Category Archives: Archives
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
Ipocon Gel Sheets
Comfort Products Ipocon Gel Sheets are made by Uniprox and constructed of silicone gel. The viscoelastic properties of the material provides partial pressure relief to feet. The sheets are free of Lycra coating and are suited for individuals who need … Continue reading