high level of daily strawberry consumption can relieve pain and reduce markers of disease progression in obese adults with knee osteoarthritis (OA).

By Jordana Bieze Foster Continue reading

Intraarticular NSAIDs and opioid meds may contribute to cartilage cell death

Treating lower extremity joint pain with intraarticular non­steroidal anti-inflammatory drugs (NSAIDs) and opioid medications may contribute to cartilage cell death, which could accelerate the progression of osteo­arthritis, according to an in vitro study from Stanford University in California.

By Jordana Bieze Foster Continue reading

Offloading and obesity: Gait study data have OA implications

Gait interventions can alter knee loading in obese patients, which may have implications for knee osteoarthritis (OA), according to three studies presented in August at the annual meeting of the American Society of Biomechanics in Raleigh, NC.

By Katie Bell Continue reading

Even mild LLD affects gait in ways that could speed knee degeneration

The effects of mild limb-length discrepancy (LLD) on gait in patients with knee osteoarthritis (OA) may contribute to disease progression, according to research epublished in August by Clinical Biomechanics.

By Jordana Bieze Foster Continue reading

Not all meniscal pathology on MRI is relevant in patients with knee OA

Some—but not all—characteristics of meniscal damage on magnetic resonance imaging (MRI) scans are associated with knee osteoarthritis (OA) severity and two-year progression, according to research from Tufts Medical Center in Boston, MA.

By Jordana Bieze Foster Continue reading

Profiling for ACL injury prevention: Biomechanics identify risk subtypes

Although existing anterior cruciate ligament (ACL) injury prevention programs have been successful at reducing the incidence of ACL injury, a new study suggests that tailoring interventions based on four risk profile subtypes could be more effective. Continue reading

Femoroacetabular impingement alters motion at both foot and hip during gait

Individuals with femoroacetabular impingement (FAI) demonstrate alterations in foot mechanics as well as hip mechanics, a finding that may have implications for orthotic management of this population, according to an Israeli study. Continue reading

MRI after hamstring injury does not help predict timing of return to sport

Magnetic resonance imaging (MRI) has no added value for predicting how soon athletes can return to sport after acute hamstring injury compared with predictions based only on patient history and clinical examination, according to a recent study. Continue reading

Risks of rigidus: Arthritis boosts hallux reamputation rates

Patients with diabetic neuropathy and hallux rigidus (HR) undergoing partial amputation of the hallux are 7.7 times more likely to need reamputation than their counterparts without HR, according to research from Georgetown University in Washington, DC. Continue reading

Two in three patients with diabetic foot osteomyelitis heal with nonsurgical care

Nearly two thirds of patients with diabetic foot osteomyelitis heal with medical management alone, with patients with metatarsal site infection most likely to require amputation, according to research from the UK. Continue reading

Annual emergency care for DFUs tops $8B, complications plague rural poor

Diabetic foot ulcers (DFUs) cost $8.78 billion per year in emergency department (ED) care and subsequent inpatient admissions, with the rural poor at particularly high risk for serious complications, according to… Continue reading

3D printing: An overview of lower extremity applications

The world of 3D printing has opened up new possibilities in every area of healthcare, including that of lower extremity medicine. 3D printing—sometimes called additive manufacturing—has already led to major changes in healthcare, but experts say…

By Shannon Lee Continue reading

Achilles oddity: Heeled shoes may boost load during gait

A recent study using innovative technology has questioned the potential role of standard running shoes with slightly elevated heels for the prevention and treatment of Achilles tendon pathology.

By Hank Black Continue reading

Patients with MS exhibit better balance, neural changes after Wii-based training

Using a video game balance board that provides high intensity, task-oriented, visual feedback training induces favorable short-term changes in brain microarchitecture related to movement and balance in people with multiple sclerosis, according to a study conducted by …

By Emily Delzell

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Vibration intervention helps counteract induced arthrogenic muscle inhibition

Both direct local muscle vibration (LMV) and whole body vibration (WBV) improve quadriceps arthrogenic muscle inhibition (AMI), according to a study from neuromuscular researchers at the University of North Carolina at Chapel Hill. The findings suggest vibratory stimuli can enhance …

By Emily Delzell Continue reading

In the Moment: O&P

Amputee runners hit the lab
Plus: Gait, work and AFOs • Morton’s extension

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In the Moment: Sports Medicine

