September 2013

LER09-13CvrSmCover Story

Taking an adaptive path to active

Adaptive sports programs offer a fun, social way for people with disability to be more physically active and improve their self-image at the same time, through pursuits ranging from tranquil fly-fishing to intense rock wall climbs.

By Emily Delzell

Editor Message

Out on a limb: Benefit without bare feet

The minimalist shoe trend may be fading, but interest in finding ways to reap the benefits of barefoot running without actually going barefoot remains strong.

Jordana Bieze Foster, Editor

LER Special Education Series

pediatric-hypotonia-specialFor a parent, the only thing more frustrating than knowing something isn’t quite right with your young child is hearing that nothing can be done until the underlying cause of the symptoms is identified. Luckily, parents of children with hypotonia can be spared the latter frustration.

As we detail in this special publication, early intervention in children with hypotonia—sometimes as early as in the neonatal intensive care unit—is not only possible but strongly recommended by experts, even in the absence of an underlying diagnosis.

Sponsored by an educational grant from SureStep.



Lower body mechanics bolster overhead throws

Lower extremity biomechanics  can significantly affect the risk of upper extremity injury in overhead throwing athletes, such as baseball and softball pitchers and catchers, and the functional stability of the lumbopelvic-hip  complex is essential to preventing those injuries.

By Gretchen D. Oliver, PhD, FACSM, ATC, LAT, Hillary Plummer, MAT, ATC, and Lisa Henning

PAD and reamputation in patients with diabetes

In patients who undergo a minor foot amputation following a diabetic foot ulcer, severe peripheral arterial disease is the primary risk factor for subsequent major amputation, which underscores the importance of early detection and intervention for PAD in this population.

By Vincent S. Nerone, DPM, Kevin D. Springer, DPM, Darren M. Woodruff, DPM, and Said A. Atway, DPM, AACFAS

Original research: Knee self-massage for OA pain

The medical literature supports the use of massage for relief of osteoarthritis symptoms, but therapist-administered treatments can be cost-prohibitive. This study found that self-massage can also be effective, even when the initial supervised sessions are continued by patients at home.

By Dorothea Atkins, ThD, RN, and David Eichler, PhD

Core stability and lower extremity injury risk

A growing body of scientific evidence suggests that clinical tests of core strength and stability can help predict risk of lower extremity injury in athletes, which in turn supports the need for a multisegmental approach to the development of injury prevention programs.

By Valerie Snider, MS, ATC, and Gary Wilkerson, EdD, ATC

Effect of sex hormones on incidence of knee pain

New research suggests that vasti muscle activation in women varies throughout the menstrual cycle, adding to the growing body of literature pointing to a connection between sex hormones and knee injury risk. The exact nature of that relationship, however, remains unclear.

By Matthew S. Tenan, MA, ATC, and Lisa Griffin, PhD


In the Moment: Sports Medicine

By Jordana Bieze Foster

The NFL’s ACL issue: Experts debate contributing factors

A flurry of anterior cruciate ligament (ACL) injuries in National Football League (NFL) players early in the preseason has medical experts theorizing about the contributing factors and what can be done to protect players in the future.

Balance training also improves jump height in youth basketball players

Twelve weeks of balance training using unstable surfaces improves jump performance as well as balance in youth basketball players, according to an Italian study published the August issue of Sport Sciences for Health.

Increased running cadence simulates some advantages of going barefoot

The acute effects of increased running cadence are similar to those of barefoot running, according to two studies that looked at the two techniques in a single group of runners.

Market Mechanics

Study finds O&P care for limb loss, impairment saves Medicare money

Taxpayers tend to pay more over the long term when Medicare patients with lower limb loss or impairment or spinal injury are not provided with prostheses or spinal, hip, knee, and ankle orthoses, according to a study commissioned by the Manassas, VA-based Amputee Coalition and conducted by Allen Dobson, PhD, a health economist and president of the healthcare consulting group Dobson DaVanzo in Vienna, VA.

PT foundation reaches $2M mark for Center of Excellence campaign

The Foundation for Physical Therapy announced in August that it has raised more than $2 million for its Center of Excellence (COE), two-thirds of the funds needed to launch the nation’s first center dedicated to expanding the number of physical therapy scientists in the field of health services and health policy.

Website highlights DFU awareness, care

Global biotech company Shire, based in Dublin, Ireland, launched in August as an online resource to increase awareness of diabetic foot ulcers (DFUs) and encourage people with diabetes to seek immediate care for foot wounds.

PA group schedules “Steel Foot” event

The Lehigh Valley Foot and Ankle Society will hold its first annual Steel Foot conference at the new Sands Hotel and Conference Center in Bethlehem, PA, October 4-6. Attendees can earn up to 25 CME credits at the conference, which will feature lectures on topics ranging from advanced wound healing to total ankle replacement.

Foot Solutions partners with Delcam

Atlanta-based Foot Solutions’ partnership with Delcam is bringing the CAD-CAM company’s digital solutions into its stores nationwide. Foot Solutions is replacing all its current scanners with iQube Minis. In some locations that have updated their technology, changes have resulted in significantly shorter turn-around times, from three to four weeks to four days.

CMTA staffer raises $9K in benefit walk

Bethany Meloche, social media director for the Charcot-Marie-Tooth Association (CMTA), walked seven miles in her “Bethany’s Walk to Run” event on August 25 in San Jose, CA, raising $9300 for the organization.

Meloche, who was diagnosed with CMT when she was 12, finished the walk in 3 hours, 23 minutes, and 47 seconds. Her average time per mile was 28.52 minutes, her fastest mile ever. She was the only official walker, ...

