Cover Story
Exercise is a cornerstone of treatment for diabetes, but for years patients with peripheral neuropathy have been discouraged from weight-bearing exercise for fear of further increasing ulceration risks. Now new research is turning that advice on its head.
By Cary Groner
Publisher’s Memo
Another year has virtually flown by, and I am so happy to share with you LER’s progress as an organization in the past year. Thanks in no small part to you, our readers, we have experienced a lot of exciting accomplishments and achieved some key goals that I had set when I started the magazine.
Richard ...
Editor Message
Those investigating alleged improprieties associated with a 2007 study on hip protectors will tell you their efforts are all about ethics. But the way I see it, the more important lesson to be learned from this situation is one of biomechanics, specifically the clinical importance of the subtleties of asymmetry.
Jordana Bieze Foster, Editor
Special Section:
KID STUFF: Pediatric clinical news update
In this special section, LER updates you on the latest research and clinical news to help optimize management of your littlest lower extremity patients. Topics include pediatric flexible flatfoot, cerebral palsy, ACL injury, clubfoot, Charcot-Marie- Tooth disease, gait patterns in autism, and footwear for early walkers.
Sponsored with educational grants from…
“Other considerations” spark debate
In January 2010, when LER first covered the controversy, Australian podiatrist and researcher Angela Evans, PhD, had recently published a paper in the Journal of the American Podiatric Medical Association suggesting that children whose feet were flatter than expected, but asymptomatic, should be monitored rather than automatically treated with orthoses.
By Cary Groner
Despite progress, research gaps remain
The January publication in NeuroRehabilitation of the recommendations from a consensus conference held in 2008 paints a less-than-perfect picture of the evidence underlying orthotic management of cerebral palsy (CP).
By Larry Hand
Age-specific protocols are key to success
Training programs aimed at preventing anterior cruciate ligament injuries have been used for many years, but injury rates remain high. Injury prevention experts suggest such programs may be more effective if implemented before children reach the ages associated with highest injury risk and if the programs utilize age-specific protocols.
By Emily ...
Barefoot-like isn’t necessarily best
Barefoot is a biomechanics buzzword these days, but not all practitioners believe soft-soled shoes are best for very young children, even if such shoes do approximate the barefoot walking experience.
By Shalmali Pal
But recognizing device limits is key
Muscle weakness and instability associated with Charcot-Marie-Tooth disease in children can be addressed with ankle foot orthoses, research suggests, but practitioners should be aware of the limitations of AFOs in this patient population as well as the ever-present challenge of compliance.
By Shalmali Pal
Casting simplifies clubfoot management
In a comparative study published in the April/May issue of the Journal of Pediatric Orthopaedics, French researchers found that Ponseti casting compared favorably to French physiotherapy for initial treatment of idiopathic clubfoot.
By Emily Delzell
Results could have clinical implications
Little research has been published about gait patterns in children with autism, but that could be changing. One recently published study, although small, appears to lay the foundation for more focused research and could have clinical implications as well.
By Larry Hand
Departments
In the ongoing battle against inversion ankle sprains in basketball and other sports, high tops are old news. But shoe designers have begun to investigate other ways that shoes might play a role in preventing sprains rather than contributing to the problem.
By Cary Groner
The medical literature generally supports the use of foot orthoses for management of plantar fasciitis symptoms, but evidence regarding specific orthotic designs is inconclusive. Early research suggests a temporary custom foot orthosis may be an effective treatment option.
By Caryn Doggett, DPT, Michelle Drake, DPT, and Robert Boyles, PT, DSc, OCS
Previous research has identified superior balance in professional golfers compared with controls as well as associations between balance and skill level in amateur golfers. This study compared standing balance characteristics between professional and highly skilled amateur golfers.
By Robert Donatelli, PT, PhD; Kenji Carp, PT, ATC, OCS; Guido Pagnacco, PhD; and John Adam, ATC
New England Baptist Hospital’s multidisciplinary prehabilitation program is grounded in research suggesting that outcomes after total joint replacement can be positively influenced by preoperative care that includes management of patient expectations as well as exercise.