Seeking a fatigue-injury link
Plus: Baseball sliding strategies • Detraining and ankle injury

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In the Moment: Footwear

Kids’ loads shift underfoot
Plus: High heels and knee OA • Children and flip-flops

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Market Mechanics

Lower extremity orgs help hurricane victims

Lower extremity organizations and business stepped up to donate resources and funds to victims of September’s devastating hurricanes, Harvey and Irma. Rockford, MI-based Wolverine Worldwide partnered with the American Red Cross… Continue reading

G&W Heel Lift celebrates half century

Family owned G&W Heel Lift in August celebrated 50 years of supplying custom heel and foot lifts to its customers. Based in Cuba, MO, the company’s signature product is its cork heel lift, designed to address complications from issues such as altered gait, Achilles tendinitis, and Achilles tendon repair. Continue reading

Diabetes Council issues shoe guideline

The Diabetes Council, an educational website for people with type 2 diabetes run by healthcare professionals, in August published a guide to buying therapeutic shoes for people with diabetes. Continue reading

AAOS offers Pain Awareness Month tips

The Rosemont, IL-based American Academy of Orthopaedic Surgeons (AAOS) is marking September as Pain Awareness Month by offering comprehensive tips for safe and effective pain relief and safe disposal of prescription pain medications to help minimize opioid use and misuse. Continue reading

Amgen drug beats osteoporosis standard

The New England Journal of Medicine on September 11 epublished the results of a trial of more than 4000 postmeno­pausal women with osteoporosis and a previous fragility fracture, in which a monoclonal antibody made by Thousand Oaks, CA-based Amgen outperformed a commonly used and effective osteoporosis medication in preventing new fractures. Continue reading

Dr. Comfort prototype improves balance

BMC Geriatrics on September 11 epublished a study examining the effects of prototype footwear made by Mequon, WI-based Dr. Comfort used with textured insoles on balance in older women. Continue reading

Rand study backs advanced device use

The Santa Monica, CA-based nonprofit Rand Health in September epublished a study showing advanced prostheses used by transfemoral amputees produce significant improvements in physical function and significant reductions in the incidence of falls and… Continue reading

NBA, GE give bone injury grants to HSS

The National Basketball Association (NBA) and GE Healthcare Orthopedics and Sports Medicine Collaboration announced in September they were awarding almost $400,000 for the study of bone stress injuries to two research teams at the Hospital for Special Surgery (HSS) in Manhattan. Continue reading

AOPA awards Zahedi, others at congress

The Alexandria, VA-based American Orthotic and Prosthetic Association (AOPA) honored Saeed Zahedi, OBE, FREng, BSc, PhD, FIMechE, CEng, RDI, with its Lifetime Achievement Award at its September World Congress in Las Vegas. Continue reading

HP, Superfeet pilot 3D retail platform

Palo Alto, CA-based Hewlett Packard (HP) in September announced Ferndale, WA-based Superfeet is piloting in select stores its new retail foot scanning platform that performs dynamic gait analysis of customers’ feet with a combination of 3D scanning and pressure plate technology Continue reading

Ottobock develops pediatric knee joint

Austin, TX-based Ottobock HealthCare in September reported it has developed the first everyday prosthesis with hydraulic swing phase control specifically for children. Continue reading

Implant sales rise in developing markets

While the hip and knee reconstruction market struggles to generate significant growth in Europe and the US, the implants are increasingly being commoditized in countries with developing economies such as Brazil, India, and China, and driving their respective markets at a rapid pace… Continue reading

Exhibit examines arts-prostheses link

A major exhibit at the Henry Moore Institute in Leeds, UK, explores the relationship between visual arts and prostheses. “The Body Extended: Sculpture and Prosthetics” traces how artists have addressed radical changes to the human body. Continue reading

Mueller outfits top UK soccer team

Prairie du Sac, WI-based Mueller Sports Medicine announced in August that it is now an official team supplier of the UK’s Leicester City Football Club, defending Premier League champions. Continue reading

Swiss Sigvaris Group acquires BiaCare

Winterthur, Switzerland-based Sigvaris Group announced in late August that the graduated compression company has completed its acquisition of BiaCare, headquartered in Holland, MI. Continue reading

