March 2012

Cover Story


Finding a formula for the optimal AFO
Finding a formula for the optimal AFO
Quantitative research from The Nether­lands suggests that for every ankle foot orthosis, there is an optimal stiffness associated with the lowest energy cost of walking for a given set of gait-related impairments. Achieving this optimal device stiffness in practice, however, may require clinicians to rethink conventional ap­proaches to AFO prescription. By Daan J.J. Bregman, PhD

Editor Message


Out on a limb: Game theory
Out on a limb: Game theory
There are plenty of reasons you might be thinking about seeing Moneyball. Maybe you’re wondering how anyone could have turned that book into a movie. Maybe you’re curious about how Angelina’s better half and the kid from Superbad ended up with Oscar nominations. Maybe you just need to forget about the snow on your lawn ...

 

Departments


ACTIVE STANCE: Barefoot balance training for runners
ACTIVE STANCE: Barefoot balance training for runners
Barefoot training and balance training have each been effective in studies of runners, but combining the methods could lead to even better results. By Emily Splichal, DPM, MS, CPT
The role of proprioception in knee OA management
The role of proprioception in knee OA management
Demonstrated associations between im­paired proprioception and knee osteo­arthritis suggest some interventions that help relieve painful symptoms in patients with knee osteoarthritis , such as exercise and bracing, do so by positively affecting joint position sense. By Barbara Boughton
Lower extremity focus helps cut risk of falls
Lower extremity focus helps cut risk of falls
Falls are common, disabling and costly. Causes are multifactorial but include foot disorders, ill-fitting footwear, and poor bal­ance. Recent research supports a multi­dis­ci­plinary approach to falls prevention and indicates that lower extremity practi­tioners can play an important role. By Hylton B. Menz, PhD, and Martin J. Spink, BPod(Hons)
Taking a team approach to diabetic limb salvage
Taking a team approach to diabetic limb salvage
Hospitals with multidisciplinary diabetic foot care programs have found that adding vascular surgeons to the team makes their amputation prevention efforts more effective, but also adds an extra layer of challenges in terms of coordinat­ion and communication. By Cary Groner
Connecting instability and ankle osteoarthritis
Connecting instability and ankle osteoarthritis
Not all patients with chronic ankle in­stability develop ankle osteoarthritis, but evidence suggests the two con­ditions are related, which in turn sug­gests that ankle sprain prevention and management could help reduce ankle replacement rates. By Larry Hand
Compartment syndrome following tibia fracture
Compartment syndrome following tibia fracture
Acute compartment syndrome can devel­op after open or closed tibial fractures, even those that appear to be benign. Early diagnosis of increased compart­mental pres­­sure and timely surgical intervention can prevent adverse out­comes including nerve injury and muscle necrosis. By Langdon A. Hartsock, MD, and William R. Barfield, PhD

News


In the Moment: O&P

By Emily Delzell

Ply trap: Prosthetic sock thickness varies
Ply trap: Prosthetic sock thickness varies
Recent research from the University of Washington in Seattle confirms what many practitioners have already learned from treating patients with lower limb amputat­ions: Sock thickness varies among dif­ferent sock products of the same ply and is also affected by biomechanical ...
Dose response for OA brace wear includes hamstring strengthening
Research from Canadian investigators suggests brace wear may positively affect activity level without decreasing muscle strength in patients with medial compartment knee osteoarthritis (OA). Investigators from Dalhousie University in Nova Scotia followed 24 patients (four women) who wore a valgus unloader ...
Study suggests rocker sole shoes help reduce circulatory calf pain
Researchers at the University of Salford in Manchester, UK, reported in March that a pilot study comparing two therapeutic shoe soles in eight individuals with claudication showed a reduction in calf pain with rocker sole wear. The investigators asked study volunteers, ...

In the Moment: Surgery

By Emily Delzell

MIS adventures: Minimal approach rivals standard TKA
MIS adventures: Minimal approach rivals standard TKA
Several studies presented in February found few differences in outcomes for minimally invasive total knee arthroplasty (TKA) and traditional TKA. By Emily Delzell
Surgical, nonsurgical Achilles care lead to similar one-year outcomes
In a study of acute Achilles tendon rupture published this month in the Clinical Journal of Sport Medicine, some strength and endurance measures improved earlier in those who underwent surgical versus nonsurgical care, but rerupture rates and patient-reported function were ...
Study finds no restoration of proximal kinematics after hallux valgus surgery
Surgical hallux valgus correction significantly improves foot geometry and hallux kinematics but does not significantly change proximal kinematics, according to research from Marquette University in Milwaukee, WI. In a study published in the February issue of Foot & Ankle International, investigators ...

