Lower Extremity Review
AFOs must find energy balance – The extent to which carbon composite ankle foot orthoses improve gait efficiency in stroke patients may be a function of walking speed, according to a Swedish study. And despite the fact that the devices are known for their energy storage, research from the Netherlands suggests that the relationship between energy storage and energy cost may be complicated.
Is earlier intervention needed? Researchers and clinicians are only beginning to understand the relationship between pediatric flexible flatfoot and obesity, which becomes even more complicated in the context of orthotic treatment. Findings from Hong Kong appear to throw another wrinkle into the mix, suggesting that obese children are significantly slower to respond to orthotic therapy than their normal-weight counterparts.
Biomechanics may offer clues – Too often, by the time Charcot neuroarthropathy is diagnosed, it is too late to do much more than accommodate the resulting deformity. That’s why researchers from Germany and the U.K. are working to find ways of screening for patients at risk for Charcot, which would facilitate earlier and more effective intervention.
But placebo findings raise questions – Three German studies presented at the ISPO meeting in Leipzig confirm that bracing for knee osteoarthritis is associated with both symptom improvement and biomechanical effects. But the findings also suggest that the relationship between those two sets of outcome measures is more complicated than one might think.
Fancy camera systems not required – A pressure measurement system is an essential clinical tool for maximizing orthotic outcomes that too many practitioners are not yet utilizing, according to two presentations at the FIP meeting in Amsterdam.
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