Category Archives: Clinical News

Current Issue News

April 2020

Preventing Re-ulceration in Diabetes

In a recent short review, Michael J. Mueller, PT, PhD, FAPTA, provided 5 evidence-based suggestions for helping patients with diabetes and peripheral neuropathy (PN) safely and effectively increase their mobility after a healed foot ulcer. Mueller is a professor of physical therapy and radiology at Washington University School of Medicine in St. Louis. Continue reading

March 2020

AFO Configuration Can Improve Efficacy of the Orthotic Intervention on Gait Patterns in CP Patients

Cerebral Palsy (CP) represents the most common cause of motor disability in childhood with dysfunctional gait being one of the main problems. Early adoption of intervention programs adapted to the patient’s functional limitation and disability represent the current standard of care; therapeutic approaches include Ankle-Foot Orthoses (AFOs) for which the evidence shows they…

By Keith Loria Continue reading

March 2020

Negative-Pressure Wound Therapy in Diabetic Foot Ulcers

Use of negative-pressure wound therapy (NPWT) is growing in the management of complex wounds as well as foot and ankle surgery. Researchers from Rush University Medical Center in Chicago and Wake Forest Baptist Health Center in North Carolina recently published a review of the evidence for NPWT in Foot & Ankle International. Their findings related to diabetic foot and neuropathic ulcers are excerpted here. Continue reading

March 2020

Updated Treatment Guideline for OA Published

The American College of Rheumatology (ACR) and the Arthritis Foundation (AF) partnered to update and publish the 2019 ACR/AF Guideline for the Management of Osteoarthritis [OA] of the Hand, Hip and Knee. Last published in 2012, the updated guideline includes contributions to the literature since the last publication, and for the first time direct patient participation was incorporated.

By Laura Fonda Hochnadel Continue reading

March 2020

What you need to know about coronavirus disease 2019 (COVID-19)

Coronavirus disease 2019 (COVID-19) is a respiratory illness that can spread from person to person. The virus that causes COVID-19 is a novel coronavirus that was first identified during an investigation into an outbreak in Wuhan, China. COVID-19 is spreading from person to person in parts of the United States. Risk of infection with COVID-19 is higher for people who are close contacts of someone known to have COVID-19, for example healthcare workers, or household members. Continue reading

February 2020

One Claudication Question May Be Quick Screen for PAD

Peripheral Arterial Disease (PAD) affects more than 200 million adults around the world. If identified early, PAD is highly treatable and may prevent patients from suffering major adverce cardiac events (MACE) and major adverse limb events (MALE). The most important criterion for definition of PAD is an ankle-brachial index (ABI) below 0.90.

By Lynn Soban, PhD, MPH, RN Continue reading

February 2020

Science Meets Fun on National Biomechanics Day: April 8, 2020

National Biomechanics Day (NBD) is a worldwide celebration of biomechanics in its many forms for middle- and high-school students and their teachers. Designed to introduce biomechanics science and its applications to young minds around the world, the event seeks to teach young people about all that biomechanics contributes to society with the hope of encouraging them to pursue it as a career. Continue reading

February 2020

Study Shows Heel Lifts Affect Biomechanics, Muscle Function

Clinicians use a variety of in-shoe heel lifts to treat a range of musculoskeletal conditions. The mechanics of how these orthotic devices work, however, is unclear. So a group from LaTrobe University in Australia put together a study that asked this question: Do heel lifts affect lower limb biomechanics and muscle function during walking and running? Continue reading

February 2020

1064-nm Laser Technique Shows Positive Results for Onychocryptosis

Onychocryptosis, more commonly known as in-grown toenail, affects nearly 20% of all patients who present a foot problem to their doctor. Current treatments include incisional procedures and nonincisional procedures, such as chemical matrixectomies and physical matrixectomies using a carbon dioxide laser.

By Keith Loria Continue reading

February 2020

Custom AFO With Walking Shoes Improves Balance, Reduces Fear of Falling for Seniors

Research shows that one out of every four older Americans falls annually. Fall-related injuries continue to be a costly and debilitating health risk, costing the US healthcare system about $50 billion annually. More importantly, falling once doubles an older adult’s risk of falling again, increasing their fear of falling and negatively impacting quality of life. Continue reading

January 2020

Aquatic Walking Relieves Arterial Stiffness in PAD

Aquatic walking can help relieve arterial stiffness among patients with peripheral artery disease (PAD), according to results from a clinical trial published in the Journal of Applied Physiology. The study also showed that aquatic walking boosts patients’ ability to tolerate exercise, cardiorespiratory capacity, and muscular strength, and that patients are largely more inclined to maintain this exercise regimen.

By Chuck Green Continue reading

January 2020

Study Examines Treatment of Chronic Wound Pain with Long-Acting Lidocaine Gel

According to 2004 figures, about 6 million people suffer from chronic wounds due to bedsores and vascular, inflammatory, and rheumatologic sources, with medical costs for this care reaching almost $10 billion.* Opioids and non-opioid treatments are often used to manage the pain associated with these chronic wounds but come with issues such as the potential for addiction or abuse.