Rishwain named Vionic global business head

San Rafael, CA-based Vionic on August 15 reported that Connie X. Rishwain, former president of Goleta, CA-based Ugg, has joined Vionic as president of its global business. Continue reading

AOPA honors Watson for O&P lifework

The Washington, DC-based American Orthotic & Prosthetic Association (AOPA) honored Thomas Watson, CP, with its Lifetime Achievement Award at the 2016 AOPA National Assembly, held September 8-11 in Boston, MA. Continue reading

ASB schedules 2017 biomechanics event

The American Society of Biomechanics has begun plans for National Biomechanics Day (NBD) 2017, scheduled for April 6. Continue reading

Footwear thesis wins brevity-based award

The University of South Australia in Adelaide announced in August that PhD candidate Joel Fuller won its 3MT (Three Minute Thesis) competition for his work exploring the link between trendy minimalist athletic shoes and injury. Continue reading

Data detail ConforMis implant benefits

Results from two clinical studies presented at the International Congress for Joint Reconstruction Pan Pacific Orthopaedic Congress, held August 10-13 in Gainesville, FL, show the iTotal CR customized knee replacement made by Bedford, MA-based ConforMis provides superior patient… Continue reading

Coral scores 100% in surprise FDA audit

Mineral supplement seller Coral reported in August that the Food and Drug Administration (FDA) gave the company a perfect score in a surprise audit. Continue reading

OPAF hosts First Swing at NAGA event

The Charlotte, NC-based Orthotics & Prosthetics Activities Foundation (OPAF) on August 15 hosted a full-day First Swing Learn to Golf Training and Clinic as the kickoff event of the National Amputee Golf Association (NAGA) Championships at Pumpkin Ridge Golf Club in North Plains, OR. Continue reading

Cascade Dafo offers virtual decoration

Cascade DAFO reported in August that its DAFO Creation Station, an online interactive tool for choosing colors and patterns for the Ferndale, WA-based company’s custom DAFOs (dynamic ankle foot orthoses) is available at Continue reading

Athletes undergo Quest biomarker tests

Virginia Polytechnic Institute and State University in Blacksburg reported in August that it plans to use Madison, NJ-based Quest Diagnostics’ blood testing service to look for associations between biomarkers and biomechanics, training, recovery, and other variables relevant to sports injury risk in some of its athletes. Continue reading

Ability P&O, Freedom Innovations join on study

Exton, PA-based Ability Prosthetics and Orthotics and Freedom Innovations, headquartered in Irvine, CA, in September reported they are collaborating on a study comparing Freedom’s new Kinnex Microprocessor Ankle with a typical carbon fiber prosthetic ankle. Continue reading

Chaco brings Tread Labs to retailers

Stoneham, MA-based Chaco’s founder and original designer of its sandals, Mark Paigen, announced on August 18 the wholesale launch of Tread Labs, a new line of orthotic insoles. The insoles’ features include four arch heights in sizes for men and women, easily replaceable Velcro top covers, and a lifetime guarantee. Continue reading

OPIE launches Amplitude resource guide

Gainesville, FL-based OPIE Software announced in August that Amplitude Media Group, headquartered in Northglenn, CO, is an integrated supplier. With this partnership, Amplitude Media’s Limb Loss Resource Guide (LLRG) can now be purchased digitally through the OPIE Software platform. Continue reading

Opposition to Medicare prosthetic care draft grows; experts, amputees join fight

Scientists disavowing the use of their research by Medicare officials to justify proposed prosthetic limb reimbursement changes, the social media campaign #not­aluxury, and protests led by amputee rights groups and professional O&P organizations are among the voices protesting the proposed rule change. Continue reading

NICE updates three diabetes guidelines

The UK’s National Institute for Health and Care Excellence on August 26 published three updated guidelines for the management of diabetes that emphasize prevention and rapid care of diabetic foot problems and tight glucose control for adults and children. Continue reading

AMP 1 team wins at stand-up basketball

The Freedom Innovation-sponsored AMP 1 national team of amputee basketball players in August competed in Los Angeles at the Nike 3on3 Tournament, winning three games of stand-up basketball against able-bodied players in the street basketball and fan festival. Continue reading

