June 2012

Cover Story


cover-feature
Knee flexion after TKA: The significance of squatting

The ability to achieve a 90° squat appears to have important functional implications for patients rehabilitating from total knee arthroplasty. However, detecting impairment may require more rigorous methods than conventional sit-to-stand testing.

By Mark D. Rossi, PhD, PT, CSCS, and Denis Brunt, EdD, PT

Continue reading

cover-feature
ACL injury and OA risk: Surgery’s complicated role

Given the accumulating evidence linking anterior cruciate ligament injury to early-onset osteoarthritis, one might reason that surgical repair of the injured joint would decrease that risk. But too often that isn’t the case. This two-part series explores the complicated ways, both negative and positive, that surgery can influence OA risk.

By Cary Groner

Continue reading

Editor Message


Jordana
Out on a limb: Flop watch

Mark Cuban, the brash billionaire owner of the National Basketball Association’s (NBA) Dallas Mavericks, has pledged $100,000 to fund a study to determine if biomechanical analysis can distinguish legitimate falls during a basketball game from “flops.” The perfectionist in me really likes this idea. But the pragmatist in me wonders whether there might be better uses for that money.

Jordana Bieze Foster, Editor

Continue reading

Jordana
Out on a Limb: Down the habit hole

Much of sports medicine research focuses on what’s never been done before: new techniques, new procedures, and new theories. Less sexy, but equally important, is the research that takes a fresh look at old practices, the ones that have somehow become standard simply because they’ve never been questioned.

Jordana Bieze Foster, Editor

Continue reading

Departments


stroke-feature
Inserts improve symmetry, velocity in stroke patients

Learned disuse of the affected limb can lead to weight-bearing asymmetries in patients with stroke-related hemiparesis. Compelled body-weight shift therapy, using shoe inserts to force loading of the affected limb, can help patients achieve a more symmetrical gait.

By Alexander S. Aruin, PhD

Continue reading

running-feature
Retraining fixes faulty gait in injured runners

Although the technique is still in its infancy, early research suggests gait retraining can be used to address medial collapse, primarily in runners with patello­femoral pain (PFP) syndrome, and to reduce impact loading in runners with PFP or tibial stress fracture.

By Ashlin Miller, BS, and Richard W. Willy, PhD, PT, OCS

Continue reading

afo-feature
Rockers and rollovers: Implications for AFOs

Practitioners and researchers are redefining rocking and rolling as key components of gait, and designing ankle foot orthoses and other orthotic and prosthetic devices to specifically address impairments in the way certain patients rock and roll.

By Cary Groner

Continue reading

tissue-feature
Soft tissue composition and bone injury risk

Documenting how shock propagates through the leg and is attenuated by the soft tissues appears to be a critical step toward advancing practitioners’ and researchers’ understanding of lower extremity injury mechanisms related to running and landing activities.

By Timothy A. Burkhart, PhD, EIT, Alison Schinkel-Ivy, MHK, and David M. Andrews, PhD

Continue reading

diabetes-feature
Relieving pain in patients with diabetic neuropathy

Given the limitations of pharmacotherapy options for treating painful diabetic peripheral neuropathy, practitioners are also considering the merits of cognitive therapy, orthotic management, and combination therapies to relieve patients’ pain.

By Larry Hand

Continue reading

diabetic-feature
Diabetic foot infections: Progress meets pitfalls

New evidence-based guidelines on the management of diabetic foot infections reflect significant advances by research­ers and clinicians, but the recent emer­gence of regulatory hurdles has slowed the development of new antibiotic drugs for treating those infections.

By Emily Delzell

Continue reading

running-feature
Foot strike in runners: Influence on injury risk

Different foot strike patterns are associ­ated with different means of attenuating and redistributing forces during running, which may have implications for injury risk and rehabilitation. Researchers, however, have yet to fully examine and understand those implica­tions.

By Peter Larson, PhD

Continue reading

knee-feature
Minimizing the effects of knee brace migration

Too many knee braces just won’t stay put, which can affect compliance and possibly even device effectiveness. Research on the topic is scarce, but experts say the key to minimiz­ing knee brace migration is making sure the device fits the patient’s anatomy as closely as possible.

By Shalmali Pal

Continue reading

footwear-feature
Rehabilitative footwear: Importance of comfort

A growing body of research suggests that footwear comfort can improve movement performance and, in particular, neuromus­cular control of balance. These findings could have significant implications for rehabilitation of older adults and patients with lower extremity disorders.

By M. Owen Papuga, PhD, and Jeanmarie R. Burke, PhD

Continue reading

ankle-feature
Effects of ankle bracing on athletic performance

Ankle braces help prevent injury by restrict­ing motion, but those restrictions don’t necessarily result in negative effects on athletic performance. Evidence sug­gests that while agility may be affected with use of an ankle brace, vertical jump and balance skills may not.

