Category Archives: Archives

January 2012

Knee OA: The evidence for gait modification

Gait retraining can potentially alter walking biomechanics such that knee adduction moment is reduced, an inexpensive off­loading option that does not require device wear. Gait modification studies to date have primarily focused on foot rotation, trunk lean, and knee medialization.

By Michael A. Hunt, PT, PhD

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January 2012

Biomechanical analysis of ankle sprain ‘copers’

Researchers are investigating why some people develop chronic ankle instabilty after a sprain while others seem to heal normally. Biomechanical differences between the two cohorts may offer clues to the mechanisms underlying CAI and enhance preventive efforts.

By Adam Rosen, MS, ATC, and Cathleen N. Brown, PhD, ATC

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January 2012

Monofilament testing withstands critiques

Experts continue to debate the relative merits of the Semmes-Weinstein mono­fila­ment for assessing diabetic foot ulcer risk, including how many sites on the foot should be tested, and which ones. But it’s tough to argue with the technique’s cost-effectiveness.

By Cary Groner

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January 2012

Breaking pointe: Foot and ankle injuries in dance

Essential to the beauty of dance are the demanding biomechanics of the dancer, particularly at the foot and ankle. Injuries and pain are almost inevitable. But an understanding of the underlying issues—artistic as well as anatomical—can help practitioners keep dancers on their toes for as long as possible.

By Jeffrey A. Russell, PhD, ATC

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December 2011

Striking a balance: Foot orthoses in DPN

Preliminary research suggests that impaired balance in patients with diabetic peripheral neuropathy (DPN) may improve with proprioceptive stimulation from foot orthoses. Postural instability is common in patients with diabetic neuropathy, said David Levine, DPM, CPed, who is in private practice in Frederick, MD.

By Katie Bell

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December 2011

Diabetic shoes: Fashion and function

Every day, people willingly trade good foot health for stylish shoes—think stilettos, platforms, and pointy toeboxes. For some time, however, patients who wore diabetic footwear didn’t have the option of worrying about style versus substance.

By Shalmali Pal

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December 2011

Debunking myths: Compression hosiery

Myths abound in discussions about healthcare (just think chicken soup). But when it comes to the use of compression hosiery, some tales can be debunked easily. The benefits of compression hosiery include improved blood circulation for patients with varicose veins, or achy swollen feet—especially helpful for those with diabetes.

By Larry Hand

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December 2011

Custom care: Offloading for foot ulcers

Any time a practitioner applies an orthotic device, such as an ankle foot orthosis (AFO) to offload a diabetic foot ulcer, he or she also has to make sure pressure is not redistributed to the point that a new ulcer is created elsewhere on the foot. Devices have to be constructed with the correct materials and properly fitted to the foot, which leaves a lot of leeway for practitioners.

By Larry Hand

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December 2011

How to “speak” central fab

Outsourcing has become integral to streamlined manufacturing and, in the O&P world, central fabrication services fit the bill. Yet, for practitioners dealing with a customer service rep in a different time zone or an employee in a far-off land, communication isn’t always easy to achieve. Lower Extremity Review checked in with O&P experts on effective ways to communicate with central fab facilities.

By Shalmali Pal

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December 2011

When diabetes complicates drop foot

In patients affected by both diabetes and drop foot, ankle foot orthoses (AFOs) can help restore a more normal gait pattern and reduce the mechanical risks of ulceration. But microtrauma caused by irritation and elevated pressure is also a significant concern in these patients, making device selection and fit critical concerns.

By Larry Hand

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December 2011

OA knee bracing in family practice

Research indicates that primary care physicians are underprescribing exercise as a treatment for knee osteo­arthritis, and experts suggest the same can be said about bracing. “I think primary care physicians probably don’t know much about braces. Being primarily internists, primary care physicians may turn to what they know best, and that’s pharmacological therapy, because that’s what they’re accustomed to doing,” said Nicholas Giori, MD, PhD, an orthopedic surgeon at Stanford University School of Medicine in Palo Alto, CA.

By Larry Hand

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December 2011

Assessing PTTD: Linking the kinetic chain

Many studies of posterior tibial tendon dysfunction (PTTD), or adult acquired flatfoot disorder, have focused on foot kinematics and benefits of bracing for pain relief and increased ambulation. But new findings from the University of Southern California in Los Angeles suggest clinicians also look higher along the kinetic chain when determining an effective treatment.