ASU installs $500K virtual reality gait lab

Alabama State University’s (ASU) Biomechanics and Motor Control Laboratory in Montgomery in August installed an advanced gait analysis device that places patients in virtual reality simulations. Continue reading

Bulldog joins Opie as integrated supplier

Gainesville, FL-based Opie Software and Bulldog Tools, of Lewisburg, OH, reported in August that Bulldog is now an integrated supplier within the Opie Purchasing & Inventory System and at Bulldog designs, engineers, and manufactures certified O&P tools and products. Continue reading

Bauerfeind partners with NBA trainers

Tampa, FL-based Bauerfeind on July 19 announced a partnership with the National Basketball Athletic Trainers Association (NBATA). Continue reading

Allied OSI Labs introduces DME crutches

Indianapolis, IN-based Allied OSI Labs noted in August that it is expanding its over-the-counter and durable medical equipment (DME) line by offering Medicare-reimbursable crutches for in-office dispensing. Continue reading

Integra’s membrane speeds DFU healing, company inks deal to sell Tornier ankles

Wound Repair & Regeneration on August 22 epublished results from a pivotal clinical trial showing Integra LifeSciences’s bilayer membrane skin regeneration system closed nonhealing diabetic foot ulcers (DFUs) faster than standard care. Continue reading

WillowWood exec Joe Arbogast dies

Joseph “Joe” Arbogast, former co-owner and executive vice president of Mt. Sterling, OH-based prosthetic manufacturer WillowWood, died on August 10. Continue reading

Insurance issues slow prosthetic market

The global market value for prosthetics will rise slowly in the next few years, from just over $1 billion in 2014 to approximately $1.21 billion by 2021, hindered by reimbursement difficulties, according to an August 25 report by London, UK-based research and consulting firm GlobalData. Continue reading

FDA fast-tracks Flexion’s OA injectable

Burlington, MA-based Flexion Therapeutics reported on September 1 that the US Food and Drug Administration (FDA) has granted Fast Track designation for FX006, Flexion’s late-stage lead drug candidate for osteoarthritis (OA) of the knee. Continue reading

Grant will fund study of Cadence device

The Physiotherapy Foundation of Canada and the Quebec Rehabilitation Research Network in August awarded a CA$20,000 grant to Cadence Biomedical’s research collaborators for study of the Seattle-based company’s Kickstart device for stroke recovery. Continue reading

Ottobock starts orthotic business unit

Austin, TX-based Ottobock in August announced the creation of a business unit focused on off-the-shelf orthoses, fbracing, and supports. The Activity & Sports Medicine (ASM) unit combines products from Ottobock acquisitions Ortho Rehab, Bio Cybernetics International, and Cybertech and its global portfolio of orthotic solutions. Continue reading

Sigvaris lobbys for lymphedema act

Peachtree City, GA-based Sigvaris sponsored an August 8 meeting between a Tennessee congressman and a wound care specialist and other stakeholders who support the Lymphdema Treatment Act. The act would amend the current Medicare statute to allow for coverage of compression supplies. Continue reading

3D printing: An overview of lower extremity applications

The world of 3D printing has opened up new possibilities in every area of healthcare, including that of lower extremity medicine. 3D printing—sometimes called additive manufacturing—has already led to major changes in healthcare, but experts say…

By Shannon Lee Continue reading

Pioneering O&P engineer Dudley Childress dies after 47-year career

Dudley S. Childress, PhD, professor emeritus of physical medicine and rehabilitation at Northwestern University’s Feinberg School of Medicine and director emeritus of the Northwestern University Prosthetic Orthotic Center (NUPOC) in Chicago, died on August 6 after a long illness. He was 79. Continue reading

FDA OKs low-dose NSAID for OA pain

The US Food and Drug Administration (FDA) in August approved Iroko Pharmaceuticals’ low-dose nonsteroidal anti-inflammatory drug (NSAID) for management of osteoarthritis pain. Continue reading

ProtoKinetics software shows reliability

An August study comparing ProtoKinetics Movement Analysis Software (PKMAS) with the widely used GaitRite system concludes the software from Havertown, PA-based ProtoKinetics is a reliable alternative processing method. Continue reading

