Category Archives: Archives

January 2010

Whole body vibration: Neuro-rehab applications

It’s popular with professional athletes and Hollywood celebrities. But WBV also has very real clinical potential for patients with neurological disorders. By Kurt Jackson, PT, PhD, GCS and Harold Merriman, PT, PhD, CLT

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January 2010

Effective compression therapy starts with you

Practitioners themselves may be to blame for not ensuring that stockings are fit properly and that patients know how to wear them correctly. By Linda Weber

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January 2010

Diabetes: Offloading difficult wounds. Part 2

The second article in this two-part series addresses preventing recurrence and management of Charcot foot and foot amputations. By Robert J. Snyder, DPM, FACFAS, CWS, and Karen K. Lanier, CPed, LPed

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January 2010

In the Moment: Olympic Sports

Spotlight on skier safety – Injury ‘avalanche’ prompts concerns When the torch is lit to kick off the Winter Olympics in Vancouver next month, the Canadian ski team will be missing no fewer than six of its best Alpine skiers, downed by five anterior cruciate ligament tears and one broken leg. All six were injured between the last week in November and the first week in January. Plus: • Average rehab after hip labral repair could fit in NHL offseason window • ‘Double-push’ cross country skiing outpaces conventional techniques

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January 2010

In the Moment: Foot Care

Kids’ shoes come up short – Study links tight fit to hallux valgus angle Keeping up with the ever-changing footwear needs of growing children can be a challenge for parents, but squeezing kids into too-short shoes may put them at risk for hallux valgus, according to research from the Medical University of Vienna. Plus: • Posted total contact insoles reduce hindfoot valgus in flexible flatfoot • Falls prevention efforts in elderly could start with toe strengthening

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January 2010

In the Moment: O&P

Knee braces activate brain – fMRI confirms proprioceptive effects Functional magnetic resonance imaging research from Belgium demonstrates the effect of lower extremity proprioceptive stimulation on brain activity and confirms that the effect of a knee brace or sleeve extends far beyond local joint biomechanics. Plus: • Ankle foot orthoses improve symmetry, gait in stroke patients with hemiplegia • Abduction bracing in infants with DDH delays learning to walk by three weeks

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January 2010

Market Mechanics

• Element semirigid ankle brace restricts passive, dynamic inversion in study • Delcam launches new insole software • Compact knee adds therapy mode • APTA podcasts focus on soldier rehab

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December 2009

Out on a limb: It’s all about you

At Lower Extremity Review, we know there are literally thousands of products out there that can help you improve your clinical outcomes. But the existence of all those products doesn’t really do you or your patients much good if you don’t know where to find them.

By, Jordana Bieze Foster, editor

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December 2009

PFPS gender gap inspires researchers

Although the mechanisms behind patellofemoral pain syndrome (PFPS), like those of anterior cruciate ligament (ACL) injuries, are still somewhat elusive, research is shedding new light on the role gender plays in the onset of this chronic overuse condition.

By Linda Weber

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December 2009

Heel pain relief: Expanding the playbook

The science of treating plantar fasciitis in athletes is evolving to consider the unusual demands these patients put on their feet. Although clinicians continue to rely on conservative management with rest, ice, anti-inflammatory medications, taping, and orthoses, some are embracing new approaches that seem counterintuitive but offer evidence of improved outcomes.

by Cary Groner

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December 2009

Lower extremity O&P warms to CAD-CAM

With a start-up cost of many tens of thousands of dollars and a steep learning curve, it’s no surprise that many O&P practitioners have been slow to transition to computer-aided design and computer-aided manufacturing (CAD-CAM).

By L.W. Barnes

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December 2009

Ankle sprain research focuses on teens

Epidemiological studies confirm what coaches, trainers, parents, and student athletes already know—that ankle sprains are the most common musculoskeletal injury among high school athletes. A study in the August issue of the American Journal of Sports Medicine bears that out, with recurrent ankle injuries accounting for 28.3% of recurrent traumatic sports injuries in teen athletes.

by Linda Weber

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December 2009

CPO seeks central fab: Finding a match

Charles Kuffel, CPO, of Blaine, MN, knows his limitations. If the clinician and father of four is going to keep his referrals happy, get products to his patients on time and have a life outside the office, it means outsourcing some orthotic orders to a central fabricator.

