KID STUFF 2012: Pediatric clinical news update

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In our second annual pediatric special section, LER updates you on the latest research and clinical news to help optimize management of your littlest lower extremity patients. Topics include cerebral palsy, clubfoot, juvenile idiopathic arthritis, ACL injury, footwear, obesity, and the pros and cons of foot screening.

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Photo courtesy of Cascade DAFO.
Energy efficiency with AFO use varies in cerebral palsy patients

Longer strides lead to increased work
Ankle foot orthoses (AFOs) are regularly prescribed to children with walking disabilities resulting from cerebral palsy, yet the effects of AFOs on energy recovery and work during gait are still unclear.

By Samantha Rosenblum

The surrogate biomodel undergoes testing in An- drew DiMeo's lab. Photo courtesy of Andrew Di- Meo, PhD.
Biomodel could help researchers optimize clubfoot brace design

Method includes complex rotations
A surrogate biomodel of a child’s lower extremities, in particular the ability to model movement along multiple axes of rotation, could help improve researchers’ biomechanical understanding of bracing for clubfoot.

By Emily Delzell

Photo by Vincent Giordano/Trinacria Photography (www.trinacriaphotography.com), courtesy of Clinical Prosthetics & Orthotics.
Juvenile idiopathic arthritis study reveals footcare information gap

Issues involve custom foot orthoses
A Scottish study suggests foot care in children with juvenile idiopathic arthritis (JIA) falls short because of poor access to care and negative perceptions about custom foot orthoses. Experts say those issues may be less prevalent in the US but emphasize the need to educate patients, parents, and referring clinicians about the benefits of lower extremity care.

By Larry Hand

istockphoto.com #3325267
Early ACL surgery could lower risk of associated knee damage

Patterns mirror those seen in adults
Timing of reconstruction surgery after pediatric anterior cruciate ligament (ACL) injuries seems to be related to the prevalence of meniscal and chondral injuries discovered during those surgeries, according to new research published in the September issue of The American Journal of Sports Medicine.

By Cary Groner

istockphoto.com #12122817
Wearing athletic shoes affects some performance measures

Standing long jump distance improves
Research has recently begun to clarify footwear’s effects on gait and functional performance in children, but the broader implications of the findings remain a matter of debate.

By Cary Groner

istockphoto.com #9709469
Dynamic data in obese children may suggest gait compensation

Low force values surprise researchers
An Austrian study exploring the role of genu valgum and flatfoot in obese and normal weight children found obesity was associated with higher peak plantar pres­sures, but lower maximum force while walking, when forces were normalized to body weight.

By Christina Hall Nettles

istockphoto.com #4525226
Experts debate relative benefits of screening feet for risk factors

Most question emphasis on flatfoot
The value of screening programs for pediatric foot problems—primarily flatfoot—was recently challenged in a commentary by Australian podiatrist Angela Evans, PhD, a researcher and lecturer in the Division of Health Sciences at the University of Adelaide.

By Cary Groner