Lower Extremity Review
Ankle foot orthoses and other O&P devices allow patients to walk faster, for longer periods of time, with a more biomechanically efficient gait. It seems logical that energy costs would decrease as a result. But that’s been surprisingly difficult for researchers to prove.
By Cary Groner
Interdisciplinary foot screening and limb salvage programs in this country and around the world have successfully reduced diabetic foot ulceration and amputation rates, and in doing so have inspired others to initiate similar prevention programs in their own countries.
By Emily Delzell
Functional knee braces can’t be effective if athletes won’t wear them, and many athletes won’t wear them because they fear their athletic performance will be negatively affected. But early research suggests that athletes accommodate to knee brace wear almost immediately.
By Neetu Rishiraj, ATC, PhD, Jack E. Taunton, MSc, MD, Robert Lloyd-Smith, MD, William Regan, MD, and Navin Prasad, MSc, MD
Many lower extremity practitioners are not aware of the risks of distress, depression, and cognitive impairment in patients with diabetes. But screening for mental health issues and adjusting patient management accordingly can significantly improve diabetic foot care outcomes.
By Larry Hand
Research suggests that different bracing designs may have different mechanisms of action for relief of patellofemoral pain syndrome, which is consistent with the heterogeneous nature of the condition and underscores the need to understand each design’s function prior to treatment.
By Song Joo Lee, MS, Yupeng Ren, MS, Nicole A. Wilson, PhD, Sang Hoon Kang, PhD, and Li-Qun Zhang, PhD
Not so long ago, the effectiveness of prefabricated foot orthoses relative to their custom brethren was a bitterly divisive topic. But the vitriol has dissipated over time, as practitioners have turned their focus to the appropriate selective use of each type of device.
by Cary Groner
The loss of bone integrity that accompanies ACL injury persists after reconstructive surgery, even with aggressive rehabilitation. Improved interventions may help decrease patients’ risk for low bone mineral density and osteoarthrosis.
By John Nyland DPT, SCS, EdD, ATC, CSCS, FACSM
Findings from studies of PRP can be conflicting and confusing, but lower extremity practitioners remain cautiously optimistic about the trendy treatment’s clinical potential to accelerate healing of soft tissues, bone, and diabetic wounds.
by Cary Groner
The digital age has ushered in many opportunities and threats that a decade ago didn’t even exist. Whether it’s social networking fueling revolutions in far-away lands or blogs giving voice to ordinary people, we know we aren’t in Kansas anymore!
By Jason Kraus
The seemingly endless quest to discover why foot orthoses relieve symptoms is veering away from skeletal alignment and toward somatosensory variables, though some still insist that kinematics play a role as well.
by Cary Groner
Early detection of Charcot neuroarthropathy is critical for preventing the bone and joint destruction associated with later stages, but symptoms that mimic other conditions can make a differential diagnosis difficult.
By Georgeanne Botek, DPM, and Gina Hild, DPM
O&P devices are all-too-public indicators of an infirmity, and often limit clothing and footwear options—all of which contributes to poor self image. But a little empathy can keep self image issues from sabotaging patient compliance.
By Emily Delzell
Much of the success of microfracture surgery for articular cartilage lesions in the knee depends on what happens after the surgery is over. Progressive, controlled loading of the repaired joint is the key to safe and effective rehabilitation.
By Jon Fravel, ATC, and Michael Shaffer PT, ATC, OCS
Malalignment or dysfunction of the foot can increase the risk of landing-related trauma such as ACL injury, but the biomechanical effects of foot orthoses and bracing may decrease that risk.
By Douglas Powell, PhD, and Nicholas J. Hanson, MS
Use of unstable footwear to strengthen the typically underused small muscles of the foot and ankle can help improve posture and gait, potentially decreasing pain and risk of injury.
By Scott Landry, PhD
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