Sports med experts offer ACL workshop

Sports medicine specialists from The Ohio State University and the Cincinnati Children’s Hospital are offering their 12th Annual ACL Workshop in Cincinnati at the hospital’s Medical Education Resource Center on October 11. Continue reading

Body in Motion partners with Aqualeg

Aqualeg, a French manufacturer of functional prosthetic covers headquartered in Thouaré-sur-Loire, in August formed a strategic partnership with Body In Motion Sports & Orthopaedics, awarding the Toms River, NJ-based company its “Center of Excellence” designation. Continue reading

New owners keep P.W. Minor in business

Batavia Shoes owners Andrew Young and Peter Zeliff announced in August that they have purchased Batavia, NY-based P.W. Minor & Son, a 147-year-old shoe company that had been in danger of going out of business. Continue reading

Professional groups ask CMS to amend ‘restrictive’ custom orthotic fitting rule

In August a number of groups, including the National Athletic Trainer’s Association (NATA), the American Orthopaedic Society of Sports Medicine, and the American Medical Society for Sports Medicine, formally called for the Centers for Medicare and Medicaid Services (CMS)… Continue reading

CMS begins fingerprinting of O&P owners

The Centers for Medicare and Medicaid Services (CMS) on August 6 began its anticipated fingerprint-based background check for certain providers the agency classifies as “high-risk,” a category that includes anyone who owns more than 5% of a company supplying orthoses, prostheses, or durable medical equipment. Continue reading

Tria, Vikings provide training for teens

Minneapolis, MN-based Tria Orthopaedic Center partnered in August with the Minnesota Vikings to provide certified athletic training coverage for all high school football programs within the Minneapolis and St. Paul school districts this upcoming season. Continue reading

Tech mag awards OPM for 3D innovation

The New Economy, a quarterly technology and innovation magazine and website, in August recognized South Windsor, CT-based Oxford Performance Materials (OPM) with its “Best Global Company for 3D Healthcare Innovation” award. Continue reading

Össur VP sets amputee marathon record

Kim De Roy, CPO, PT, Össur Vice President of Sales & Marketing and Education, Prosthetics, set a new world marathon record for transtibial amputees at the Reykjavik Marathon on August 23, the Reykjavik, Iceland-based company announced. Continue reading

Down syndrome talk on APTA website

Video of the American Physical Therapy Association’s (APTA) roundtable discussion on Down syndrome is now available on its website. Continue reading

Dr. Comfort fields team for ADA walks

Dr. Comfort reported in August that the Mequon, WI-based company is forming a national team to join the American Diabetes Association’s (ADA) 2014 “Step Out: Walk to Stop Diabetes” effort.

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Market Mechanics

Horseshoe shape is luckiest for hips In a study comparing hip protector products, Hipsaver’s 16 mm thick continuous pad provided the greatest reduction in peak force to the hip, but the SafeHip 16 mm horseshoe-shaped pad most effectively deflected force … Continue reading


Unloader One Lite Brace

Össur has launched its Unloader One Lite Brace, for patients suffering from mild to moderate knee pain associated with osteoarthritis and degenerative meniscal tears. The Unloader One Lite is based on the technology behind the original Unloader brace, including the 3-Points of… Continue reading

ProtecTozz Cleat Guard

New to the market is the ProtecTozz Cleat Guard, developed and field-tested over five years by Mark Tozzi, DPM, and his son Michael Tozzi, former captain of the John Carroll University football team in University Heights, OH. Made of polycarbonate material, the ProtecTozz is lightweight (1.5 oz) and… Continue reading

Dr. Comfort Cara Chukka

New from Dr. Comfort, the women’s Cara chukka boot features a roomy, protective toe box to help prevent skin irritation and toe stubbing. With a firm heel counter, this stylish lace-up ankle bootie provides extra medial and lateral support and stability. Continue reading

OPTP Joint Distractor

OPTP has introduced a new product for use as an adjunct to manual therapy methods: the OPTP Joint Distractor. The product’s hook-and-loop strap design fastens a patient’s ankle securely in place, allowing for complete isodynamic joint distraction for the lower extremities. Continue reading

Silhouette Wound Imaging

Aranz Medical has announced the availability of Silhouette version 3.19, a camera and software package for lower extremity wound imaging, 3D measure­ment, and documentation. The three-part Silhouette package includes SilhouetteStar… Continue reading

