Category Archives: Feature Article

Featured Issue Article

August 2014

AFO tuning: Balancing function and satisfaction

Tuning of ankle foot orthoses (AFOs) and AFO-footwear combinations can significantly improve gait in patients with neuromuscular impairments. Even so, some pa- t­ients still prefer their untuned devices, which has led researchers and clinicians to reexamine their approach to intervention.

By Cary Groner Continue reading

August 2014

Return of strength after Achilles tendon surgery

Despite excellent subjective outcomes following Achilles tendon repair, significant plantar flexion and dorsiflexion strength deficits often persist. However, modern trends in postoperative rehabilitation represent a progression toward a more functional strength recovery.

By David A. Porter, MD, PhD, Kirk Cleland, MD, and Angela M. Rund, MEd, ATC Continue reading

August 2014

Flexible flatfoot: Foot orthoses and outcomes

Many studies have shown an effect of foot orthoses on biomechanical function in patients with flexible flatfoot, but few studies have focused on patient-centered outcomes. There is a need to investigate the effect of foot orthoses on pain and fatigue in these individuals over time.

By Sarah A. Curran, PhD Continue reading

August 2014

Running shoe mass: Can feet tell any difference?

Research suggests that when trying on athletic shoes in a retail store, an individual’s perceptions of shoe mass primarily come from handling the shoes and less (if at all) from test-wearing them. In addition, the foot’s perception of shoe mass does not appear to improve with practice.

By Joel G. Greenya, BS, Stephen J. Slade, BS, Christopher L. Kliethermes, PhD, and David S. Senchina, PhD Continue reading

August 2014

Dynamic compression for recovery in athletes

US Olympic Committee researchers have found that peristaltic pulse compression of the lower extremities may provide a means of enhancing the rheological properties of the lower extremities without resorting to extreme temperatures, expensive body work, or stretching.

By William A Sands, PhD, FACSM, CSCS Continue reading

July 2014

Functional movement tests and injury risk in athletes

Efficient, low-cost, field-ready functional movement tests may be useful in preparticipation physicals to identify and provide preventive treatment for individuals with an elevated risk of injury, as well as aiding return-to-sport…

By Kathryn Schwartzkopf-Phifer, PT, DPT, OCS, CSCS, and Kyle Kiesel, PT, PhD, ATC Continue reading

July 2014

Studies explore statin use for lower limb indications

A growing body of research suggests that statins may help improve not just cardiovascular outcomes but also those associated with lower extremity conditions such as peripheral arterial disease and knee…

By Larry Hand Continue reading

July 2014

Revisiting the status quo for AFO strap placement

Conventional wisdom says dorsal straps for ankle foot orthoses should be positioned at a certain angle to resist heel rise. Now preliminary research from Georgia Tech is calling that practice into question…

By P.K. Daniel Continue reading

July 2014

Foot ulceration in patients with rheumatoid arthritis

Research has identified ankle-brachial index, loss of sensation, and deformity as predictors of foot ulceration in patients with rheumatoid arthritis, and also suggests that ulceration influences…

By Jill Firth, PhD, BSc (Hons), and Heidi J Siddle, PhD, MSc, BSc (Hons)
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June 2014

Patient Perspective: Walking 600 miles is tough; plantar fasciitis is tougher

In 2008 I walked the 500-mile Camino de Santiago, the medieval pilgrimage route through northern Spain leading to the Cathedral of Santiago de Compostela. It was my first long distance walk, and because I completed it without injury, pain, or a blister, I fancied myself a walking superhero, immune to suffering or discomfort.

By Laura Potts Continue reading

June 2014

Managing foot and ankle injuries in baseball players

Baseball players at all skill levels routinely suffer from foot and ankle injuries, with position players being afflicted more often than pitchers or catchers. Making the correct initial diagnosis without delay can lead to more rapid and effective treatment, rehabilitation, and return to play.

By Gabriel V. Gambardella, DPM, Jeffrey Delott, DPM, and Zachary J. Korwek Continue reading

June 2014

A virtual reality approach to lower extremity rehab

When commercially available active video games are used in rehabilitation settings, often the level of challenge does not match the patient’s ability level. Customized interventions can address these limitations while capitalizing on the fun and motivating aspects of the technology.

By Rachel Proffitt, OTD, OTR/L Continue reading

June 2014

Cost-benefit data support reconstruction of ACL tears

In both the short term and the long term, anterior cruciate ligament reconstruction produced greater quality of life improvements at a lower cost compared with rehabilitation only, suggesting that limiting access to ACL reconstruction may be harmful to patients and costly to society.

