Lower Extremity Review
Stress fractures are generally thought to occur due to a multitude of factors. These include age and activity level (those under age 24 experience most such injuries, probably during high-intensity athletics and military service); gender (women are at higher risk, partly as a result of endocrine issues); and training (or overtraining) while wearing inadequate footwear.
ike other common multifactorial conditions, patellofemoral pain syndrome (PFPS) can be frustrating to treat. Contributing factors may include overuse, malalignment, muscular dysfunction, microtrauma, or a combination; multimodal treatment regimens are popular for relieving immediate symptoms.
Shane Coltrain, CPO, knows computer-aided design and computer-aided manufacturing (CAD-CAM) as well as anyone in his field. That’s because he’s been using it for about eight years, gaining experience with the tool every day while so many of his industry colleagues remain resistant to make the technological leap.
With so many factors outside of the control of practitioners and practice managers, it’s becoming increasingly important to focus energy and resources on the areas that are well within your ability to influence.
By Jason Kraus
Patients with diabetes who have undergone partial foot amputation are vulnerable to reulceration. Footwear, orthotic devices, and partial foot prostheses can reduce risk while improving function.
By Erick Janisse, CPed, CO, and Dennis Janisse, CPed
Yoga can help improve balance and increase confidence in older adults who are at risk for fall-related injury. The key to successful outcomes is to modify traditional poses in ways that accommodate both physical limitations and fears in this patient population.
By Arlene Schmid, PhD, OTR
Successful management of articular cartilage lesions starts with a thorough examination emphasizing patient history, range of motion limitations, and an understanding of underlying anatomy and biomechanics.
By Walter L. Jenkins, PT, DHS, ATC
Patients with diabetes are at increased risk for delayed union or nonunion following skeletal trauma or elective orthopedic surgery, due to impaired osseous regeneration.
By David N. Paglia MS, Siddhant K. Mehta BS, Kristen Mason BS, Eric A. Breitbart MD, Aaron Wey BS, Andrew Park MS, Swaroopa Vaidya MS, Ravi Verma BS, Dana Graves PhD, J. Patrick O’Connor PhD, and Sheldon S. Lin MD
Clinicians are already embracing carbon-fiber ankle foot orthoses, which provide a dynamic assist and may even help strengthen calf muscles in patients with foot drop. Now, slowly, research is exploring how these devices can best be used.
by Cary Groner
Researchers have explored numerous offloading strategies to decrease plantar pressures in patients with diabetes, but few have studied whether making a deliberate change to a patient’s walking pattern might have a similar effect on pressure distribution.
by Mansoo Ko, PhD
Evidence suggests that calf muscle stretching, whether manually or with the aid of a brace or splint, can help alleviate plantar fasciitis pain. What’s less clear is which protocol is most effective.
By Neena K Sharma, PT, PhD, CMPT, and Gurpreet Singh, PT
Nowhere are the effects of aging on gait mechanics and neuromuscular control more apparent than on the stairs, an all- too-common site of fall-related injuries in older adults. Prevention starts with understanding the unique demands of stair ascent and descent.
By Alison C. Novak, MSc, Samantha M. Reid, MSc, Patrick A. Costigan, PhD, and Brenda Brouwer, PhD
Preoperative exercise has been shown to improve total knee arthroplasty outcomes, but may not be feasible in patients with severe pain. Bracing and other offloading methods may be able to help.
By John Kenney, CO, and Robert Hamblen, MD
Rehabilitation science and medicine professionals are realizing that extracorporeal orthotics and prosthetics are sensory as well as functional substitution devices, and that these substitutions are equally important and mutually beneficial. Researchers have identified a high correlation co-efficient between normal body imagery and acquired sensory perception skills with orthotic- prosthetic control and manipulation skills.
By Michael T. Wilson, CPO/LP
Altering joint alignment is associated with decreased pain and improved function. Researchers are working to explain the mechanisms underlying these effects, particularly with respect to bracing.
By Yatin Kirane, D.Orth, PhD; Rebecca Zifchock, PhD; and Howard Hillstrom, PhD
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