Category Archives: Feature Article
Study findings and anecdotal reports suggest that newer-generation total ankle replacement can match or exceed ankle arthrodesis when it comes to gait and range of motion, but neither procedure returns gait to normal. Implant survival has also improved, but continues to be a challenge.
By Barbara Boughton
Total hip arthroplasty can significantly improve quality of life in obese patients, but high body mass index is also associated with higher rates of complications and readmissions than in normal-weight patients. The emerging subgroup of super-obese patients poses additional challenges.
By Raghav Rajgopal, MD, and James L. Howard, MD, MSc, FRCSC
Opportunistic microorganisms called biofilms constitute an age-old diabetic wound care problem that defies traditional antimicrobial therapies. Experts believe interventions customized to individual patients based on molecular diagnostics may be the best line of defense.
By Larry Hand
Patients with chronic refractory lower extremity tendinopathies often continue to have symptoms after exhausting most of their therapeutic options. Preliminary evidence supports the use of platelet-rich plasma in these patients, though higher-level research is needed.
By Ricardo E. Colberg, MD, and Kenneth Mautner, MD
Lower extremity biomechanics can significantly affect the risk of upper extremity injury in overhead throwing athletes, such as baseball and softball pitchers and catchers, and the functional stability of the lumbopelvic-hip complex is essential to preventing those injuries.
By Gretchen D. Oliver, PhD, FACSM, ATC, LAT, Hillary Plummer, MAT, ATC, and Lisa Henning
In patients who undergo a minor foot amputation following a diabetic foot ulcer, severe peripheral arterial disease is the primary risk factor for subsequent major amputation, which underscores the importance of early detection and intervention for PAD in this population.
By Vincent S. Nerone, DPM, Kevin D. Springer, DPM, Darren M. Woodruff, DPM, and Said A. Atway, DPM, AACFAS
The medical literature supports the use of massage for relief of osteoarthritis symptoms, but therapist-administered treatments can be cost-prohibitive. This study found that self-massage can also be effective, even when the initial supervised sessions are continued by patients at home.
By Dorothea Atkins, ThD, RN, and David Eichler, PhD
A growing body of scientific evidence suggests that clinical tests of core strength and stability can help predict risk of lower extremity injury in athletes, which in turn supports the need for a multisegmental approach to the development of injury prevention programs.
By Valerie Snider, MS, ATC, and Gary Wilkerson, EdD, ATC
New research suggests that vasti muscle activation in women varies throughout the menstrual cycle, adding to the growing body of literature pointing to a connection between sex hormones and knee injury risk. The exact nature of that relationship, however, remains unclear.
By Matthew S. Tenan, MA, ATC, and Lisa Griffin, PhD
Practitioners know patients who feel that ankle foot orthoses (AFOs) hinder their sartorial style are less likely to be compliant, but many clinicians feel ill-equipped to give fashion advice. That’s when the expertise of a stylist, seamstress, or personal shopper can come in handy.
By Shalmali Pal
Not only do basketball players have many of the same risk factors for plantar fasciitis as the general population, they also have the added challenge of a grueling season and very little opportunity to rest. That means practitioners have had to be creative when it comes to treatment.
By P.K. Daniel
A number of different gait modifications have been demonstrated to significantly reduce the knee adduction moment in patients with knee osteoarthritis (OA). Now research suggests gait retraining can also help reduce the pain associated with knee OA and improve function.
By Pete B. Shull, PhD
When preventive measures have been exhausted, various surgical approaches can be employed to provide each diabetic patient with a functional, biomechanically sound foot that is free of infection, while minimizing the risk of future lower limb complications.
By Gabriel V. Gambardella, DPM, and Peter A. Blume, DPM, FACFAS
Significant progress has been made in quantifying gait impairment in patients with multiple sclerosis, but clinician-friendly assessment techniques that are sensitive to mild levels of impairment are needed to facilitate early intervention and in turn improve patient outcomes.
By Douglas A. Wajda and Jacob J. Sosnoff, PhD
I can’t recall exactly when the bunion on my left foot started causing discomfort, but it was probably when I was about 40. I waited some time to get a referral to a podiatrist, and when I finally saw one, life with two kids and a full-time job stalled my pursuit of treatment for another three and half years.
By Karen Bakar
Military populations experience high rates of disability related to post-traumatic osteoarthritis (PTOA), which does not always originate from combat injury. But military researchers are also uniquely positioned to explore therapeutic options to minimize the effect of PTOA.
By Jessica C. Rivera, MD, Joseph C. Wenke, PhD, James R. Ficke, MD, and Anthony E. Johnson, MD
Variables related to iliotibial band strain appear to be important risk factors for development of iliotibial band syndrome (ITBS) in runners, a finding that is beginning to change the way researchers assess the effectiveness of gait retraining interventions to treat or prevent ITBS.
By Stacey Meardon, PT, PhD, ATC, CSCS, and Ross H. Miller, PhD
Kicking is a whole-body movement that is responsive to a wide range of constraints related to the task, the environment, and the athlete. Preliminary research also suggests that balance control in the support leg plays a key role in athletes’ kicking performance.
By David I. Anderson, PhD, and Ben Sidaway, PT, PhD
Learned disuse of the affected limb can lead to weight-bearing asymmetries in patients with stroke-related hemiparesis. Compelled body-weight shift therapy, using shoe inserts to force loading of the affected limb, can help patients achieve a more symmetrical gait.
By Alexander S. Aruin, PhD
Although the technique is still in its infancy, early research suggests gait retraining can be used to address medial collapse, primarily in runners with patellofemoral pain (PFP) syndrome, and to reduce impact loading in runners with PFP or tibial stress fracture.
By Ashlin Miller, BS, and Richard W. Willy, PhD, PT, OCS
Practitioners and researchers are redefining rocking and rolling as key components of gait, and designing ankle foot orthoses and other orthotic and prosthetic devices to specifically address impairments in the way certain patients rock and roll.
By Cary Groner
Documenting how shock propagates through the leg and is attenuated by the soft tissues appears to be a critical step toward advancing practitioners’ and researchers’ understanding of lower extremity injury mechanisms related to running and landing activities.
By Timothy A. Burkhart, PhD, EIT, Alison Schinkel-Ivy, MHK, and David M. Andrews, PhD Continue reading
Given the limitations of pharmacotherapy options for treating painful diabetic peripheral neuropathy, practitioners are also considering the merits of cognitive therapy, orthotic management, and combination therapies to relieve patients’ pain.
By Larry Hand
Ankle foot orthoses can help compensate for muscle weakness and accommodate related structural deformities in patients with Charcot-Marie-Tooth disease, but practitioners are constantly looking for ways to improve suboptimal compliance rates.
By Cary Groner
Researchers have identified gait alterations in patients with diabetic peripheral neuropathy but also in diabetic patients with normal sensation, raising questions about the extent to which factors other than neuropathy might also be affecting gait.
By Cary Groner