In the Moment: Sports medicine

By Jordana Bieze Foster

Loading lessons: Select exercises carefully for ACL rehab
Loading lessons: Select exercises carefully for ACL rehab
Exercises prescribed for rehabilitation after anterior cruciate ligament (ACL) reconstruction should be designed to protect the healing graft from excessive strain in addition to rebuilding muscle strength and activation, according to evidence-based recommendations from a multicenter team of experts. By Jordana ...
Barefoot running offers no metabolic advantage over lightweight footwear
The metabolic cost of running increases with heavier footwear, but barefoot running is no more metabolically efficient than running in a lightweight shoe, according to research from the University of Colorado at Boulder. In 12 men experienced in barefoot running, investigators ...
Custom brace outperforms others for inversion control during cutting
A custom-molded hinged ankle brace more effectively controls inversion during cutting maneuvers than two other brace designs tested by researchers from the Hong Kong Polytechnic University, a finding with potential implications regarding ankle sprain prevention. Eight individuals with a history of ...

Market Mechanics


Products


Sani-Cast Hygiene Kit
Sani-Cast Hygiene Kit
MD Americas offers a new hygiene product designed to help sanitize and deodorize the skin wrapped in an orthopedic cast. The Sani-Cast kit includes a reusable medical-grade 21” easy-reach applicator and 36 premoistened disposable cleansing pads. Patients simply attach one ...
Ultra Zoom Ankle Brace
Ultra Zoom Ankle Brace
Breg has released the Ultra Zoom, a full season performance ankle brace that is lightweight and flexible for daily wear yet sturdy enough to reinforce, support, and protect during athletic activities. The Ultra Zoom is designed for prevention of ankle ...
Heat-Moldable Ultimate Insole
Heat-Moldable Ultimate Insole
Archmolds has introduced the Ultimate, a new heat-moldable custom insole offering up to twice the support of the company’s other heat moldable insoles. The Ultimate is designed to prevent foot, leg, hip, or back pain while enhancing comfort and performance ...
Excel Lace-up Ankle Brace
Excel Lace-up Ankle Brace
For athletes looking for the best of both worlds, the Excel lace-up brace from Active Ankle provides the comfort and mobility of a lace-up with support and security of a “tape job” at an inexpensive price point.  A circumferential strap ...
Microprocessor Raize Foot
Microprocessor Raize Foot
The new Raize Ankle/Foot system from Hosmer utilizes dual microprocessors to control a hydraulic ankle coupled to a composite foot platform. The Raize constantly monitors data from multiple sensors in the ankle to maintain stability in changing environments, including the ...
BioSculptor AFO Scanning Table
BioSculptor AFO Scanning Table
The new AFO Scanning Table from BioSculptor Corporation allows users to scan the plantar and dorsal surfaces of a patient’s foot while maintaining the lower leg in a neutral position. This scanning table has acrylic lasting boards of three different heights ...
Neoprene Hinged Knee Brace
Neoprene Hinged Knee Brace
The Advantage Neoprene Hinged Knee Brace provides support for patients with weak or injured knees that require medial and lateral support without restricting mobility. This product is now available in sizes small through extra-large and may be dispensed by orthopedic ...
Hot and Cold Foot Therapy
Hot and Cold Foot Therapy
Health Enterprises offers two new hot and cold therapy products: TheraToes and TheraPed, which have been awarded the American Podiatric Medical Association (APMA) Seal of Acceptance. Either Therma gel product can be heated in the microwave for targeted heat therapy ...
CosySoles Warming Slippers
CosySoles Warming Slippers
CosySoles offers microwaveable slippers to relieve cold feet in patients whose circulation is compromised by conditions such as arthritis, muscular dystrophy, Charcot-Marie-Tooth disease, Raynaud’s disease, scleroderma, lupus, diabetes, multiple sclerosis, cerebral palsy, fibromyalgia, reflex sympathetic dystrophy, and other peripheral neuropathies. ...
Topical BioMedics Gift Sets
Topical BioMedics Gift Sets
Topical BioMedics offers health and wellness gift sets featuring Topricin pain relief and health cream or Topricin Foot Therapy Cream. The gift sets, designed for a variety of budgets and lifestyles, also feature natural soaps, handmade candles, foot reflexology rollers, ...