Lower Extremity Review
The authors present four cases of complex lower extremity reconstruction involving segmental bone loss and deformity – failed total ankle arthroplasty, talus avascular necrosis, ballistic trauma, and nonunion of a tibial osteotomy.
By Rishin J. Kadakia, MD, Colleen M. Wixted, Nicholas B. Allen, Andrew E. Hanselman, MD, and Samuel B. Adams, MD
Foot drop, a complex condition that can have a significant impact on independent ambulation, can have many causes. Treatment options vary by cause. These authors provide a review of the condition from etiology through treatment. Foot drop (also known as steppage gait) is an inability to lift the forefoot due to the weakness of dorsiflexors of the foot. This, in turn, can lead to an unsafe antalgic gait, potentially resulting in falls.
By Subhadra L. Nori, MD, and Michael F. Stretanski, DO
Researchers from Korea have developed a new type of AFO that uses neoprene and a novel wire configuration for use with foot drop after stroke. Foot drop can be a sequela of stroke. An ankle–foot orthosis (AFO) is the most widely used method to prevent foot drop in patients with stroke, and is used during weight-bearing training of the limb on the affected side or when there is ankle spasticity or deformity.
By Jung-Hoon Lee, Im-Rak Choi, and Hyun-Su Choi
Research is showing that it’s not “just an ankle sprain,” but rather the first step on a perilous journey to physical instability and lower quality of life. The clinical presentation of chronic ankle instability (CAI) has been defined as the perceived or subjective instability with feelings of giving way, pain, and recurrent sprains.
In a study that debuted at the National Athletic Trainers Association virtual meeting and was subsequently published later, a multidisciplinary team of clinicians sought to analyze the effects of visual gait biofeedback along with impairment-based rehabilitation on gait biomechanics in a group of patients with chronic ankle instability (CAI).
This 2-part series examines the current state of peripheral artery disease. This article focuses on disease burden, risk factors, and clinical presentation. Part 2, which will appear next month, will examine current recommendations for diagnosis and treatment.
By Aisha Cobbs, PhD
With existing knowledge, much of the cardiovascular risk burden of peripheral artery disease (PAD) is preventable. PAD is a common atherosclerotic syndrome that is estimated to affect 12.5 million Americans and 237 million people worldwide.1 One in five Americans over the age of 65 has PAD.2 Based on national treatment patterns, more than half of all patients with PAD do not know they have it.
By Sue Duval, PhD
Reported incidence rates for ankle sprains range from 15% to 45%. This study looked at self-reported ankle instability in regional European football players and found that age and injury repetition as well as exposure time and position on the field were associated with instability rates, suggesting the need for specific prevention strategies.
By A. Cruz, R. Oliveira, A.G. Silva
Foam rolling and roller massage, instrument-assisted soft tissue mobilization, and percussion massage are all the rage amongst consumers all along today’s fitness continuum. But what is the evidence base for the countless claims proponents offer? These authors provide a review of the peer-reviewed literature.
By Linden A. Lechner, BSc; Michael A. Rosenblat, PT, PhD(c), CEP; and Leanne M. Ramer, PhD
When conservative therapies fail, surgical reconstruction of the foot is often required to restore function, heal ulcerations, and decrease risk of amputation in patients with CN. External fixation remains a reliable method, with plenty of advantages.
By P. Tanner Shaffer, DPM, Jonathan Hook, DPM, FACFAS, and Ben Potter, DPM
A trained Pilates professional in a fully equipped studio can help your patient make significant improvement in strength and flexibility by addressing postural habits and alignment problems. Joseph Hubertus Pilates began development of his method – a body–mind approach to exercise –in the early 1920s. As a child, Pilates suffered from asthma, rickets, and rheumatic fever.
By Marianne Adams, MA, MFA
Unique partnership between University Hospitals’ Sports Medicine Team and the Cleveland Ballet focuses on performer preparation to avoid long-term problems. Efficient movement in ballet is easy to recognize, as every step the dancer takes flows seamlessly into the next, representing a perfect balance of muscular engagement and release.
By Douglas J. Guth
Over the past decades, pronation has been discussed as a potential risk factor for injuries or as the mechanism behind impact damping. However, little is understood about pronation. The objectives of this paper were to (a) define and differentiate between the terms of pronation and eversion, (b & c) underline the importance and problematic aspects of pronation.
By Benno Nigg, Anja-Verena Behling, and Joseph Hamill
Empower athletes and work in partnership with them to reduce their risk and severity of overuse injury and keep them at the level of performance they want. Getting better at any sport, at any level, takes practice, commitment—and repetition. Basketball players shoot jump shot after jump shot, soccer players drill footwork, and cross-country athletes log seemingly endless miles.
By Nicole Wetsman
Why are female basketball players increasingly at risk of lower-extremity injury? How should an injury prevention program for them be devised and implemented? The authors undertook a team study to find the answers. Knee injuries account for 10% to 25% of sports-related injuries.
By Major Kyle East, PT, DPT, DSC; Lieutenant Commander Lauren Brown, PT, DPT, DSC; and Colonel Donald Goss, PT, PHD
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