Fillauer AllPro Foot

The AllPro prosthetic foot from Fillauer crosses all boundaries, combining high flexibility and dynamic performance to allow the user to work and play like a pro. This “do-it-all” foot easily transitions from the gym to tennis and basketball courts, as… Continue reading

Pediatric Triple Action Joint

Developed by Becker Orthopedic, the Pediatric Triple Action Ankle Joint is designed to provide control of the lower limb through all phases of gait. This advanced orthotic ankle joint is engineered to keep pace with active patients… Continue reading

TayCo Ankle Brace

The TayCo ankle brace is an external, over-the-shoe ankle foot orthosis for adults and teens. Developed by a University of Notre Dame team physician and trainer, it is an easy-to-use alternative to walking boots or in-shoe AFOs. Continue reading

Maverick Fiberglass Feet

Freedom Innovations has released the complete portfolio of its Maverick fiberglass prosthetic feet, showcasing the durability and flexibility of fiberglass. These include the Maverick Xtreme and Xtreme AT feet for use in extreme activities, such as… Continue reading

Venodol Analgesic

Caretta Therapeutics is intro­ducing Venodol, a nonaddictive alternative to opioid and steroi­dal analgesics for patients with moderate to severe chronic pain associated with inflammation. Continue reading

Feetz 3D-Printed Shoes

Feetz is a shoe company that leverages advanced technology to produce a full 3D-printed, wearable shoe using a customized app. Clients can customize the color and arch support on any available Feetz styles. Continue reading

Spinal Solutions EZ-APO

Spinal Solutions announces the availability of the EZ-APO (Atlanta Prosthetics & Orthotics) ankle foot orthosis (AFO). The EZ-APO device is ergonomically designed to optimize fit around the footpad and malleolus and provide tibial tuberosity relief. Continue reading

Össur Rebound PCL Brace

New from Össur is the Rebound PCL, a dynamic force brace for rehabilitating posterior cruciate ligament (PCL) ruptures. The Rebound PCL is designed to stabilize the knee while providing appropriate levels of physiologic loading force during both knee extension and… Continue reading

Cascade DAFO Creation Station

Cascade DAFO announces the launch of the Creation Station for decorating custom dynamic ankle foot orthoses (DAFOs). With this new online interactive tool, DAFO users can “try on” various transfer patterns, ribbon trims, and strap and padding colors. Continue reading

Anatomical Concepts Abby AFO

The Abby Articulating Ankle Foot Orthosis (AFO) from Ana­tomical Concepts is a multifunctional, posterior dual-jointed device for the early stages of rehabilitation. With a stable base of support and a new nonskid low-profile plantar surface, it is… Continue reading

Pro-Roller Soft Half

OPTP has added a new foam roller to its elite Pro-Roller line. The Pro-Roller Soft Half measures 36″ in length and 3″ in diameter. The roller’s unique shape is flat on one side and round on the other. Using the flat side down provides improved stability for balance training and… Continue reading

Microfiber Shades Now in Heather

For people who need to wear graduated compression every day but want to add a pop of color to their wardrobe, Sigvaris North America is launching two fun new additions to the Microfiber Shades line of compression socks—navy heather and graphite heather socks. Continue reading

FC2 Flexion Control Ankle Joint

Lower Extremity Technology has retooled the FC2 Flexion Control Ankle Joint to simplify fabrication. The multi-axis hinge offers 70° of full range of motion. The new design features an improved hinge axis for strength and durability, and updated casting for more support around the… Continue reading

Custom-milled Orthotic Flip-flops

Footmaxx now offers custom-milled orthotic flip-flops. The orthotic flip flops are hand-crafted from durable materials, including a slip-resistant rubber sole, to support and stabilize the feet and lower extremities. Women’s styles include Rio, with… Continue reading

KLM Ankle Brace

The new KLM Brace from KLM Laboratories is a custom-molded gauntlet-style ankle foot orthosis (AFO) specifically designed to stabilize the lower extremity, improve mobility, reduce pain, and decrease the risk of falls in patients with instability… Continue reading

OA Reaction Web Brace

DJO Global’s DonJoy brand offers the new OA Reaction Web brace as a discreet solution for knee osteoarthritis pain. The brace frame features lightweight silicone hexagonal webbing, with a soft silicone condylar pad and air pockets that… Continue reading

