January 2010

Market Mechanics

Element semirigid ankle brace restricts passive, dynamic inversion in study

The Element semirigid ankle brace from Powell, TN-based DeRoyal effectively restricts passive and dynamic ankle inversion compared to a no-brace condition, according to research published in the December issue of the Journal of Orthopedic & Sports Physical Therapy.

Researchers from the University of Tennessee studied the effects of the Element and two other braces in 19 healthy volunteers as they performed an ankle inversion drop test and a lateral cutting maneuver.

All three braces significantly reduced peak ankle inversion and inversion range of motion during the inversion drop test. The Element and a functional test brace also significantly reduced peak inversion velocity.

During lateral cutting, the Element and functional brace were associated with a small but significant reduction in peak inversion angle during initial contact and peak eversion velocity at push-off. Peak vertical ground reaction force was also significantly lower when the Element brace was worn than during the unbraced condition.

However, research from the same group presented last fall suggest that brace performance on the trapdoor-style inversion drop test does not necessarily reflect how that brace will perform during a drop landing on an inclined surface, which incorporates the type of plantarflexion and vertical loading seen during real-world inversion sprains.

Eleven healthy volunteers were analyzed while performing inversion drops and drop landings onto an inclined surface; each test was performed with the Element brace and with no brace.

The inversion landings were associated with significantly higher maximum inversion angle and maximum inversion and eversion velocities, and significantly less time for the ankle musculature to adjust to the impact.

Brace wear significantly controlled dorsiflexion range of motion during both movement tests, but more so during the landing protocol than the inversion drop. However, the brace’s effectiveness for reducing inversion velocity and increasing time to peak inversion velocity during the inversion drop test was not replicated during the landing test.

The findings were presented in August at the annual meeting of the American Society of Biomechanics.

Delcam launches new insole software

OrthoModel

Salt Lake City-based Delcam will launch new versions of its OrthoModel and OrthoMill software this month at the annual meeting of the Florida Podiatric Medical Association in Orlando.

OrthoModel software, used for the design of custom orthotic insoles, has been redesigned to offer more flexibility. The new version includes the ability to create flat-bottom orthotics as well as constant-thickness designs across the various modelling methods. In addition, users can add a “skive” (a flat correcting surface) to either the medial or lateral side of the orthotic and can vary the angle of the plane. Previously, the software was limited to a 15º plane on the medial side of the design.

OrthoMill

The most significant addition to the OrthoMill manufacturing software, according to the company, is the ability to “batch” machining calculations. A single batch can include design instructions for multiple orthotics, either to be cut from a single block or from several pieces of material. The software can then generate all the required toolpaths in a continuous series of calculations, even overnight.

A related change is the option to apply different machining templates to each of a group of orthotics that will be cut from one block of material in a single manufacturing sequence. Previously, all items produced in one operation had to use the same template, which reduced the overall machining efficiency.

Compact knee adds therapy mode

The Compact Microprocessor Knee from Minneapolic-based Otto Bock HealthCare now features a Therapy Mode to allow recent transfemoral amputees to transition through rehabilitation with a single device.

The Therapy Mode allows a practitioner to lock the knee in full extension. The feature can be de-activated using the remote control during sitting; upon standing, the knee automatically locks again.

Once the amputee is ready for a fully functional microprocessor knee, the Therapy Mode can be permanently turned off.

Other features of the Compact include Static Stance, which allows the amputee to lock the knee between 0º and 30º to decrease loading on the sound limb, and Stumble Recovery, which offers support when it senses the user is in an insecure position.

APTA podcasts focus on soldier rehab

The American Physical Therapy Association has created a two-part podcast on rehabilitation of soldiers returning from the Middle East, which is now available online.

The podcast, titled Rehabilitation for Military Service Members Returning from Iraq and Afghanistan, can be downloaded from the Physical Therapy journal website, www.ptjournal.org.

Part 1 focuses on the Center for the Intrepid, a state-of-the-art physical rehabilitation facility for wounded warriors at Brooke Army Medical Center. The podcast describes research being conducted at the center and advances in prosthetic technology that are being tested.

Part 2 discusses how injured soldiers are transported from the field of combat to the United States, what happens when they return, and how they are being treated for wounds and loss of limbs.

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