August 2019

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Cover Story


Pregnancy Changes the Body: Here’s What That Means for Gait, Balance, and Falls

About a quarter of women fall during pregnancy and 10% fall more than once. Understanding the biomechanical changes of this transitional period may help researchers find ways to prevent such falls. When Robert Catena’s wife was pregnant and working at a restaurant, she fell. It was scary, he says, but everything was ok.

By Nicole Wetsman

 

Guest Editorial


Force and Pressure: Understanding Differences and Purposes

Whenever I talk about foot pressure-mapping technology during my courses or keynote lectures at international conferences, I am always surprised by the volume of misunderstanding that surrounds  force and pressure measurements and questions about differences between them.

By Antonio Robustelli, MSc, CSCS

Feature Articles


Early Orthotic Intervention in Pediatric Patients, Part I: Cerebral Palsy

Children with cerebral palsy (CP) typically encounter a host of gait- and balance-related issues associated with spasticity, dyskinesia, and weakness. How severe these are depends on CP type and the individual case. As a result, experts have long debated how early to intervene with bracing strategies that include ankle-foot orthoses (AFOs), and how long to maintain those interventions.

By Cary Groner

Healthcare Provider-Implemented Foot Evaluations for Walking Exercise Programs

Encouraging exercise and appropriate footwear selection may be key in helping patients maintain healthy activity levels. Exercise is recommended for the majority of patients regardless of age, gender, or physical disability. The 2008 Physical Activity Guidelines for Americans1 recommended that all adults perform 150 minutes…

By Audris Tien, DPM, Brad Franklin, DNP, RN, FNP-C, FAANP, and Jarrod Shapiro, DPM, FACFAOM, FACFAS

Chronic Ankle Pain? Put Os Trigonum Fracture in the Differential

This overlooked, often-left-undiagnosed ankle pathology causes long-term pain and instability. Appropriate treatment protocols, applied in a timely manner, can get patients back on their feet. The ankle presents an interesting dichotomy of strength and frailty: Whereas the ankle supports body weight, makes sharp twists and turns, and keeps the body from falling…

By Scott Pensivy, PT, LAT, ATC

From the Literature


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

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.

Orthotic insoles for people with diabetes at-risk of ulceration

This study focused on pressure-relieving orthotic insoles designed for retail footwear and people with diabetes and at risk of first forefoot ulceration. The aim was to investigate whether the pressure-relieving effects of a customized metatarsal bar and forefoot cushioning are sensitive to bar location and shape, and material choice.

By Ana Martinez-Santos, Stephen Preece, and Christopher J. Nester

Industry News & Updates


MedShape Launches DynaNail Mini Fusion System

MedShape, Atlanta, GA, an orthopedic device manufacturer, announced the launch of its DynaNail Mini™ Fusion System, which is available in 7mm and 8mm diameters and 60mm to 100mm lengths. Featuring MedShape’s patented superelastic nickel titanium (NiTiNOL) technology, the DynaNail Mini is the first orthopedic device designed specifically for subtalar fusion that offers…

Policy Article Revised for Therapeutic Shoes

The Durable Medical Equipment (DME) Medicare Administrative Contractor (MAC) Policy Article (PA) for Therapeutic Shoes for Persons with Diabetes was recently revised, as follows. The effective date is January 1, 2019.

New DME QIC Contract Effective September 1

Effective September 1, the Durable Medical Equipment (DME) Qualified Independent Contractor (QIC) contract for administering all reconsiderations (second-level appeals) on processed DME claims has been transitioned to the contract awardee, MAXIMUS Federal Services. All reconsideration requests must now be submitted to Maximus Federal Services…

PT Professor Authors New Guideline to Treat PFP

University of Montana (UM) Assistant Professor Richard Willy, PT, PhD, is the lead author on a paper that offers new guidelines for treating patellofemoral pain (PFP), often known as runner’s knee. PFP affects 25% of the general population every year, with women reporting PFP twice as often as men.

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