Lower Extremity Review
Assessing the clinical efficacy of different therapeutic options for KOA will aid clinicians in treating patients. While clinicians recognize the positive role of physical therapy in improving symptoms and functionality in knee osteoarthritis (KOA) patients, these methods may differ in mechanisms of action, applicability, and efficacy variances.
By Xiao Chen, Yuanhe Fan, Hongliang Tu, and Yuan Luo
I used to think documentation was the easy part. Write what you saw, describe what you did, keep it clear and detailed. I was trained well. I took pride in good notes—organized, clinical, complete. The kind you’d feel confident handing off to a colleague.
By Cassandre Voltaire, DO, ABWMS
The biomechanics of the diabetic foot are an intricate interplay of physiological and mechanical challenges that necessitate specialized care strategies. Diabetes often triggers changes in foot structure and function as a result of complications including peripheral neuropathy, vascular issues, and obesity.
By James McGuire, DPM, LPT, LPed, FAPWHc
This study highlights the importance of a user-centered design in enhancing adherence to and satisfaction with AFOs. Ankle-foot orthoses (AFOs) are essential in pediatric rehabilitation particularly for children with conditions such as cerebral palsy, drop foot, or neuromuscular impairments.
By Peter Dabnichki and Toh Yen Pang
Dirty Truth #4: Shock Absorption is Energy Loss–Understanding Loading in Gait Analysis
Perhaps the most surprising and unintuitive of all the dirty truths is number four, “Shock absorption via cushion is energy loss.” At first blush, cushion seems like a no-brainer benefit. When we delve into this idea a bit deeper, applying our structure, the forces acting on the lower limbs, and applying the physics that we talked about in the last three dirty truths, the truth of number four becomes clear.
By Jay Segel, DPM; Sally Crawford, MS
Integrating targeted exercises focused on AH strengthening, both pre- and post-surgery, offers a comprehensive approach to HV management. The abductor hallucis (AH) is the most important muscle in the…
By Giacomo Farì, Laura Dell’Anna, Francesco Paolo Bianchi, Rachele Mancini, Enrica Chiaia Noya, Carlo De Serio, Riccardo Marvulli, Luisa De Palma, Danilo Donati, Roberto Tedeschi, Maurizio Ranieri, Marisa Megna, and Andrea Bernetti
Emergency medical services (EMS) calls accounted for 65.2% of all incidents to which United States (US) fire departments responded in 2023. A portion of fire department EMS calls are likely to involve lower extremity injuries. The objective of this study was to describe the pattern of these lower extremity injuries.
By Mathias B. Forrester, BS
Chronic, hard-to-heal wounds are a major aspect of care in most podiatric offices, which is why antimicrobial resistance (AMR) is an escalating concern for healthcare practitioners. AMR is not only a growing concern for patient health but also poses potential legal and economic ramifications for healthcare providers.
By Windy Cole, DPM, CWSP, FAPWH
Hind foot non-unions are a complex orthopedic challenge that clinicians face, particularly due to the unique anatomy and weight-bearing responsibilities of this part of the foot. Non-unions occur when a fracture fails to heal nine months after injury or shows no radiographic improvement over a consecutive 3-month period. This condition is not only painful but can also severely impact mobility and quality of life.
By Zeeshan Husain, DPM, FACFAS, FASPS
Dirty Truth #3: What We Can’t See Is Key. In the last 2 installments, we talked about our problematic foot anatomy and what happens to the structure during weight bearing and activity. Much like how a mousetrap precisely captures its target, analyzed computer-aided gait analysis (CAGA) reports accurately “mousetrap” and track the unseeable, providing valuable insights and objective data.
By Jay Segel, DPM; Sally Crawford, MS
Background: In 2023, an estimated 13,350 civilian fire injuries were reported in the United States (US). The objective of this study was to characterize civilian lower extremity injuries resulting from fires in the US. Methods: Data were obtained from the National Fire Incident Reporting System (NFIRS), which collects information on incidents to which fire departments respond in the US. Cases were civilian lower extremity injuries resulting from fires reported to NFIRS during 2014-2023. The distribution of cases was determined for patient characteristics, type of injury, and circumstances of injury.
By Mathias B. Forrester, BS
Using computerized posturographic parameters provides a highly quantitative and objective measure without ceiling or floor effect as a classifier or predictor of falls. The balance control problem is one of the major contributing factors to falls and may change with aging, medication, or acute illness. Computerized posturography obtained in standing conditions has been applied to classify fall risk for older adults or disease groups.
By Huey-Wen Liang, Rasoul Ameri, Shahab Band, Hsin-Shui Chen, Sung-Yu Ho, Bilal Zaidan, Kai-Chieh Chang, and Arthur Chang
Performing a biopsy is crucial for achieving diagnostic accuracy. Podiatric physicians may biopsy less frequently than their dermatology counterparts, but an earlier biopsy can significantly improve patient care. Many skin conditions can mimic common podiatric issues, and a biopsy allows for histopathological examination, which can…
By Leland Jaffe, DPM, FACFAS.CWSP
It’s a physics problem – We live dynamic lives, in turn, we suffer dynamic consequences! In the last installment, we focused on our problematic anatomy. We continue this discussion by looking at what happens when we add the interaction between 2 dissimilar bodies, the foot and the floor, and the introduction of force.
By Jay Segel, DPM; Sally Crawford, MS
Dynamic knee valgus, a highly reliable measure of this alignment assessed in the frontal plane, is a valuable tool for identifying this pathomechanical dysfunction. The purpose of this study was to investigate the effectiveness of functional hip abductor strength training on reducing contralateral pelvic drop angle…
By Shreen Ahmed Lashien, Ahmed Omar Abdelnaeem, and Ebtessam Fawzy Gomaa
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