Helli Dynamic Walking Shoe

The Helli Dynamic Walking Shoe from Waldlaufer USA is designed for people suffering from plantar fasciitis, heel spurs, hallux limitus, or metatarsal pain. The mild rocker sole supports the arch while gently propelling the foot through the gait cycle… Continue reading

Standard Cyborg Water Leg

The Standard Cyborg Water Leg is a 3D-printed, waterproof leg that a transtibial amputee can use in the shower, at the beach, or in the pool with no need to worry about damaging his or her primary prosthesis. The 30-minute scanning process can be… Continue reading

LP EmbioZ Socks

La Pointique International offers the new LP EmbioZ Ankle Stabilizer Socks in regular (pictured) and calf lengths. The sock design features a Heel Lock strap to support and stabilize the ankle joint, helping to reduce the risk of ankle sprain. Continue reading

Mephisto Mobils Ergonomic Shoes

The Mobils Ergonomic Collection of all-over padded shoes by Mephisto includes three advanced technological features. All-over soft padding between the lining and the natural leather upper cushions the entire foot. The anatomic removable foot­bed… Continue reading

APS-500 Polyethylene

The new APS-500 material from Allied O&P Supply is a flesh tone colored, high-strength polyethylene that can be used in place of Sureform and Subortholen when making custom foot orthoses. It is suitable for deep draws and embossing. Continue reading

Coral Chewables Supplements

The new Coral Chewables supplement has a Bavarian cream flavor and delivers 500 mg of bioavailable coral calcium in addition to 73 other minerals. The above-sea coral calcium is intended to help patients reduce the risk of osteoporosis and… Continue reading

Arcopedico Boots and Flats

Arcopedico USA offers new comfort boots and flats for fall and winter 2015. Claire is a classic riding boot with a 14″ soft leather shaft, a wide toe box, detailed stitching, two adjus­table calf buckles, a 1″ heel, and an antimicrobial, cushioned insole. Continue reading

Becker Ankle Joint

Becker Orthopedic now offers the new Compact Double Action Ankle Joint (Model 725) for orthotic devices, designed to provide a variety of options in one complete small package. The Compact Double Action Ankle Joint comes optimized with… Continue reading

Therafirm Ease Hosiery

Ease gradient compression hosiery from Therafirm is designed to promote better blood flow, prevent swelling, and relieve tired, achy legs and feet and to be donned with ease by people with limited mobility or dexterity. The soft, breathable… Continue reading

Stabilized Heel Cup

Sols has released a new orthotic design with the company’s signature Stabilized Heel Cup. The Stabilized Heel Cup feature, intended for patients who overpronate or underpronate, helps improve ankle stability and alignment by… Continue reading

3D printing: An overview of lower extremity applications

The world of 3D printing has opened up new possibilities in every area of healthcare, including that of lower extremity medicine. 3D printing—sometimes called additive manufacturing—has already led to major changes in healthcare, but experts say…

By Shannon Lee Continue reading

Allard ToeOff 2.0

Allard USA announces the ToeOff 2.0 ankle foot orthosis, with the same functionality as the original ToeOff plus new enhancements based on patient feedback. The D-Ring straps with Alligator Tabs are easily applied for right or left hand “pull” and… Continue reading

DynaFlange Insole

The DynaFlange insole, exclusive to The Orthotic Group and Langer Biomechanics, introduces a new method of proprioceptive stimulation to awaken the nervous system, moving it out of a stuck posture with every step. Studied at Noraxon USA… Continue reading

littleSteps in New Sizes

Nolaro24 introduces new sizes for littleSteps, its prefabricated foot orthoses specifically designed for kids. Four new sizes (00, 0, 8, and 9) have been added to the line, which now accommodates kids from toddler size 5 up to adult/children’s size 9. Continue reading

LunaPur M Material

nora systems offers LunaPur M, a transparent and flexible material made of pure EVA (ethylene vinyl acetate). LunaPur M is an elastic material used in orthopedic shoe engineering and general orthopedics when a particularly flexible material is required for stabilizing purposes. Continue reading

