KID STUFF: Pediatric clinical news update

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In this special section, LER updates you on the latest research and clinical news to help optimize management of your littlest lower extremity patients. Topics include pediatric flexible flatfoot, cerebral palsy, ACL injury, clubfoot, Charcot-Marie-Tooth disease, gait patterns in autism, and footwear for early walkers.

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Photo courtesy of SureStep.
New papers revisit, rekindle flexible flatfoot controversy

“Other considerations” spark debate

In January 2010, when LER first covered the controversy, Australian podiatrist and researcher Angela Evans, PhD, had recently published a paper in the Journal of the American Podiatric Medical Association suggesting that children whose feet were flatter than expected, but asymptomatic, should be monitored rather than automatically treated with orthoses.

By Cary Groner

Photo courtesy of Allard USA.
CP experts assess evidence for use of orthotic devices

Despite progress, research gaps remain

The January publication in NeuroRehabili­tation of the recommendations from a consensus conference held in 2008 paints a less-than-perfect picture of the evidence underlying orthotic management of cerebral palsy (CP).

By Larry Hand

www.istockphoto.com #5897024
ACL injury prevention training focuses on younger athletes

Age-specific protocols are key to success

Training programs aimed at preventing anterior cruciate ligament injuries have been used for many years, but injury rates remain high. Injury prevention experts suggest such programs may be more effective if implemented before children reach the ages associated with highest injury risk and if the programs utilize age-specific protocols.

By Emily Delzell

www.istockphoto.com #13508539
Not all practitioners embrace soft soles for novice walkers

Barefoot-like isn’t necessarily best

Barefoot is a biomechanics buzzword these days, but not all practitioners believe soft-soled shoes are best for very young children, even if such shoes do approx­imate the barefoot walking experience.

By Shalmali Pal

Photo courtesy of Clinical Prosthetics +Orthotics.
Charcot-Marie-Tooth patients respond to AFO management

But recognizing device limits is key

Muscle weakness and instability associated with Charcot-Marie-Tooth disease in children can be addressed with ankle foot orthoses, research suggests, but practi­tioners should be aware of the limitations of AFOs in this patient population as well as the ever-present challenge of compliance.

By Shalmali Pal

Photo courtesy of M.J. Markell Shoe Company
French study favors Ponseti over compatriots’ technique

Casting simplifies clubfoot management

In a comparative study published in the April/May issue of the Journal of Pediatric Orthopaedics, French researchers found that Ponseti casting compared favorably to French physiotherapy for initial treatment of idiopathic clubfoot.

By Emily Delzell

www.istockphoto.com #8393713
Early research characterizes gait associated with autism

Results could have clinical implications

Little research has been published about gait patterns in children with autism, but that could be changing. One recently published study, although small, appears to lay the foundation for more focused research and could have clinical implications as well.

By Larry Hand