Category Archives: Clinical News
November 2018
New NATA Recommendations Address Patellofemoral Pain
Patellofemoral pain (PFP), one of the most common knee problems in active people, is also one of the most challenging conditions to manage, due to its complex nature. To support athletic trainers and other healthcare providers who treat the problem, the National Athletic Trainers’ Association (NATA) has published recommendations and a framework for identifying risk factors and managing patients who experience PFP. Continue reading
November 2018
Poor Balance Tied to Visual Acuity–Peripheral Vascular Disease Interaction
Poor vision has long been known as a risk factor for poor balance. This is particularly true in older adults as they perform complex balancing tasks, such as standing on 1 foot. A team of Canadian researchers wanted to determine whether poor vision would be more strongly related to standing balance in older adults who had peripheral vascular disease (PVD) or diabetes.
November 2018
ADA Issues New Guidelines for Youth with T2D
Youth-onset type 2 diabetes (T2D), defined as T2D that develops before 20 years of age, is a growing medical challenge in the United States. A national study reported a 4.8% increase in newly diagnosed cases of T2D in this age group from 2002 to 2012. Continue reading
November 2018
VA Reports Downward Trend in Surgical Adverse Events
In an 8-year quality improvement follow-up study of reported surgical adverse events (AEs) at the US Veterans Health Administration (VHA), researchers found 277 AEs and 206 “close calls.” The data show a continuing of the downward trend from 1.74 to 0.47 AEs with harm for every 100,000 procedures, compared to the previous similar VHA studies (the periods 2001-2006 and 2006-2009). Continue reading
November 2018
HIPAA Violations Can Be Costly
A Connecticut allergy practice has agreed to pay $125,000 and enter a corrective action plan to settle an alleged Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule violation. According to the US Department of Health and Human Services (HHS), the violation occurred when one of the practice’s physicians disclosed a patient’s protected health information to a member of the media. Continue reading
May 2018
Wearable sensors assess relationship between foot problems and frailty
Assessing how foot problems— namely, pain, neuropathy, and deformity— contribute to frailty syndrome has been a challenge for researchers, as transporting frail elders to lab facilities creates its own set of issues. But a recent study from the University of Arizona used wearable sensors to assess the seniors in their “natural” environment and found significant relationships between the number of foot problems and degree of frailty. Continue reading
May 2018
Three-year follow-up: Close contact casting vs surgery
In a pre-specified, 3-year extension of a randomized clinical trial of equivalence, close-contact casting maintained equivalence in function compared to surgery in older adults with unstable ankle fracture. Furthermore, no significant differences were reported in quality of life or pain. The authors concluded that the focus of treatment for these patients should be on obtaining and maintaining reduction until union, using the most conservative means possible. Continue reading
May 2018
Lower-extremity amputation feared more than death
Both type 1 and type 2 diabetes are known for their life-threatening complications—in particular, blindness from retinopathy, kidney failure, and peripheral neuropathy. For patients with diabetes and foot pathology, amputation is a significant worry. A recent study in Foot & Ankle Specialist sought to understand just how much this population fears lower-extremity amputation (LEA).
May 2018
Wasp stings: Some really do hurt more than others, and how to counsel patients
As summer approaches and we become more active outdoors, wasps will become more active, too. Two recent studies highlight the pain and danger of the ubiquitous wasp. The first study, from entomologists at the University of Utah, looked at stinger length compared to reported pain and toxicity.1 Continue reading
May 2018
Flip flops, bare feet, or sports shoes: Which are best and which are worst?
