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As true as it is in advertising, it may be even more true in healthcare. As evidence, this issue features not one but two articles on the ongoing battle to improve patient compliance—a battle practitioners have been fighting since even before the halcyon days of the three martini lunch.
By Jordana Bieze Foster
This three-step approach, based on a vertical alignment axis, offers a low-tech alternative for prosthetic alignment in developing nations, but also has applications in developed countries as
a simple clinical test to identify gait deviations.
By Yeongchi Wu, MD
Orthotic and prosthetic intervention for partial foot amputation is intended to restore the effective foot length and normalize gait and function. Research is only beginning to examine whether current interventions are up to the challenge.
By Michael P. Dillon, BP&O (Hons.), PhD
Perfect compliance is probably too much to hope for. But patient education, diligent follow-up, empathy and a little imagination can go a long way toward improving device wear rates and clinical outcomes.
By L.W. Barnes
Tactics borrowed from the advertising world could be just what is needed to effectively communicate the risks of foot ulcers and amputation to patients with diabetes and improve outcomes as a result.
By Jeffrey M. Robbins, DPM, Gerald Strauss, PhD, and Jennifer Regler, DPM
Research suggests that individuals with chronic ankle instability are also likely to have impaired neuromuscular function at the knee and hip – findings that could change your approach to preventing recurrent ankle sprains.
By Phillip A. Gribble, PhD, ATC
A high school forward rebounds the basketball, as she has thousands of times before. She lands with a flat foot, extended knee, and torso leaning awkwardly sideways, as her knee buckles inward. An audible pop is heard and felt as the anterior cruciate ligament (ACL) in her knee tears and ends her season, compromising her hopes of a college scholarship and perhaps even her expectation of a long, active, and healthy life.
by Timothy E. Hewett, PhD
Athletes know about the importance of keeping your head in the game. Just ask Lindsey Jacobellis. Or Chris Webber. But a growing body of research suggests that poor decision making isn’t the only way the brain can sabotage an athlete’s performance.
Jordana Bieze Foster, editor
Positive physician-patient relationships are critical to the healing process and have been shown to directly impact clinical results.
By Jason Kraus
A recent paper recommends waiting before prescribing orthotics for children with asymptomatic flexible flatfoot. But some insist such children could have underlying structural abnormalities and should be treated. Without data, it’s hard to know who’s right.
By Cary Groner
If the knee loads generated during a golf swing are enough to take down Tiger Woods, should it really be considered a low-impact sport?
By Judy A. Blake, BA, Nikolai Steklov, BA, Shantanu Patil, MD, Clifford W. Colwell Jr., MD, and Darryl D. D’Lima, MD, PhD
Controlled stress would seem to be the ideal environment for orthotic management of PTTD. How could that be accomplished?
By Frank Caruso, CO
It’s popular with professional athletes and Hollywood celebrities. But WBV also has very real clinical potential for patients with neurological disorders.
By Kurt Jackson, PT, PhD, GCS and Harold Merriman, PT, PhD, CLT
Practitioners themselves may be to blame for not ensuring that stockings are fit properly and that patients know how to wear them correctly.
By Linda Weber
The second article in this two-part series addresses preventing recurrence and management of Charcot foot and foot amputations.
By Robert J. Snyder, DPM, FACFAS, CWS, and Karen K. Lanier, CPed, LPed
At Lower Extremity Review, we know there are literally thousands of products out there that can help you improve your clinical outcomes. But the existence of all those products doesn’t really do you or your patients much good if you don’t know where to find them.
By, Jordana Bieze Foster, editor
Although the mechanisms behind patellofemoral pain syndrome (PFPS), like those of anterior cruciate ligament (ACL) injuries, are still somewhat elusive, research is shedding new light on the role gender plays in the onset of this chronic overuse condition.
By Linda Weber
The science of treating plantar fasciitis in athletes is evolving to consider the unusual demands these patients put on their feet. Although clinicians continue to rely on conservative management with rest, ice, anti-inflammatory medications, taping, and orthoses, some are embracing new approaches that seem counterintuitive but offer evidence of improved outcomes.
by Cary Groner
With a start-up cost of many tens of thousands of dollars and a steep learning curve, it’s no surprise that many O&P practitioners have been slow to transition to computer-aided design and computer-aided manufacturing (CAD-CAM).
By L.W. Barnes
Epidemiological studies confirm what coaches, trainers, parents, and student athletes already know—that ankle sprains are the most common musculoskeletal injury among high school athletes. A study in the August issue of the American Journal of Sports Medicine bears that out, with recurrent ankle injuries accounting for 28.3% of recurrent traumatic sports injuries in teen athletes.
by Linda Weber
Charles Kuffel, CPO, of Blaine, MN, knows his limitations. If the clinician and father of four is going to keep his referrals happy, get products to his patients on time and have a life outside the office, it means outsourcing some orthotic orders to a central fabricator.
By L.W. Barnes
Shoes with rocker-bottom soles have long been used to alleviate plantar pressures in diabetes patients and others susceptible to forefoot pain or ulceration. The soles move the apex of the toe rocker behind the metatarsal heads, reducing pressure as the patient’s weight transfers forward over the ball of the foot.
by Cary Groner
Clinicians have known for many years that uneven plantar pressures, combined with the loss of sensitivity caused by peripheral neuropathy, are associated with foot ulcers in diabetes patients. Ulcers often occur in different areas than peak pressures do, however. Shear forces, caused by pressure differentials in the foot, may be more to blame than plantar pressures per se.
by Cary Groner
Conditions associated with drop foot are as varied as post-stroke hemiplegia, brain or spinal cord injury, and neuromuscular disorders including multiple sclerosis (MS). Patients with drop foot are unable to use the dorsiflexor muscles to lift the foot clear of the ground during the gait’s swing phase, nor can they control plantar flexion during heel strike. The result is an awkward, unstable gait and a tendency to trip when the toes brush the ground.
by Cary Groner
Stretching and splinting have long been treatment strategies for plantar fasciitis. However, new research and ongoing clinical experience are calling into question older methodologies and providing evidence for some new approaches.
by Cary Groner
January 2010
December 2009
November 2009
October 2009