Lower Extremity Review
One of the most-talked-about images from the 2013 Orthotics Technology Forum (OTF) depicted 11 custom foot orthoses made by 11 experienced orthotists and podiatrists for a single patient. All 11 practitioners had been given the same information about the patient’s condition, yet all 11 orthoses were distinctly different.
The Orthotics Technology Forum presentation given by Ben Boyer, CPed, was as much about what the speaker was wearing as what he was saying. Boyer, who is the lab manager at Kintec in Vancouver, Canada, wore a product he thinks may represent part of the future of orthotic design and manufacture—orthoses he’d printed with a hobbyist-level desktop 3D printer.
The need to replace entrenched processes and thinking with fluid, fast-moving orthotic design and manufacture that minimizes errors and maximizes resources was highlighted by several speakers at the Orthotics Technology Forum, including Jarret Eschenburg, CPed, director of operations at Coral Springs, FL-based SureFit, a subsidiary of Hanger.
Lower extremity practitioners were among the first responders after two explosions ravaged the Boston Marathon last month, and are continuing to help heal the hundreds of victims who lost limbs or experienced other traumatic lower extremity injuries.
By Emily Delzell
Brace wear time, not torque, is key – Dynamic orthoses offer an effective alternative to static devices for management of tip-toe gait and knee flexion contracture in children with cerebral palsy (CP), particularly because the dynamic devices are associated with greater compliance, according to separate studies from Sweden and France.
A Taiwanese study offers more evidence that offloading knee braces and wedged foot orthoses are both associated with significant biomechanical improvements in patients with knee osteoarthritis (OA).
A rocker bar proximally positioned on a running shoe can relieve tension on the Achilles tendon as well as reduce the force required of the calf muscles during walking and slow running, according to research from the Netherlands.
Swedes also find low ulceration rate – Research from Sweden and Egypt provides more evidence that foot orthoses can significantly decrease plantar pressures in patients with diabetes, theoretically reducing the risk of foot ulcers and lower extremity amputation.
Orthotic management of pediatric talipes planovalgus starting at an early age is associated with significant improvement in weightbearing arch structure, according to research from Saga University in Japan.
Tibial inclination appears significant – Orthotic walkers have significant effects on proximal joint mechanics during gait, the extent of which appear to depend on individual device design, according to research from the University of Central Lancashire in the UK.
What appears to be idiopathic scoliosis may actually be functional scoliosis that can be effectively treated with foot orthoses in children who are hyperpronators, according to research from Chungnam National University in Daejeon, South Korea.
Functional balance test scores rise – Use of an ankle foot orthosis (AFO) within six weeks of stroke results in better balance outcomes and earlier independent ambulation than if AFO use is delayed, according to research from the Netherlands.
The Ponseti method of clubfoot management has achieved worldwide acceptance, but practitioners and researchers are still working to identify the best ways to optimize clinical outcomes while remaining sensitive to issues of cost effectiveness and cultural...
Treatment of children with clubfoot has evolved considerably in the five years that have elapsed since the inaugural International Clubfoot Symposium, and the benefits of this evolution are particularly evident in resource-poor nations—home to about 80% of the 200,000 children born each year with clubfoot. But practitioners who treat patients in these areas still face financial, cultural, and logistical challenges.
By Emily Delzell
Clubfoot correction ideally should be performed during infancy, before children learn to walk, but experts agree that the Ponseti treatment method can also be effective in older children. Speakers at the International Clubfoot Symposium in October presented successful outcomes for Ponseti treatment of neglected clubfoot in patients aged up to 21 years.
By Jordana Bieze Foster
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