By Jatin P. Ambegaonkar, PhD, ATC, OT, CSCS; Nelson Cortes, PhD; and Shruti J. Ambegaonkar, MS, PT

Continue reading

amputation-feature
Amputation vs salvage for lower limb tumors

Studies assessing the relative functional benefits of limb salvage and amputation for lower extremity bone and soft tissue tumors have produced inconsistent re­sults, but the range of subjective and objective tests used in those studies may have influenced the findings.

By Lucy Kupersmith, BA, and Jeremy S. Somerson, MD

Continue reading

News


In the Moment: Sports medicine

By Jordana Bieze Foster

6TIMortho-iStock4374640a
Time to talk: Back pain therapy manages expectations

Selecting the right patients and committing time to education and management of their expectations when using orthoses to treat chronic low back pain can yield  symptomatic relief, according to research conducted at the University of Salford and epublished by the Journal of Foot and Ankle Research in May.

Continue reading

Plantar pressure measurements reveal not all sham devices are created equal

Not all sham orthoses used in research settings provide the same mechanical effects or are perceived by study participants as equally credible, according to research epublished in May by the Journal of Foot and Ankle Research.

Continue reading

Varying rearfoot posting has multiple dose-response effects, gait study finds

Varying rearfoot post angle levels in foot orthoses designed to correct pronation has dose-response effects at the rearfoot and knee in individuals both with and without pronated feet, according to a study published in May in the Journal of Biomechanics.

Continue reading

6ITMsports-iStock19470488a
Minimalist miss: Even over time, gait differs from barefoot

The biomechanical differences between barefoot running and running in minimalist shoes appear to amount to more than just a matter of time.

Continue reading

Altering landing to reduce ACL load may decrease jumping performance

Changes in landing mechanics that are intended to decrease risk of anterior cruciate ligament (ACL) injury may also inadvertently decrease jumping performance in athletes, according to research presented in late May at the annual ACSM meeting.

Continue reading

Kinetic changes postmeniscectomy mimic those associated with knee OA

One to five years after partial medial meniscectomy, young adults demonstrate kinetic alterations associated with knee osteoarthritis (OA), according to research presented in late May at the annual ACSM meeting.

Continue reading

istockphoto.com #16508120
Going to extremes: Battling dangers of high intensity exercise

The exploding popularity of so-called extreme conditioning programs is now infiltrating the armed forces, prompting military sports medicine experts to take a closer look at the potential risks and benefits of high intensity exercise.

Continue reading

Hip strength deficits characterize both patellofemoral pain and osteoarthritis

Patellofemoral osteoarthritis (PFOA) is associated with deficits in hip abduction strength, a similarity to patellofemoral pain syndrome (PFPS) that appears to support the theory that the two conditions lie on the same continuum, according to research from the University of Calgary presented in late May at the ACSM meeting.

Continue reading

Ankle instability patients exhibit landing kinematics suggestive of ACL injury risk

Sagittal plane landing kinematics in patients with chronic ankle instability (CAI) mimic those associated with risk of anterior cruciate ligament (ACL) injury, sug­gest­ing that similar neuromuscular control deficits may be involved in both processes, according to research from the University of Toledo (OH) presented in late May at the ACSM meeting.

Continue reading

In the Moment: Footwear

By Jordana Bieze Foster

6TIMortho-iStock4374640a
Time to talk: Back pain therapy manages expectations

Selecting the right patients and committing time to education and management of their expectations when using orthoses to treat chronic low back pain can yield  symptomatic relief, according to research conducted at the University of Salford and epublished by the Journal of Foot and Ankle Research in May.

Continue reading

Plantar pressure measurements reveal not all sham devices are created equal

Not all sham orthoses used in research settings provide the same mechanical effects or are perceived by study participants as equally credible, according to research epublished in May by the Journal of Foot and Ankle Research.

Continue reading

Varying rearfoot posting has multiple dose-response effects, gait study finds

Varying rearfoot post angle levels in foot orthoses designed to correct pronation has dose-response effects at the rearfoot and knee in individuals both with and without pronated feet, according to a study published in May in the Journal of Biomechanics.

Continue reading

itm-footwear
Toning shoe twist: Embattled footwear may still have benefit

The research on toning shoes presented early this month at the annual meeting of the American College of Sports Medicine in San Francisco didn’t add much support for controversial claims that the rocker-bottom footwear promotes muscle activa­tion and energy expenditure. But the presenters did point out more subtle benefits of toning shoes that manufac­turers might find are more acceptable to the Federal Trade Commission.