By Christina Hall Nettles

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December 2011

Finding a footwear-AFO fit in kids

Finding shoes that fit over ankle foot orthoses (AFOs) is a challenge for thousands of children with neuromuscular disorders that affect walking ability. Parents have waited patiently while custom AFOs were molded and fitted, only to find themselves at wit’s end when trying to finish the morning dress routine.

By Christina Hall Nettles

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December 2011

Maximizing postamputation joint health

After amputation patients and practitioners tend to focus on the affected side. But the intact limb, or “sound side,” is also worth watching as long-term shifts occur in weight distribution between limbs during gait. This stress can often lead to knee osteoarthritis (OA) in the intact limb.

By Shalmali Pal

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December 2011

The wear and tear of ankle sprains

Chronic ankle instability (CAI) has been linked to devel­opment of early ankle osteoarthritis (OA), but questions remain as to how and why the degeneration occurs and how bracing and other interventions might slow the process.

By Larry Hand

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December 2011

Foot orthoses and landing mechanics

Research suggests foot orthoses can affect frontal and transverse plane motion in proximal joints during landing from a jump, which could help decrease the risk of anterior cruciate ligament injury, especially in female athletes.

By Katie Bell Continue reading

December 2011

PET/CT for PFP: Not ready for prime time

The latest research on patellofemoral pain (PFP) syndrome suggests that different mechanisms are responsible and treatments must be tailored accordingly. A new imaging study has drilled down into the source of PFP, offering evidence of a link between the syndrome, bone metabolic activity, and increased mechanical stress.

By Shalmali Pal

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December 2011

Stretching out plantar fasciitis

Tight hamstrings play an important role in plantar fasciitis, according to a study published in the June issue of Foot and Ankle Specialist. “These findings show that while we always consider the tightness of the gastrocnemius/soleus complex and the subsequent restricted ankle motion from this equinus, we also need to consider the role of the hamstrings,” said Jonathan Labovitz, DPM, lead author and associate professor at Western University of Health Sciences, Pomona, CA.

By Katie Bell

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December 2011

Orthotic CAD-CAM workflow management

A customized CAD-CAM system can streamline each step of creating custom foot orthoses. Experts say proper preparation is the key to managing this technology’s workflow. Philip Wells, BSc (Hons) Podiatry, technical support manager for Stepahead and Salts Techstep in Birmingham, UK, emphasized the way in which creating a more efficient workflow improves profitability for a practice.

By Stephanie Zultanky Pavlou

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December 2011

Shoe stiffness and pressure patterns

Pressure measurement technology can differentiate between the impact forces of a stability shoe and a flexible shoe during gait, according to a preliminary study presented in August at the annual meeting of the American Society of Biomechanics in Long Beach, CA.

By Katie Bell

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2011

Depreciation Bonus and Section 179 Deductions Set to Expire 12/31/11

Recently the U.S. Federal government made a change to the tax code which provides unprecedented incentives for investing in manufacturing technology. Specifically, the U.S. Federal government has increased “Bonus Depreciation” to 100% on qualified assets, which includes software. This level … Continue reading

November 2011

KidZerts Wear-moldable Insole

KidZerts has released the first wear-moldable arch support insole that shapes itself to match the unique contours of the bottom of a child’s foot. The ethyl vinyl acetate (EVA) moldable sublayer molds slowly to the plantar surface during wear; other … Continue reading

November 2011

Foot/Ankle E-Module

PhysioTools’s new Foot and Ankle Strengthening module installs easily on Mac or PC computers, and includes exercise sequences and educational information as well as advice notes on a number of common foot and ankle disorders. The software helps podiatrists and … Continue reading

November 2011

Seattle LP Low Profile Foot

Trulife introduces its first low profile prosthetic foot for community ambulators and high activity amputees – the Seattle LP. Designed of carbon fiber and titanium, this low profile foot is ideally used with long residual limbs. The Seattle LP’s multi-axial … Continue reading

November 2011

AliMed Bariatric Positioners

AliMed has added to its products a line of bed positioning devices engineered to withstand the compressive weight of bariatric patients and help prevent pressure ulcers. The positioners, made from a closed-cell foam that resists compression better than standard foam, … Continue reading