Lower Extremity Review
Demonstrated associations between impaired proprioception and knee osteoarthritis suggest some interventions that help relieve painful symptoms in patients with knee osteoarthritis , such as exercise and bracing, do so by positively affecting joint position sense.
By Barbara Boughton
Falls are common, disabling and costly. Causes are multifactorial but include foot disorders, ill-fitting footwear, and poor balance. Recent research supports a multidisciplinary approach to falls prevention and indicates that lower extremity practitioners can play an important role.
By Hylton B. Menz, PhD, and Martin J. Spink, BPod(Hons)
Hospitals with multidisciplinary diabetic foot care programs have found that adding vascular surgeons to the team makes their amputation prevention efforts more effective, but also adds an extra layer of challenges in terms of coordination and communication.
By Cary Groner
Not all patients with chronic ankle instability develop ankle osteoarthritis, but evidence suggests the two conditions are related, which in turn suggests that ankle sprain prevention and management could help reduce ankle replacement rates.
By Larry Hand
Acute compartment syndrome can develop after open or closed tibial fractures, even those that appear to be benign. Early diagnosis of increased compartmental pressure and timely surgical intervention can prevent adverse outcomes including nerve injury and muscle necrosis.
By Langdon A. Hartsock, MD, and William R. Barfield, PhD
Most conservative measures to reduce knee adduction moment in patients with knee osteoarthritis involve altering proximal biomechanics, but research suggests that similar kinetic changes and pain relief can be achieved with the use of wedged foot orthoses.
By Emily Delzell
Recent interest has focused on the use of Nordic hamstring strengthening exercises to prevent hamstring injuries in athletes, but evidence also supports eccentric exercise for managing tendinopathy and for prevention and rehabilitation of anterior cruciate ligament injury.
By Daniel Lorenz, DPT, PT, ATC/L, CSCS
Misalignment between the mechanical joint of an articulated AFO and the corresponding anatomical joint can significantly affect the device’s mechanical properties, particularly resistance and stiffness, which can impair AFO effectiveness and negatively affect proximal joints.
By Fan Gao, PhD, and Susan Kapp, MEd, CPO, LPO, FAAOP
Golfers demonstrate significant asymmetries between hips with regard to rotational range of motion and rotational velocity, which can contribute to the development of conditions including low back pain, femoroacetabular impingement, and hip labral degeneration.
By Heather Gulgin, PhD, ATC
Survey results suggest that at least one-third of individuals at risk for foot pain or diabetic foot ulcers are wearing shoes that are at least one size too big or too small, which can further increase those risks. Proper shoe fit and foot health start with patient education.
By Stephanie Swensen, BSc, and Ran Schwarzkopf, MD, MSc
This study found that closed basket-weave ankle taping significantly affects ankle range of motion and time to peak vertical ground reaction force, which can have implications higher up the kinetic chain that appear to vary from one individual to another.
By Matthew L. Santos-Vitorino, MS, ATC, LAT, Sue Shapiro, EdD, ATC, LAT, Kathy Ludwig, PhD, and Claire Egret, PhD
New research suggests that serious injuries occur as frequently in off-road motorcycle racing as they do in football, but such injuries occur less frequently in riders who wear knee braces.This may be why, although it is not well studied, knee bracing is widespread among off-road motorcycle riders.
By Wesley M.Gladin, BS, Robert A.Cates, BA, and Mark S.Sanders, MD, FACS
Adult acquired flatfoot deformity, primarily posterior tibial tendon dysfunction, in many cases can be successfully managed with conservative treatment modalities including early immobilization, long-term bracing, physical therapy, and anti-inflammatory medications.
By Robert W. Mendicino, DPM, FACFAS, Alan R. Catanzariti, DPM, FACFAS, and Kyle S. Peterson, DPM
Gait retraining can potentially alter walking biomechanics such that knee adduction moment is reduced, an inexpensive offloading option that does not require device wear. Gait modification studies to date have primarily focused on foot rotation, trunk lean, and knee medialization.
By Michael A. Hunt, PT, PhD
Researchers are investigating why some people develop chronic ankle instabilty after a sprain while others seem to heal normally. Biomechanical differences between the two cohorts may offer clues to the mechanisms underlying CAI and enhance preventive efforts.
By Adam Rosen, MS, ATC, and Cathleen N. Brown, PhD, ATC
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