May 2020

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Cover Story


The Utility of External Fixation for Midfoot Charcot Neuroarthropathy

When conservative therapies fail, surgical reconstruction of the foot is often required to restore function, heal ulcerations, and decrease risk of amputation in patients with CN. External fixation remains a reliable method, with plenty of advantages.

By P. Tanner Shaffer, DPM, Jonathan Hook, DPM, FACFAS, and Ben Potter, DPM

Editorial Observations


COVID-19: Highlights of Responses—Clinical, Economic, Regulatory

The pandemic caused by COVID-19 (brought on by the severe acute respiratory syndrome coronavirus, SARS-COV-2), has now touched every continent, save Antartica. The World Health Organization (WHO) is now estimating the global death toll will reach 400,000 by mid-June, with no end in sight.

From the COVID-19 Frontlines


Keep Your Business Safe During COVID-19

The COVID-19 crisis is creating unprecedented challenges for practitioners and business owners. Organizations are facing new challenges and need to help employees transition back to the physical workplace. A few thoughts on keeping your business safe.

By Andrew Rawson

Feature Articles


Bike Fit Unplugged

This Bike Fit specialist explains his process for fitting the cyclist, not the bike, to address the individual needs of the rider. He provided commentary to LER Editor Janice T. Radak for the photographs taken at a recent bike fitting clinic and displayed in this story. Bike Fit Unplugged is the technique I developed…

By Happy Freedman

Wound Care Update: The Role of Topical Oxygen Therapy in the Treatment of Wounds

When you think back to your early studies in General Biology you may recall memorizing the steps of the Krebs Cycle. It is through this process of aerobic respiration that most living things generate energy. In aerobic organisms, cells utilize oxygen (O2) as a final electron acceptor to synthesize high-energy…

By Windy Cole, DPM

CRITICAL ANALYSIS: Prefab or Custom: Which Foot Orthosis Is Better for Plantar Heel Pain?

Recent analysis of the podiatric literature concludes that custom foot orthoses aren’t superior to prefab inserts—an account one expert rejects. It’s a matter of who does the custom work, he says.

By Stanley Beekman, DPM

From the ATPA Combined Sessions


Pole Walking Offers Health Benefits, Improved Gait Parameters

The use of trekking poles while walking has been around for decades, having originated in Finland as a way for skiers to maintain fitness off season. Since then, pole walking has been capitalized and expanded upon as the health benefits of this total body workout have been recognized, and in recent years has gained in popularity in the US.

Use of a Wearable Plantar Sensory Neuroprosthesis Improves Fall Risk

One of the complications of peripheral neuropathy is a lack of sensation in the feet. This, in turn, can cause difficulties with gait and balance, as well as increased fall risk. As a means of addressing these issues, Lars Oddsson, PhD, developed a neuroprosthesis, called Walkasins, to replace the lost sensation.

By Laura Fonda Hochnadel

From the Literature


Starting with gait retraining: an analysis of changes in impact over time

The repetitive impact that is experienced upon collision with the ground may be related to running injuries but is modifiable. Lower-impact running can be achieved by receiving biofeedback in response to the peak tibial acceleration, but when are runners adapting to lower-impact running?

By the Biomechanics of Human Movement research group of Ghent University

Fragility Fractures, Bone Health Management, and Caregiving

Patients who have fragility fractures may experience a disruption of their responsibilities as caregivers to family members and others who depend on them.  The purpose our study was to examine how caregiving responsibilities were associated with, and possibly impacted by, the fracture experience and the resulting management of bone health.

By Joanna Sale, PhD

Does Physical Activity Relate to Motor Development?

Do certain kinds of physical activity (PA) help children develop motor skills better than others? To find out, researchers from East Carolina University used data from 342 children who had taken part in the 2012 National Youth Fitness Survey to look at specific kinds of PA and motor skill development in preschool-aged children.

Prevalence of Obesity in US Continues Upward Trend

Nearly 1 out of every 2 US adults will be obese by 2030, and nearly 1 in 4 will be severely obese, according to estimates published in the New England Journal of Medicine. Researchers used 1993-2016 data on 6.3 million US adults who participated in the Behavioral Risk Factor Surveillance System to project the prevalence of different body-mass index (BMI) categories through 2030.

Industry News & Updates


FDA CLEARS EXTERNAL ELECTROSTIMULATION DEVICE FOR PERIPHERAL BLOOD CLOTS

Sky Medical Technology, Daresbury, England, has received US Food & Drug Administration (FDA) 510(k) clearance for its geko electrosimulation device, which is designed to stimulate the calf muscles to increase blood flow in the deep veins of the calf, thereby preventing blood clots in at-risk non-surgical patients.

HERSCO PARTNERS WITH IORTHOTICSUSA IN NEW 3D PRINTING HUB

iOrthoticsUSA, Astoria, NY, announced its launch as a 3D-printing central fabrication hub to supply custom orthotics to orthotic labs. This is a new venture between iOrthotics Australia, a 5-year veteran in 3D printing, and Hersco Ortho Labs, Long Island City, NY, an experienced US manufacturer.

ALLARD USA PARTNERS WITH FSHD SOCIETY TO EDUCATE ON FOOT DROP MANAGEMENT

Allard USA, Rockaway, NJ, is partnering with the FSHD (Facioscapulohumeral Muscular Dystrophy) Society. Together they will work to educate the population served by the FSHD Society on how to best manage foot drop, including discussing the use of orthoses. FSHD is a genetic disorder that leads to weakening of the skeletal muscles

VIRTUAL GAMES HELP PEOPLE STAND, WALK IN REHAB

Virtual reality video games, activity monitors, and handheld computer devices can help people stand as well as walk, the largest trial worldwide into the effects of digital devices in rehabilitation has found. The study was undertaken at hospitals in Sydney and Adelaide, Australia, and had 300 participants ranging from…

UCONN BIOMEDICAL ENGINEER CREATES SMART BANDAGES TO HEAL CHRONIC WOUNDS

Diabetes-related chronic and non-healing wounds are a leading cause of limb amputation in the United States. Due to the complex nature of these wounds, proper clinical treatment has been limited. Now, for what they say is the first time, faculty in the University of Connecticut (UConn) Biomedical Engineering Department…

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