Lower Extremity Review
The literature on preschool-aged and older children with Down syndrome tends to be consistent with conventional understanding of orthotic principles, but in very young children clinical decision-making about orthoses must also encompass neuromotor implications.
By Julia Looper, PT, PhD
Pittsburgh researchers found that patients with diabetes have higher complication rates than nondiabetic patients following open surgical management of ankle fractures, but also that the rate of major complications in the diabetic patients was relatively low.
By Robert W. Mendicino, DPM, FACFAS; Alan R. Catanzariti, DPM, FACFAS; Brian Dix, DPM; and Phillip Richardson, DPM
Bone bruises are commonly associated with anterior cruciate ligament (ACL) tears, but researchers are only beginning to understand the potential clinical significance of these chondral lesions with regard to knee osteoarthritis (OA) and preventing ACL injury recurrence.
By Cary Groner
The medical literature suggests that changes in bone density and other bone characteristics after stroke persist after patients have regained ambulatorystatus. Whether ankle foot orthoses have a shielding effect on bone remodeling, however, remains unclear.
By Kyle Sherk, MS, CPO
Anterior knee pain is one of the most common injuries affecting runners, accounting for 25% of all running injuries.1 The etiology of anterior knee pain is multifactorial in nature,2 but one of the most commonly cited biomechanical risk factors is excessive rearfoot pronation.
By Pedro Rodrigues, MS, PT, PhD, Trampas TenBroek, PhD, and Joseph Hamill, PhD
Two February publications sum up the polarizing nature of hyperbaric oxygen therapy (HBOT) for treating recalcitrant diabetic foot ulcers. A meta-analysis supported use of HBOT, while a large cohort study found a lack of effectiveness in community-care settings.
By Larry Hand
Research suggests that exercise therapy can help reverse the ambulatory impairments associated with lower extremity pain in patients with peripheral arterial disease. The next step is to determine the methods of exercise therapy most likely to result in optimal outcomes.
By Ana I. Casanegra, MD, Omar L. Esponda, MD, and Andrew W. Gardner, PhD
Varus thrust is a characteristic of dynamic alignment that has been shown to be predictive of medial tibiofemoral structural progression. Treatments aimed at minimizing varus thrust may reduce structural progression and symptoms related to knee osteoarthritis.
By Grace Hsiao-Wei Lo, MD, MSc
Team practitioners at the United States Naval Academy designed an orthotic intervention to prevent turf toe and Lisfranc sprains in football linemen and gained valuable insights about how players’ preferences and predispositions can affect compliance.
By CAPT Jeff Fair, EdD, ATC, LAT; CAPT David Keblish, MD; and LCDR Anthony Rabaiotti, DPM
Arthrodesis remains effective for most patients with end-stage hallux rigidus, but finding an alternative that allows more range of motion can be challenging. Faced with disappointing arthroplasty outcomes, surgeons have had to get creative.
By Cary Groner
In patients with spastic hemiplegic CP, practitioners and researchers tend to focus primarily on the hemiplegic limb. But hemiplegia also leads to impairments in the uninvolved limb, which are important to consider when designing a therapeutic approach.
By Julieanne P. Sees, DO, and Freeman Miller, MD
Excessive rotational traction that occurs at the interface between the shoe and the playing surface, as well as shoe properties such as rotational stiffness, may have the potential to influence the high incidence of lower extremity injuries in athletes.
By Feng Wei, PhD, and Eric G. Meyer, PhD
This two-part series examines trends and techniques in materials development and fabrication. This second installation focuses on technological advances that are likely to affect the structural properties and manufacture of in-shoe foot orthoses.
By Cary Groner
Obese patients are more likely than nonobese individuals to sustain an ankle fracture, particularly a severe ankle fracture. Contributing factors may include increased torque on the ankle or low bone mineral density relative to body weight.
By Christy King, DPM, AACFAS
Evidence suggests that when an athlete stops or tapers his or her training, the resulting effects on endurance, strength, balance, and lower extremity biomechanics may increase the risk of injury. Understanding these effects can help practitioners minimize injury risks.
By Boyi Dai, PhD, and Jason C. Gillette, PhD
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