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March 2013

Active Stance: Rethinking the concept of excessive pronation

Anterior knee pain is one of the most common injuries affecting runners, accounting for 25% of all running injuries.1 The etiology of anterior knee pain is multifactorial in nature,2 but one of the most commonly cited biomechanical risk factors is excessive rearfoot pronation.

By Pedro Rodrigues, MS, PT, PhD, Trampas TenBroek, PhD, and Joseph Hamill, PhD

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March 2013

Foot ulcer experts weigh use of hyperbaric oxygen

Two February publications sum up the polarizing nature of hyperbaric oxygen therapy (HBOT) for treating recalcitrant diabetic foot ulcers. A meta-analysis supported use of HBOT, while a large cohort study found a lack of effectiveness in community-care settings.

By Larry Hand

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March 2013

Exercise helps reduce claudication symptoms

Research suggests that exercise therapy can help reverse the ambulatory impairments associated with lower extremity pain in patients with peripheral arterial disease. The next step is to determine the methods of exercise therapy most likely to result in optimal outcomes.

By Ana I. Casanegra, MD, Omar L. Esponda, MD, and Andrew W. Gardner, PhD

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March 2013

The role of varus thrust in knee osteoarthritis

Varus thrust is a characteristic of dynamic alignment that has been shown to be predictive of medial tibiofemoral structural progression. Treatments aimed at minimizing varus thrust may reduce structural progression and symptoms related to knee osteoarthritis.

By Grace Hsiao-Wei Lo, MD, MSc

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March 2013

Foot orthoses and injury prevention in football

Team practitioners at the United States Naval Academy designed an orthotic intervention to prevent turf toe and Lisfranc sprains in football linemen and gained valuable insights about how players’ preferences and predispositions can affect compliance.

By CAPT Jeff Fair, EdD, ATC, LAT; CAPT David Keblish, MD; and LCDR Anthony Rabaiotti, DPM

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February 2013

Over the Edge: Lower extremity injuries in figure skaters

Competitive figure skating today is much less about artistry and much more about athleticism than in years past. Training is longer and harder than ever, while the classic unforgiving skate boot design has remained essentially unchanged. And lower extremity injuries in skaters are on the rise.

By Nathan W. Saunders, MA, and Steven T. Devor, PhD, FACSM

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February 2013

Assessing alternatives to first MTP joint fusion

Arthrodesis remains effective for most patients with end-stage hallux rigidus, but finding an alternative that allows more range of motion can be challenging. Faced with disappointing arthroplasty outcomes, surgeons have had to get creative.

By Cary Groner

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February 2013

Hemiplegic CP: Effects in the uninvolved limb

In patients with spastic hemiplegic CP, practitioners and researchers tend to focus primarily on the hemiplegic limb. But hemiplegia also leads to impairments in the uninvolved limb, which are important to consider when designing a therapeutic approach.

By Julieanne P. Sees, DO, and Freeman Miller, MD

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February 2013

Footwear properties and football injuries

Excessive rotational traction that occurs at the interface between the shoe and the playing surface, as well as shoe properties such as rotational stiffness, may have the potential to influence the high incidence of lower extremity injuries in athletes.

By Feng Wei, PhD, and Eric G. Meyer, PhD

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February 2013

Trends in materials, part II: Foot orthoses

This two-part series examines trends and techniques in materials development and fabrication. This second installation focuses on technological advances that are likely to affect the structural properties and manufac­­ture of in-shoe foot orthoses.

By Cary Groner

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February 2013

The influence of obesity on ankle fracture risk

Obese patients are more likely than nonobese individuals to sustain an ankle fracture, particularly a severe ankle fracture. Contributing factors may include increased torque on the ankle or low bone mineral density relative to body weight.

By Christy King, DPM, AACFAS
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January 2013

The value of walking in children with CP: A matter of perception

The achievement of independent walking is a major focus of rehabilitation for children with cerebral palsy (CP). Even when mobility could be achieved more easily through the use of assistive technologies such as wheelchairs, independent walking is typically pursued as a major rehabilitation goal and other forms of mobility are often discouraged.

By Barbara E. Gibson, BMR(PT), MSc, PhD

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January 2013

Lower extremity effects of detraining in athletes

Evidence suggests that when an athlete stops or tapers his or her training, the resulting effects on endurance, strength, balance, and lower extremity biomechanics may increase the risk of injury. Understanding these effects can help prac­ti­tioners minimize injury risks.

By Boyi Dai, PhD, and Jason C. Gillette, PhD

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January 2013

Trends and techniques in materials, part I: O&P

This two-part series examines trends in materials development and fabrication. This first installment focuses on how material strength, stiffness, and other variables affect the structural properties and design of orthotic and prosthetic devices.

By Cary Groner

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January 2013

Choosing children’s shoes: Mechanical considerations

Children’s shoes often are designed to look like adult shoes but lack the same structural components. Perhaps not surprisingly, research has dem­on­strated that running kinematics and kinetics differ significantly between seemingly similar child and adult shoes.

By Janet S. Dufek, PhD, Dana Forrest, MS, and John A. Mercer, PhD

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January 2013

Ankle instability treatment focuses on postural control

Interventions to improve postural control in patients with functional ankle instability include strength training, balance training, taping, bracing, and foot orthoses, but further research is needed to determine which therapeutic approaches work best in which patients.

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

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January 2013

Whole body vibration for knee osteoarthritis

Whole body vibration may help improve strength and function in patients with knee osteoarthritis and may even slow disease progression. But contradictory findings, a lack of consensus on optimal parameters, and safety issues have even WBV advocates proceeding with caution.

By Cary Groner

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January 2013

Exploring mechanisms of diabetic foot ulceration

Prevention and treatment of foot ulcers in patients with diabetes requires an understanding of the various factors that contribute to increased risk, including anatomical deformity, poor vascular function, and di­min­ished capacity for healing at a microscopic level.

By Allyson Berglund, DPM, Matthew Juriga, DPM, Aristidis Veves, MD, DSc, and Thanh Dinh, DPM

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December 2012

Company Profiles: Technology

December 2012

Company Profiles: Pediatric

December 2012

Company Profiles: Knee

December 2012

Company Profiles: Foot

December 2012

Company Profiles: Fabrication

December 2012

Company Profiles: Ankle

November 2012

Genetics: The future of injury prevention

Evidence is linking genetic mutations to Achilles tendon and anterior cruciate ligament injuries as researchers try to connect complex motor control processes to small segments of DNA. But genetic testing is still a long way from becoming a clinical tool.

By Larry Hand

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