Continue reading

Balance control in occupational boots reflects shaft height more than mass

In workers wearing occupational footwear, the mass of a boot may be less important for maintaining balance than its shaft height, according to a study presented in late May at the annual ACSM meeting.

Continue reading

Injuries prevent runners from adapting to acute changes in midsole hardness

Injured runners do not make sagittal plane kinematic adaptations to changes in midsole hardness the way that healthy runners do, according to research from the University of Wisconsin-La Crosse (UW-L) presented in late May at the ACSM meeting.

Continue reading

Market Mechanics


AOPA prepares for 2013 world congress, invites entries for abstracts, competitions

The American Orthotic and Prosthetic Association (AOPA) invites O&P students and residents to present their research findings or case studies at the 2013 O&P World Congress, scheduled for September 18-21 in Orlando, FL. AOPA will give the Otto and Lucille … Continue reading

DOD awards $1M in research grants to help amputees regain walking ability

The US Department of Defense (DOD) Joint Warfighter Medical Research Program awarded Seattle-based Cadence Biomedical $1 million on May 30 to fund development of new technology for amputees. Cadence makes the Kickstart Walking System, a wearable device without batteries or … Continue reading

Mayo Clinic plans major sports center

Mayo Clinic in Rochester, MN, announced on May 28 that it will expand its sports medicine practice as part of the 100,000-square-foot Mayo Clinic Dan Abraham Healthy Living Center building project. The Mayo Clinic Sports Medicine Center at the Dan … Continue reading

PFP experts will convene in Canada

Vancouver, British Columbia will host the third International Patellofemoral Pain Research Retreat & Clinical Symposium, a three-day gathering of scientists who meet every two years to present new research on patellofemoral pain (PFP) and engage in panel discussion and consensus-building … Continue reading

Shire sponsors wound care fellowships

Shire Regenerative Medicine announced at the May 2013 Symposium on Advanced Wound Care and Wound Healing Society, held in Denver, CO, that it will partner with the Association for the Advancement of Wound Care (AAWC) to provide a $100,000 grant … Continue reading

Studies suggest antimicrobial dressings reduce infections, wound complications

Skillman, NJ-based ConvaTec reported in May that two recent studies suggest its Aquacel Ag Surgical cover dressing has benefits over standard dressings for prevention of wound complications. The antimicrobial dressing is designed to protect surgical incisions with a waterproof viral … Continue reading

Ektio shoes assist high-flying Slamball players with ankle sprain prevention

New York City-based Ektio is continuing to strengthen its partnership with professional Slamball athletes. Slamball players, whose full-contact hybrid sport of basketball played from trampolines puts them at risk for ankle sprains, started trying out Ektio shoes, which are designed … Continue reading

JMS Plastics teams with nora systems

Neptune, NJ-based JMS Plastics joined with nora systems in May to bring its EVA (ethylene vinyl acetate) products to JMS customers who are seeking high-quality EVA for orthoses and diabetic shoes. nora systems, headquartered in Weinheim, Germany, is internationally recognized … Continue reading

IOC calls for injury prevention abstracts

The International Olympic Committee (IOC) invites abstracts and workshop proposals for its 4th IOC World Conference on Prevention of Injury & Illness in Sport, scheduled for April 10-12, 2014, in Monaco. The deadline for workshop proposals is September 1, and … Continue reading

New ACSM president speaks at May event

William W. Dexter, MD, FACSM, new president of the American College of Sports Medicine (ACSM), officially took the reins of the organization at the 60th ACSM Annual Meeting and the Fourth World Congress on Exercise is Medicine, which drew more … Continue reading

This Skechers ad features one of the product claims called into question by the FTC.
Skechers settles for $50 million but stands by advertising claims

Manhattan Beach, CA-based Skechers USA will pay $50 million to settle deceptive advertising complaints made by the Federal Trade Commission (FTC), 44 states, and the District of Colombia. Skechers settled the complaints on May 16 but continues to defend its … Continue reading

BioMedix grant funds PAD testing

St. Paul, MN-based BioMedix, a healthcare information technology solutions provider, joined with the Western University of Health Sciences (WesternU) in May to promote amputation prevention through aware­ness and early detection of peripheral arterial disease (PAD). BioMedix gave WesternU College of … Continue reading

O&P networking site continues growth

O&P Social, a network for O&P professionals, students, patients, caregivers, and vendors launched in June 2011, now boasts 1100-plus members worldwide. “O&P Social is the only community of its kind in the industry that supports real-time communication between practitioners, technicians, … Continue reading