By Claire E. Robbins, PT, DPT, MS, GCS, James V. Bono, MD, and Carl T. Talmo, MD
News
In the Moment: Sports medicine
By Jordana Bieze Foster
Some surgeries may predict AC lesions
Research presented this month at the annual meeting of the American Orthopaedic Society for Sports Medicine spelled more bad news for advocates of meniscectomy, potentially linking the embattled procedure to the development of articular cartilage ...
Gender appears to affect patterns of hamstring injury in soccer, suggesting that different prevention strategies may be in order for male and female players, according to a study presented in June at the National Athletic Trainers Association meeting.
Researchers from the ...
A preseason evaluation of the New York Giants football team found that nearly all players suffered from vitamin D insufficiency, a factor that may have contributed to muscle injuries, according to a study presented this month at the AOSSM meeting.
Researchers ...
Anterior stiffness may be a key differentiator between people who develop chronic instability following an ankle sprain and those who recover fully, according to research presented in June at the annual meeting of the National Athletic Trainers Association.
Investigators from the ...
In the Moment: Footcare
By Jordana Bieze Foster
New approach supports orthotic care
In contrast with previous findings based on peak pressure values, an abstract presented at July’s International Society of Biomechanics (ISB) meeting in Brussels used a new method of measuring dynamic plantar pressure distribution to confirm that ...
Posterolateral shear stress increases with heel height and could play a key role in high-heeled shoe-related foot disorders, according to a study in the June issue of the Journal of Biomechanics.
Investigators from Hong Kong Polytechnic University used in-shoe triaxial force ...
A multifaceted fall-prevention program introduced in a group of community dwelling older adults reduced falls by 36% compared with a control group, according to a June British Medical Journal study.
Investigators at La Trobe University in Bundoora, Australia, randomized 305 adults ...
Market Mechanics
Products
Offering patients appealing styles of diabetic shoes can improve compliance and outcomes. Dr. Comfort’s new Double Depth Collection adds four new style options to its two classic designs; all come in several colors. This collection works for hard-to-fit patients, including ...
Amfit introduces direct-milled polypropylene functional orthotics (FOs). This addition to Amfit’s central fabrication facility allows practitioners to specify and dispense polypro FOs with the same ease as its ethyl vinyl acetate (EVA) functional orthotics. Amfit Polypro FOs offer adjustable rigidity, ...
Apis’s Mt. Emey Medical Collection shoes are designed for hard-to-fit feet as well as those with more challenging orthotic needs. These shoes offer a variety of closures for adjustability and accommodate mild or severe foot deformities, including those caused by ...
FootStride Technology’s custom orthotic lab offers an improved version of its QuikStride prefabricated insole. The insole’s full-length cover provides a shock-absorbing cushion that molds to patients’ feet while its combination of Dri-Lex Eco antimicrobial material and perforated EVA wicks away ...
ComfortFit Labs’ Classic Leather Collection’s trio of handcrafted orthotics includes the Leather Balancer, Leather Shaffer, and Leather Laminate. The Leather Balancer’s deep heel cup provides rearfoot control and minimizes mediolateral instability. The Leather Shaffer’s medial flange offers firm arch support, ...
Aquatic Access’s redesigned line of IGAT (in-ground automatic turn) pool lifts is compliant with 2010 Standards for Accessible Design, which require public recreational facilities to be handicapped accessible. Easily removable Aquatic Access lifts, for aquatic therapy patients who are unable ...
Pro-Tec’s Gel-Force Knee Support is designed to alleviate knee pain and provide moderate knee joint stability for patients with patellofemoral pain syndrome, patellar maltracking, chondromalacia, and minor meniscus and ligament tears. It provides patellar compression and offers stability on the medial ...
Health Enterprises’ Therapeutic Hot & Cold Foot Massager provides three massage options to help relieve pain and reduce stress. The over-the-counter massager can be filled with warm water or ice or cold water and offers alternate pressures for relaxing or ...
Hersco Ortho Labs introduces the extra low profile Butterfly brace, a lightweight, flexible, custom-made ankle gauntlet designed to fit in almost any shoe. The Butterfly is a slim version of the traditional plastic-in-leather ankle support and is an option for ...