By L.W. Barnes

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December 2009

For those about to rock, we caution you

Shoes with rocker-bottom soles have long been used to alleviate plantar pressures in diabetes patients and others susceptible to forefoot pain or ulceration. The soles move the apex of the toe rocker behind the metatarsal heads, reducing pressure as the patient’s weight transfers forward over the ball of the foot.

by Cary Groner

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December 2009

Shear Madness: Beyond plantar pressure

Clinicians have known for many years that uneven plantar pressures, combined with the loss of sensitivity caused by peripheral neuropathy, are associated with foot ulcers in diabetes patients. Ulcers often occur in different areas than peak pressures do, however. Shear forces, caused by pressure differentials in the foot, may be more to blame than plantar pressures per se.

by Cary Groner

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December 2009

Drop foot mechanics outweigh etiology

Conditions associated with drop foot are as varied as post-stroke hemiplegia, brain or spinal cord injury, and neuromuscular disorders including multiple sclerosis (MS). Patients with drop foot are unable to use the dorsiflexor muscles to lift the foot clear of the ground during the gait’s swing phase, nor can they control plantar flexion during heel strike. The result is an awkward, unstable gait and a tendency to trip when the toes brush the ground.

by Cary Groner

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December 2009

Finding—and breaking—the ACL-OA link

In recent years, scientific studies have shown that anterior cruciate ligament (ACL) injury in athletes can lead to later osteoarthritis in a large proportion of cases. In fact, some studies have documented osteoarthritis rates of 50% to 100% in former athletes who have experienced ACL injury, when followed for 15 to 20 years.

By Barbara Boughton

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December 2009

The Home Stretch: Paths to pain relief

Stretching and splinting have long been treatment strategies for plantar fasciitis. However, new research and ongoing clinical experience are calling into question older methodologies and providing evidence for some new approaches.

by Cary Groner

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December 2009

Underuse, overuse both can lead to PTTD

Ongoing research into posterior tibial tendon dysfunction (PTTD) has revealed risk factors that include female sex, increasing age, overweight, unsupportive footwear, and even metabolic syndromes such as diabetes. Although typically associated with older, inactive patients, PTTD is also seen more rarely in young athletes.

by Cary Groner

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December 2009

CP gait studies document AFO efficacy

Clinicians who treat ambulatory cerebral palsy patients rely heavily on ankle-foot orthoses, which are the most effective treatment option for improving gait mechanics. But because CP encompasses such a wide range of symptoms, selecting the most appropriate corrective brace for a patient’s specific gait abnormality or abnormalities can present clinical challenges. Recent studies that shed light on ankle-foot orthoses’ impact on gait are characteristic of crucial ongoing research.

By Linda Weber

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December 2009

Sport-specific advances benefit all amputees

Whether it’s rock climbing, triathalons, cycling, running or the high jump, advances in prosthetic design have made high-caliber athletic competition a reality for some amputees. One such athlete testified in the September issue of Prosthetics and Orthotics International, “Snowboarding with the new prosthesis is like it was before the amputation!”

by Barbara Boughton

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December 2009

Early, active ACL rehab maximizes ROM

Achieving full range of motion is a key outcome of any rehabilitation program after ACL reconstruction. But what are the ingredients of a rehabilitation program that produces the best outcomes in terms of ROM?

By Barbara Boughton

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November 2009

Market Mechanics

• Ascent-descent studies show benefits of Proprio-Foot adaptive technology
• WalkAide effects persist for 11 months
• Fillauer expands with OTS acquisition
• ProLab launches orthotic web resource

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November 2009

Orthofeet tie-less lace line

Orthofeet is adding new designs to its Tie-Less Lace line of shoes. This patent-pending system combines laces with hook-and-loop straps that offer an easy way of fastening without the need for tying laces, which can be challenging for patients who … Continue reading

November 2009

Pro-Tec Roller Massager

The Pro-Tec Roller Massager with Trigger Point Release Grips is designed to reduce muscle tightness, soreness, and pain. Features include raised Vynafoam sections that “sink” into soft tissue to roll out tightness, rounded grip ends to provide precision trigger point … Continue reading