Muscle drug gets breakthrough status

Drug manufacturer Novartis announced on August 20 that the US Food and Drug Administration (FDA) granted breakthrough therapy designation to BYM338 (bimagrumab) for treatment of sporadic inclusion body myositis (sIBM).

The designation is based on results of a phase 2 proof-of-concept study that showed BYM338 substantially benefited patients with sIBM compared with placebo. Investigators will present study results at the American Neurological Association meeting in October in New Orleans.

BYM338 (bimagrumab) is ...

Horse hooves inspire footwear design

An Israeli design student took horse hooves, which act as a circulatory pump that sends blood flowing up the legs, as her inspiration for a shoe to improve circulation in people with diabetes and peripheral artery disease.

After learning that daily leg massage has a beneficial effect on blood flow, Lilach Steiner designed a shoe, named the Flow, that takes of advantage of body weight to create a massage effect through ...

Aesculap offers surgical skills courses

Center Valley, PA-based Aesculap Implant Systems and its Aesculap Academy are accepting registration for two surgical skills courses that address recent advancements in total knee arthroplasty and direct anterior hip replacement.

Each course provides a full day of training led by experienced surgeons and features a combination of didactic classroom lectures highlighting applicable case studies, as well as a cadaveric lab for hands-on exposure to new techniques and instrumentation.

Advanced Technologies in ...

Swanson directs Bulls’ sport performance

The Chicago Bulls announced on August 27 that Jennifer Swanson, PhD, has come on board as the team’s director of sports performance.

She will oversee the Bulls’ athletic training and strength and conditioning department, as well as take charge of massage therapy, chiropractic, nutritional, and auxiliary services.

Swanson joins the team from Los Angeles-based Athletes Performance, where she was performance physical therapy manager and worked with professional basketball, football, hockey, and baseball ...

Educating educators on diabetic shoes

A research review presented at American Association of Diabetes Educators annual meeting in Philadelphia in August highlighted the role of therapeutic footwear in reducing incidence of diabetic foot ulcers (DFUs) and amputations.

Dennis Janisse, CPed, clinical assistant professor in the Department of Physical Medicine and Rehabilitation at the Medical College of Wisconsin in Milwaukee and director of scientific affairs for the Northvale, NJ-based Orthofeet, gave the sole podium presentation on foot ...

AOPA honors Näder for work in O&P

The American Orthotic & Prosthetic Association (AOPA) will honor Professor Hans Georg Näder, president and CEO of the Otto Bock Group and Otto Bock Healthcare at its 2013 World Congress, scheduled for September 18-21 in Orlando, FL.

AOPA will award Näder, grandson of the Otto Bock Group’s eponymous founder, its annual Lifetime Achievement Award in recognition of his important contributions to the advancement of the O&P industry.

Pistorius murder trial set for March 2014

The South African Pretoria Magistrates Court indicted double-amputee Olympic and Paralympic sprinter Oscar Pistorius on August 19 on a charge of premeditated murder, setting March 3, 2014 as the start date for his trial.

Pistorius is accused of murdering his girlfriend, Reeva Steenkamp on February 14 in his Pretoria East home.

If convicted, Pistorius could face a life sentence and serve a minimum of 25 years.

Ottobock partners with Krabat AS

Minneapolis, MN-based Ottobock announced a new partnership deal in August with Norwegian company Krabat AS, a developer of high quality mobility aids for children and youth designed for functionally and aesthetics headquartered in Hvalstad.

The agreement grants Ottobock exclusive North American distribution rights for three Krabat products: the Krabat Pirat, a floating aid that gives children opportunities to be independent in the water and stimulates self-activity; the Krabat Pilot, an aid ...


Nature Fit Foot Orthoses

The Nature-Fit 9000 series of prefabricated semirigid foot orthoses from Tri Hawk International is designed to provide instant relief in the practitioner’s office, while the patient is waiting for custom devices to arrive, or in some cases as an alternative to a custom device. Orthoses in the series are made from a durable nonporous polymer that is injection-molded for precise control of foot movement—thinner sections flex more while thicker sections ...

DCS-FS6 Plantar Fasciitis Sleeve

Darco International announces the DCS-FS6 Plantar Fasciitis Sleeve. The DCS features FS6 technology that provides graduated compression zones that work together to help relieve pain. The sleeve can be worn while sleeping or relaxing, or under socks when active. The DCS-FS6 is constructed of medical-grade fabric that is latex free and designed for comfort. Zones 1 and 6 provide gentle compression and minimize pressure on the lower ankle and toes. ...

I-Runner Footwear

I-Runner athletic footwear is a new category of shoes for people with and without diabetes: medical shoes for the comfort shoe market and comfort shoes for the medical shoe market. These lightweight, extra-depth shoes feature a breathable upper, a neuropathy-friendly toe box with bunion/bunionette pockets, polyurethane insoles, and shock-absorbing midsoles. Designed by a pedorthist and made in the US, they are fabricated on a modified last to fit a narrow ...

EVO Hinge Ankle Stabilizer

The EVO Hinge Ankle Stabilizer, which features a removable plastic hinge, is easily converted to the traditional ASO (ankle stabilizing orthosis) EVO to facilitate treatment progression. The combination of the plastic hinge and the stabilizing strap technology provide even greater inversion/eversion control and protection against syndesmotic ankle sprains than the original ASO. The stabilizing straps function as both a stirrup strap to control the calcaneus and a figure-8 strap to ...