Mobils by Mephisto

Mephisto USA introduces new styles for fall within its Mobils by Mephisto handcrafted women’s shoe collection. Multiple advanced technical features enhance the comfort of the wearer. Continue reading

Modular Ring Lock

Becker Orthopedic offers the new Modular Ring Lock Knee Joint, model 1402-B. Like the traditional Modified Ring Lock, the new model has no protrusions in the flexed position. The design minimizes size and weight without compromising strength or durability… Continue reading

Rightstride D30 Insoles

D30 comfort insoles from Rightstride Orthotics feature smart-material technology based on a rate-sensitive dilatant fluid, in which viscosity increases with the rate of shear strain, so the choice of an orthotic material is no longer limited to soft or hard. Continue reading

Sigvaris Sleeves Now in Red

In response to popular demand, Sigvaris now offers its sports performance sleeves in red. Sigvaris performance sleeves help improve circulation and flush out lactic acid after a workout. The sleeves are measured at the ankle and calf for an accurate fit and provide 20 to… Continue reading

New Footwear Styles from Sole

The new footwear styles from Sole—which include the Navigate, Inhale, and Gasp—are designed to help the wearer feel confident and comfortable during any ambitious adventure. Made with moldable platforms that adapt to the shape of the wearer’s foot, Sole footwear… Continue reading

Stabilizing Speed Pro

New from DJO Global is the DonJoy Stabilizing Speed Pro ankle brace, designed to meet the needs of demanding athletes. Improving on the Stabilizing brace design that has been associated with a 61% reduction in the incidence of ankle injuries, the Stabilizing Speed Pro features… Continue reading

Air Active Kinegen Knee

Streifeneder USA introduces a new addition to its Kinegen Knee Line: the Kinegen.air-active 3A1800. Using polycentric technology, the knee joint provides an expanded range of motion with flexion angles up to 150°, as well as extra mechanical stance-phase safety in the… Continue reading

Hames Air Brace

Hames Ortho Tech introduces the Hames Air Brace, a day brace for treating plantar fasciitis and Achilles tendinitis. When in use, with each step the heel is cushioned by a U-shaped bladder surrounding the plantar insert. Continue reading

Bunion Aid

Bunion Aid is an award-winning hinged foot splint that relieves bunion pain. It is clinically proven to correct mild to moderate bunions (hallux valgus) and maintain post-surgical fixation of the toe, reducing rehab time. The splint can be worn at … Continue reading

Easy Slip-On Shoes

The new Easy Slip-On Shoes from Orthofeet offer the slip-on look with the comfort of adjustable strap shoes. The shoes feature hook and loop straps that provide a wide opening for easy on/off. The two-way strap system allows the user … Continue reading

TORCH Walker

American Shoe has launched the TORCH Walker (Total contact Orthotic Restraining Custom Hybrid) to replace the C.R.O.W. This new design combines the support and positioning of a traditional AFO with the accommodation and functionality of custom molded footwear. The TORCH … Continue reading

Swing Phase Lock 2

The Swing Phase Lock 2 is an updated version of Fillauer’s most popular stance control orthotic joint. New features include an extended wear bumper, security stops at 15 and 32, teflon bushings for longer wear, and a PEEK high wear … Continue reading

UltraSafeGait ADR-AFO

Ultraflex announces the launch of the UltraSafeGait pediatric ADR-AFO. The pediatric version is now available in markets around the world, including the United States. The UltraSafeGait Adjustable Dynamic Response ADR-AFO pediatric version now completes the adjustable dynamic response product line … Continue reading

Otto Bock CPM Devices

Featuring state-of-the-art electronics, the LiteLift Pro Knee and 480E Pro Series Knee CPM devices from Otto Bock are the first in a series of continuous passive motion devices to use the Pro (for “progres- sive”) controller that cross-platforms to each … Continue reading

Medi USA Knee Braces

Medi USA announces the distribution of two new knee braces for the treatment of unicompartmental osteoarthritis knee pain. The single-upright M.3 OA knee brace is designed for patients who suffer from unicompartmental osteoarthritis knee pain but do not need the … Continue reading

ControlTecc Foot Beds

ControlTecc breathable foot beds provide superior biomechanical support and performance. The device consists of a firm arch shell with a deep heel seat for full control of the heel and arch. The special arch peg design helps to keep the … Continue reading