By Richard C. Mather III, MD, and Lane Koenig, PhD Continue reading

June 2014

Effects of targeted exercise on chronic ankle instability

Clinicians and researchers are increasingly utilizing exercise protocols focused on improving proprioception, range of motion, and strength to influence the more active and functional deficits that have been associated with chronic ankle instability in the literature.

By Mark A. Feger, MEd, ATC, and Jay Hertel, PhD, ATC Continue reading

May 2014

Healing hypoxic wounds: Fighting an uphill battle

A lack of oxygen can negatively affect wound healing in a number of ways, but surgical, pharmacological, and other technological advances are allowing clinicians to enhance oxygen delivery to damaged tissues and…

By Nanjin Park, DPM; Latricia Allen, DPM, MPH; Mary Nametka, MSN, RN, CWS, CWON, FNP-BC; Vickie R. Driver, MS, DPM, FACFAS Continue reading

May 2014

Elastic therapeutic tape: Applications at the ankle

Research on the use of elastic therapeutic tape in patients with chronic ankle instability is limited, but recent findings do suggest that leaving the elastic tape on for several days is associated with improvements in…

By Janet Simon, MS, ATC; Emily Hall, MS, ATC; and Carrie Docherty, PhD, ATC Continue reading

May 2014

Knee OA guidelines take patient-centric approach

Updated guidelines and new appropriate use criteria for nonoperative management of knee osteoarthritis aim to focus more directly on typical knee OA patients, who often have comorbidities that can complicate care and…

By Larry Hand Continue reading

May 2014

Clinicians’ shoes can send mixed message to patients

Patients often look to foot and ankle practitioners for advice about footwear choices. But a recent survey of physicians found that nearly half don’t educate their patients about footwear guidelines, and that only one in…

By Daniel Farber, MD Continue reading

April 2014

Patient Perspective: Taking an alternative path to chronic foot pain relief

After a year in a fracture boot with a broken foot, I thought my ordeal was over. I was wrong. The broken bone in my foot, sustained after a fall down a staircase in my home, had occurred midway down the fifth metatarsal bone below my little toe—a site that is notoriously difficult to heal, according to my podiatrist.

By Barbara Boughton Continue reading

April 2014

Cyclists and foot orthoses: A unique set of challenges

Finding the right orthotic design starts with the space limitations presented by cycling shoes, but the challenges for lower extremity practitioners don’t end there. Factors to consider when prescribing foot orthoses include biomechanics, skill level, cycling discipline, and bike technology.

By P.K. Daniel

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April 2014

Foam rolling: Early study findings suggest benefits

Foam rolling is a relatively new therapeutic approach, but early research suggests that it can help improve range of motion and muscle performance and aid in recovery after exercise. Questions remain, however, about the extent to which the effects involve myofascial mechanisms.

By Duane C. Button, PhD, CSEP-CEP, and David G. Behm, PhD

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April 2014

Foot and ankle strategies for patients at risk for falls

As a result of limitations in the fall prevention research to date, investigators and
clinicians are often left to make their best guesses about the effect of foot and ankle interventions based on the effect such strategies have on issues related to falls, rather than on falls themselves.

By Cary Groner

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April 2014

Vitamin D and knee OA: Many theories, few answers

Several patient populations with an increased risk of knee osteoarthritis also are at increased risk for vitamin D deficiency, and research suggests vitamin D levels may be related to knee OA symptoms. The exact nature of the relationship, however, remains perplexing.

By Greg Gargiulo Continue reading

March 2014

Active Stance: Developing the sustainable knee in an age of early TKA

To sustain is to endure. Knee osteoarthritis (OA) is a considerable worldwide health concern, as it greatly impacts an individual’s quality of life, general health, and societal role participation.

By John Nyland, DPT, SCS, EdD, ATC, CSCS, FACSM, David N.M. Caborn, MD, and Roland Jakob, MD

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March 2014

Functional tests to predict lower extremity injury risk

Adding four functional tests to the preparticipation physical evaluations performed in student athletes may allow clinicians to identify individuals at risk for lower extremity musculoskeletal injury and implement preventive interventions to maximize safe­ty in sports participation.

By Alexis Meister, BS, ATC; Dustin Grooms, MEd, ATC, CSCS; Cambrie Starkel, MS; and James Onate, PhD, ATC, FNATA Continue reading