By Laura Fonda Hochnadel Continue reading

January 2020

Rehab May Improve 1st MTP Arthrodesis Long-term Outcomes

While arthrodesis of the first metatarsophalangeal (MTP) joint is known to alleviate pain from osteoarthritis in the hallux, long-term outcomes vary, with nearly 20% of patients reporting dissatisfaction with the surgical outcome. “There are a number of patients who have symptoms of pain, metatarsalgia, lateral toe arthritis or… Continue reading

January 2020

Are Lateral Ankle Sprains Being Treated Correctly?

Lateral ankle sprain is the most common injury in physically active populations, yet some believe those who sustain an acute lateral ankle sprain may not receive timely formal rehabilitation and are at an increased risk to have subsequent sprains which can lead to chronic pain and instability.

By Keith Loria Continue reading

October 2019

Bilateral Custom AFOs Reduce Fear of Falling, Up Physical Activity

For older adults who have fears about falling, the daily use of custom-made ankle-foot orthoses (AFOs) with walking shoes is effective in improving balance and reducing fear of falls, according to a recent study published in the journal Gerontology. In the elderly population, falls are a particularly serious problem. According to the US Centers for Disease Control and Prevention, about 3 million older patients are treated in emergency rooms for fall injuries each year.

By Robert Sberna Continue reading

October 2019

Wearable Tech May Enhance Benefits of Structured Exercise  

Combining structured exercise with wearable technology interventions designed to enhance non-exercise physical activity (NEPA) may help reduce cardiovascular disease (CVD) in high-risk older adults, according to a October 2019 study published in the online medical journal, Clinical Interventions in Aging. Researchers from the University of Alabama at…

By Douglas J. Guth  Continue reading

October 2019

AHA Scientific Statement on CLI Emphasizes Early Diagnosis, Treatment

Critical limb ischemia (CLI), a condition characterized by the narrowing or blocking of arteries that lead to the legs, is the most severe form of peripheral artery disease (PAD) and a leading cause of lower-limb amputation. Moreover, patients with CLI have high mortality rates. As such, early diagnosis and treatment are key, according to a scientific statement recently published by the American Heart Association (AHA) in its journal, Circulation. Continue reading

October 2019

Extra Cushioning May not Help Shoes Prevent Injuries

While innovations in running shoes have helped everyone from top athletes to casual joggers push the boundaries of speed, efforts to determine the characteristics of shoes that will help reduce injury risks are more elusive. In his lab at San Jose State University, JJ Hannigan, PhD, ATC, CSCS, is working to understand the way different levels of cushioning affect gait and running mechanics.

By Nicole Wetsman Continue reading

October 2019

Ankle Replacement System Receives FDA Premarket Approval

The Hintermann Series H3 Total Ankle Replacement System (DT MedTech, Towson, MD), received premarket approval from the US Food & Drug Administration (FDA). This is a non-cemented, implanted medical device intended to replace a painful arthritic ankle joint and improve ankle motion and is indicated for use in the first surgical treatment for the joint.

By Laura Fonda Hochnadel Continue reading

September 2019

Unilateral remote daily temperature monitoring to predict diabetic foot ulcers shows promise

Diabetic foot ulcers (DFUs), the primary antecedent to diabetes-related lower extremity amputation (LEA), are common, costly, and preventable. Following a period of decline in incidence, the Centers for Disease Control and Prevention found the occurrence of diabetes-related LEA had rebounded an alarming 50% percent between 2009 and 2015.

By Lynn Soban, PhD, MPH, RN Continue reading

September 2019

Association Between Running Shoe Characteristics and Lower Extremity Injuries in United States Military Academy Cadets

Running-related overuse injuries are very common among recreational runners with the reported annual injury rates ranging from 39% to 85%. There are few large prospective cohort studies investigating injury risk associated with different running shoe characteristics and they are often contradictory. Our goal was to prospectively investigate the relationship between running shoe…

By Gary Helton, PT, DSc, SCS, OCS Continue reading

September 2019

KneeKG Effective in Management of Knee Osteoarthritis

Knee osteoarthritis (OA), a chronic progressive disease, is a common complaint in adults over age 45. Indeed, osteoarthritis is the most common joint disorder in many countries, affecting for example 13.9% of adults 25 years and older and 33.6% of people 65 years and older in the United States. The challenge for clinicians is the multifactorial nature of the disease and understanding the everyday mechanical factors that affect it. Continue reading

September 2019

An Excerpt: Physical Frailty: ICFSR International Clinical Practice Guidelines for Identification and Management 

Frailty is prevalent in all countries and is a leading contributor to functional decline and early mortality in older adults. The condition is defined as “a clinical state in which there is an increase in an individual’s vulnerability for developing an increased dependency and/or mortality when exposed to a stressor.” Frailty can begin before 65 years of age, but the onset escalates in those aged 70 years and over. Continue reading

August 2019

AFOs and FES Offer Comparable Outcomes for Foot Drop in MS Patients

Foot drop is a common presentation in people who have multiple sclerosis (MS). The inability to lift the forefoot off the ground adequately, such as to clear curbs and stairs, affects gait and increases fall risk. Ankle–foot orthoses (AFOs) and functional electrical stimulation (FES)…

By Laura Fonda Hochnadel Continue reading

August 2019

Prevalence of Neuropathic Pain Symptoms

Managing pain in patients with foot and ankle pathology can be a challenge. In addition to nociceptive mechanisms, neuropathic mechanisms can contribute to pain in patients with orthopedic conditions and can be found in 10.5% to 53% of patients with chronic pain, depending on the location of the pathology. Continue reading