Many have long suspected the answer, but a new study would appear to resolve the question: Are flip flops really that bad for your feet? According to Chen and colleagues from the Department of Biomedical Engineering at The Hong Kong Polytechnic University, flip flops are most likely no better than barefoot when it comes to lower-limb co-contraction and joint contact force in the ankle. Continue reading
April 2018
Treatment for post-stroke spastic equinovarus and plantar flexor spasticity
Spasticity occurs in 20% to 40% of stroke patients. Two new studies add to the body of evidence supporting the use of botulinum toxin type A (BT-A) injections for post-stroke spasticity: the first looked at the ideal timing of injections for plantar flexor spasticity, and the second looked at ultrasound-guided injections for spastic equinovarus. Continue reading
April 2018
Crossover prosthetic design
Prosthetic feet are typically optimized for a narrow range of activities, meaning active prosthetic users may need more than 1 prosthesis to fully participate in activities with varying degrees of impact. Modern energy-storing feet (ESF) support users’ ability to walk at differing speeds, as well as support static standing, but they can limit aerobic activities and running speeds. Running-specific feet (RSF), while ideal for running and sprinting, do not support low impact activities, particularly standing or walking. Continue reading
April 2018
Post-operative complications after Achilles tendon rupture repair
Achilles tendon rupture (ATR) is one of the most common injuries resulting from sports and exercise activities. Its resulting functional deficits can last more than 2 years from the original injury. While traditionally it has been an injury seen more among men, prevalence among women has been increasing, most likely due to increased participation in recreational sports. Continue reading
April 2018
Low-cost trans-femoral prosthesis uses plantar insole sensors
Indian researchers have designed a trans-femoral prothesis with plantar insole sensors that they found allow users to achieve near able-bodied gait kinematics. The passive prosthesis uses a magneto-rheological (MR) damping system with electronic control based on plantar insole feedback Continue reading
April 2018
Supportive footwear for children with CMT
The effect of footwear on gait and balance of children and adolescents with Charcot-Marie-Tooth (CMT) disease is of interest to parents and clinicians. Children with CMT, which causes progressive damage to peripheral nerves, particularly the feet and ankles, often have gait difficulties due to muscle weakness, including problems with balance, resulting in falls. Continue reading
April 2018
Study assesses role of corticosteroid therapy in Achilles tendinopathy
Achilles tendinopathy is the most common overuse injury in sport, and it is common in non-athletes as well. High volume image guided injection and structured rehabilitation (HVIGI+SR) has been shown in repeated studies to provide significant improvement in… Continue reading
March 2018
Study finds little difference between DMO and PMO for hallux valgus
Guiding patients to make the most appropriate choice among options to correct hallux valgus has long been a challenge: Distal metatarsal osteotomy (DMO) is liked for its shorter incision, low level of invasiveness, lower complication rate, and its ability to improve pain and functionality across a wider range of deformities. Continue reading
March 2018
Center of pressure in normal, pes planus, and pes cavus feet
To better understand the association of non-normal foot postures with an increased risk of injury to the lower extremity, Australian researchers evaluated center of pressure (COP) in adults with pes planus, pes cavus, or normal feet. Continue reading
March 2018
Midfoot mobility and patellofemoral pain
Seeking to better understand foot mobility in adults with patellofemoral pain (PFP, or so-called runner’s knee), Australian researchers studied almost 200 adults aged 18 to 50 years. Both weight-bearing and non-weight-bearing measures were used to calculate… Continue reading
March 2018
Foot pain, ill-fitted footwear increase risk of falls in elderly
Foot pain and poor-fitting footwear are among the well-known risk factors for falls among the elderly. Two new studies from Spain sought to quantify the significance of these issues in the elderly by looking at lesser toe deformities (LTD) in a general population, and footwear fit among those with Alzheimer’s disease. Continue reading
March 2018
Reliability of FPI-6 in older adults warrants caution
Because it uses 6 items to quantify and classify foot pressure, the Foot Pressure Index-6 (FPI-6) is considered a more complete measure than many others. The FPI-6 has been validated for use with adults aged 18 to 57, where it can play a role in identifying risk factors for sports and training injuries. Continue reading
March 2018
Neuromuscular training in high-risk female adolescent athletes
Noting that an up to 10-fold increased risk of injury has been demonstrated in female athletes compared with male athletes, particularly for anterior cruciate ligament (ACL) sprains, patellofemoral pain, and ankle injuries, researchers sought to evaluate the effects of… Continue reading
March 2018
How might power training improve gait in older adults?
Building on previous data that tentatively supports the possibility that power training could induce changes in neuromuscular activation during level walking in older adults, researchers tested the effects of a 10-week… Continue reading
March 2018
Effects of running-specific prostheses at varying speeds
Most previous studies on running mechanics in amputees have used prostheses originally designed for walking, and those that have looked at running mechanics using prostheses designed for running have focused on sprinting. Continue reading
February 2018
Exercising arms improves post-stroke walking
Canadian researchers have demonstrated that that arm exercises—specifically, cycling the arms—improves post-stroke gait. The authors said this is the first study to test the effect of arm training on post-stroke leg function, even years after the event. The results appear in the Journal of Neurophysiology. Continue reading
