Lower Extremity Review
As evidence accumulates suggesting negative effects of depression, dementia, and other mental health issues on gait and foot-related outcomes in people with diabetes, researchers are looking at ways to screen for risk factors and psychosocial issues earlier in the continuum of care.
By Hank Black
Although most clinicians tend to emphasize hip abductor and external rotator muscle strengthening in injury prevention and rehabilitation, recent research suggests exercises to increase explosive hip extensor strength may be critical for controlling frontal plane motion during cutting tasks.
By Marc Norcross, PhD, ATC, and Sam Johnson, PhD, ATC
Inertial measurement units (IMUs) facilitate the creation of a gait analysis system that is portable and suited for use in the clinic. Research suggests IMUs can be used to measure clinically important gait metrics in children with cerebral palsy, which may improve patient outcomes.
By Mahmoud El-Gohary, PhD; Sean Pearson, BS; Paul Vasilyev, BS; James McNames, PhD; and James Carollo, PhD, PE
As ciprofloxacin and other fluoroquinolones are prescribed more frequently, tendon-related adverse effects are also becoming more common. Experts often do not recommend these drugs, particularly for athletes or elderly patients, and emphasize that all patients should know the risks.
By Barbara Boughton
Although not as common as Achilles tendinitis, peroneal tendinitis is seen in a certain group of patients with chronic ankle instability or with a cavovarus foot.1 Peroneal tendinitis presents as lateral foot pain and may also be of unknown etiology or associated with an acute inversion injury.
By Patricia Pande, MClScPT, CSCS, CPed
Decisions related to the stiffness of an ankle foot orthosis (AFO)—whether they involve device design or the materials from which it’s fabricated—can help lower extremity clinicians customize stability, biomechanics, and muscle function to meet individual patients’ needs.
By Lori Roniger
Professional football players are enduring higher levels of force than ever, and foot and ankle injury rates are increasing as a result. Advances in surgery and rehabilitation have helped get players back on the field more quickly, but injury prevention remains a significant challenge.
By Will Carroll
Altered biomechanics after ankle arthrodesis often increase stress on the adjacent joints in the foot, which can cause or exacerbate osteoarthritic degeneration in those joints. Clinicians and researchers are working to better understand this process and how to minimize patients’ risk.
By Cary Groner
The ability to identify and treat patients at risk for mental health issues after anterior cruciate ligament (ACL) injury may help improve psychological readiness for reconstructive surgery, attitudes toward postoperative rehabilitation, and successful surgical and rehabilitation outcomes.
By John Reaume, MD, MHSA; Dana Reaume, PsyD; and Melissa A. Christino, MD
Pronation is a triplanar movement and is the combination of rearfoot eversion, midfoot abduction, and talocrural dorsiflexion.1 Pronation in normal gait allows flexible, adaptive changes to varying types of terrain; it dissipates ground reaction forces; and encourages lower extremity internal rotation.
By Frank Layman, PT, DPT, EdD, MT; and April Wilson, PTA, BS, CI, CKTP, IASTM
Weight loss following bariatric surgery can have biomechanical and symptomatic benefits for obese patients with knee osteoarthritis (OA). But it’s less certain whether that weight loss can also reduce the risk of obesity-related complications following total knee arthroplasty.
By Shalmali Pal
The mechanisms underlying the so-called crossover effect—when a unilateral intervention results in bilateral changes—are still unclear, but clinical applications related to lower extremity strengthening, fatigue, and stretching are already being explored by rehabilitation specialists.
By Cary Groner
A growing body of evidence suggests that foot orthoses may be a helpful addition to other therapies for improving balance and potentially reducing the risk of falls. The findings have been mixed, however, and clinical enthusiasm for this type of insole intervention also varies.
By Hank Black
Posterior tibial tendon dysfunction (PTTD), known also as tibialis posterior tendon dysfunction, is one of the leading causes of acquired flatfoot in adults, but the…
By By Frank Layman, PT, DPT, EdD, MT; and April Wilson, PTA, BS, CI, CKTP, IASTM
Dry needling is gaining momentum as an alternative therapy for myofascial pain, and is supported by a small but growing body of research as well as anecdotal evidence. But the training and expertise required to perform the procedure has become a topic of debate.
By P.K. Daniel
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