Category Archives: Feature Article

Featured Issue Article

October 2014

Offloading the diabetic foot: Effects of obesity

Increasing body mass index is associated with significantly increased peak plantar pressures regardless of the type of off­loading device used. However, it is possible to decrease plantar pressures in some regions of the foot with the use of offloading devices.

By Andrew J. Meyr, DPM, FACFAS; Kelly Pirozzi, DPM, AACFAS; and Matthew R. Wagoner, DPM Continue reading

October 2014

Functional contributors to outcomes after TKA

The increasing utilization of total knee arthroplasty has led to increased efforts to identify variables that can be modified to help improve postoperative functional outcomes. These risk factors include patient weight, smoking, diabetes, infection, and joint range of motion.

By John Ryan Quinn, MD, and Ran Schwarzkopf, MD, MSc Continue reading

September 2014

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

September 2014

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

September 2014

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

September 2014

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

September 2014

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

August 2014

Patient Perspective: The long struggle to get a knee back in the game

It happened about two years ago while I was playing a friendly game of basketball with my teenage sons and friends. I was 49 years old and never felt like slowing down. Like most guys, while playing ball, we would imitate our favorite players.

By Joseph Hayward Continue reading

August 2014

AFO tuning: Balancing function and satisfaction

Tuning of ankle foot orthoses (AFOs) and AFO-footwear combinations can significantly improve gait in patients with neuromuscular impairments. Even so, some pa- t­ients still prefer their untuned devices, which has led researchers and clinicians to reexamine their approach to intervention.

By Cary Groner Continue reading

August 2014

Return of strength after Achilles tendon surgery

Despite excellent subjective outcomes following Achilles tendon repair, significant plantar flexion and dorsiflexion strength deficits often persist. However, modern trends in postoperative rehabilitation represent a progression toward a more functional strength recovery.

By David A. Porter, MD, PhD, Kirk Cleland, MD, and Angela M. Rund, MEd, ATC Continue reading

August 2014

Flexible flatfoot: Foot orthoses and outcomes

Many studies have shown an effect of foot orthoses on biomechanical function in patients with flexible flatfoot, but few studies have focused on patient-centered outcomes. There is a need to investigate the effect of foot orthoses on pain and fatigue in these individuals over time.

By Sarah A. Curran, PhD Continue reading

August 2014

Running shoe mass: Can feet tell any difference?

Research suggests that when trying on athletic shoes in a retail store, an individual’s perceptions of shoe mass primarily come from handling the shoes and less (if at all) from test-wearing them. In addition, the foot’s perception of shoe mass does not appear to improve with practice.

By Joel G. Greenya, BS, Stephen J. Slade, BS, Christopher L. Kliethermes, PhD, and David S. Senchina, PhD Continue reading

August 2014

Dynamic compression for recovery in athletes

US Olympic Committee researchers have found that peristaltic pulse compression of the lower extremities may provide a means of enhancing the rheological properties of the lower extremities without resorting to extreme temperatures, expensive body work, or stretching.

By William A Sands, PhD, FACSM, CSCS Continue reading

July 2014

Functional movement tests and injury risk in athletes

Efficient, low-cost, field-ready functional movement tests may be useful in preparticipation physicals to identify and provide preventive treatment for individuals with an elevated risk of injury, as well as aiding return-to-sport…

By Kathryn Schwartzkopf-Phifer, PT, DPT, OCS, CSCS, and Kyle Kiesel, PT, PhD, ATC Continue reading

July 2014

Studies explore statin use for lower limb indications

A growing body of research suggests that statins may help improve not just cardiovascular outcomes but also those associated with lower extremity conditions such as peripheral arterial disease and knee…

By Larry Hand Continue reading

July 2014

Revisiting the status quo for AFO strap placement

Conventional wisdom says dorsal straps for ankle foot orthoses should be positioned at a certain angle to resist heel rise. Now preliminary research from Georgia Tech is calling that practice into question…

By P.K. Daniel Continue reading

July 2014

Foot ulceration in patients with rheumatoid arthritis

Research has identified ankle-brachial index, loss of sensation, and deformity as predictors of foot ulceration in patients with rheumatoid arthritis, and also suggests that ulceration influences…

By Jill Firth, PhD, BSc (Hons), and Heidi J Siddle, PhD, MSc, BSc (Hons)
Continue reading

June 2014

Patient Perspective: Walking 600 miles is tough; plantar fasciitis is tougher

In 2008 I walked the 500-mile Camino de Santiago, the medieval pilgrimage route through northern Spain leading to the Cathedral of Santiago de Compostela. It was my first long distance walk, and because I completed it without injury, pain, or a blister, I fancied myself a walking superhero, immune to suffering or discomfort.

By Laura Potts Continue reading

June 2014

Managing foot and ankle injuries in baseball players

Baseball players at all skill levels routinely suffer from foot and ankle injuries, with position players being afflicted more often than pitchers or catchers. Making the correct initial diagnosis without delay can lead to more rapid and effective treatment, rehabilitation, and return to play.

By Gabriel V. Gambardella, DPM, Jeffrey Delott, DPM, and Zachary J. Korwek Continue reading

June 2014

A virtual reality approach to lower extremity rehab

When commercially available active video games are used in rehabilitation settings, often the level of challenge does not match the patient’s ability level. Customized interventions can address these limitations while capitalizing on the fun and motivating aspects of the technology.

By Rachel Proffitt, OTD, OTR/L Continue reading

June 2014

Cost-benefit data support reconstruction of ACL tears

In both the short term and the long term, anterior cruciate ligament reconstruction produced greater quality of life improvements at a lower cost compared with rehabilitation only, suggesting that limiting access to ACL reconstruction may be harmful to patients and costly to society.

By Richard C. Mather III, MD, and Lane Koenig, PhD Continue reading

June 2014

Effects of targeted exercise on chronic ankle instability

Clinicians and researchers are increasingly utilizing exercise protocols focused on improving proprioception, range of motion, and strength to influence the more active and functional deficits that have been associated with chronic ankle instability in the literature.

By Mark A. Feger, MEd, ATC, and Jay Hertel, PhD, ATC Continue reading

May 2014

Healing hypoxic wounds: Fighting an uphill battle

A lack of oxygen can negatively affect wound healing in a number of ways, but surgical, pharmacological, and other technological advances are allowing clinicians to enhance oxygen delivery to damaged tissues and…

By Nanjin Park, DPM; Latricia Allen, DPM, MPH; Mary Nametka, MSN, RN, CWS, CWON, FNP-BC; Vickie R. Driver, MS, DPM, FACFAS Continue reading

May 2014

Elastic therapeutic tape: Applications at the ankle

Research on the use of elastic therapeutic tape in patients with chronic ankle instability is limited, but recent findings do suggest that leaving the elastic tape on for several days is associated with improvements in…

By Janet Simon, MS, ATC; Emily Hall, MS, ATC; and Carrie Docherty, PhD, ATC Continue reading

May 2014

Knee OA guidelines take patient-centric approach

Updated guidelines and new appropriate use criteria for nonoperative management of knee osteoarthritis aim to focus more directly on typical knee OA patients, who often have comorbidities that can complicate care and…

By Larry Hand Continue reading