ABC sponsors first-ever design contest for O&P technicians at annual meeting

The American Board for Certification in Orthotics, Prosthetics and Pedorthics (ABC) will sponsor the first-ever Technical Fabrication Contest offered by the American Orthotic & Prosthetic Association (AOPA) and the Orthotic & Prosthetic Technological Association (OPTA) and premiering at the AOPA … Continue reading

Total Gym garners award for training equipment from medical wellness group

San Diego-based Total Gym was deemed Best in Class for medical wellness training equipment by the Medical Wellness Association (MWA) at the 10th annual Medical Wellness Forum at the International Health, Racquet & Sportsclub Association’s 2012 International Convention, held March … Continue reading

OPAF, First Volley score USTA grants

The United States Tennis Association (USTA) awarded the Orthotic and Prosthetic Activities Foundation (OPAF) and its First Volley adaptive tennis clinics several grants last month. USTA Serves, the organization’s national charitable foundation, gave First Volley an $8000 matching grant to … Continue reading

Canadian pedorthists pen guidelines

At its annual symposium in April, the Pedorthic Association of Canada (PAC) launched its first Clinical Practice Guidelines. The comprehensive manual was written by 60 Canadian pedorthists and reviewed by 33 foot professionals from Canada, the US, the UK, and … Continue reading

Delcam names orthotics forum speakers

Birmingham, UK-based Delcam has announced some of the speakers who will take part in its Orthotics Technology Forum, scheduled for July 12-13 at the University of Salford in Manchester, UK. Speakers will include Chris­to­pher Nester, PhD, School of Health Sciences, … Continue reading

Aetrex upgrades scanning software

Teaneck, NJ-based Aetrex has introduced the iStep 8.0, the latest version of its foot scanning software. The software, available for use in select retail stores to help shoppers select shoes that best meet their individual needs, measures foot size and … Continue reading

Products


pressure-positive
Raw Topical Analgesics

The Pressure Positive Company is partnering with Raw Health International to offer Raw Heat and Raw Ice certified natural topical analgesics. The analgesics are certified by the Natural Products Association and made with all-natural and organic ingredients. The products are … Continue reading

icy-feet
Icy Feet Cold Therapy

Icy Feet is an easy-to-use, no-mess way to apply cold therapy evenly to the soles of the feet. The patent-pending orthotic cold pack features an engineered insole shape with a recessed heel cup and an elevated arch to allow for … Continue reading

products-powerstep
Leather Orthotics

Powerstep’s new Signature Leather Orthotics are functionally correct orthoses for management of plantar fasciitis, overpronation, metatarsal pain, heel pain, arch discomfort, or sore, aching feet. Product features include natural, distressed leather that softens and conforms to the contours of the … Continue reading

gel-force
Gel Force Knee Support

Pro-Tec Athletics offers the Pro-Tec Gel Force Knee Support. The knee support is designed to help alleviate knee pain while providing moderate knee joint stability for multiple conditions that include patellofemoral pain syndrome, chondromalacia, and minor meniscus and ligament tears. … Continue reading

jerry-miller
Jerry Miller Shoes for Kids

Custom-molded pediatric footwear from Jerry Miller Shoes are created using state-of-the-art CAD/CAM techniques. Each shoe is engineered according to fundamental orthopedic principles and customized according to the personal needs of the pediatric patient. Features include glove leather uppers or lightweight … Continue reading

products-cadence
Kickstart Orthosis

The Kickstart orthosis from Cadence Biomedical is a wearable device that helps stroke survivors and others with weakened muscles or disabilities regain mobility and independence. The new, diagnostic version of Kickstart allows practitioners to try the device and see its … Continue reading

products-willowwood
Omega Scanner 3D

WillowWood announces the Omega Scanner 3D, its newest shape capture device. The Omega Scanner 3D uses structured light to create a 3D image. When the light hits an object the pattern deforms and is then measured by the scanner at … Continue reading

Sharp-Shape
Sharp Shape COR Manager

As part of its ongoing efforts to integrate and advance its Automated Orthotic Manufacturing System, Sharp Shape is beta-testing a new product called COR Manager for managing and modeling cast-correction COR files, the company’s proprietary file format for foot orthotic … Continue reading

Learning-Loft
Fashionable Brace Covers

The Learning Loft, manufacturer of the Fashions For Casts collection of decorative fabric covers for concealing a fiberglass cast, announces Brace Cover Fashions. Brace Cover Fashions are trendy, fashionable fabric covers worn over orthopedic braces to make healing more stylish. … Continue reading

products-nufoot
Nufoot Indoor Shoes

Nufoot indoor shoes are designed to meet a variety of needs. Uses include yoga, Pilates, at the gym, in the pool, and other indoor activities. Made with antimicrobial materials from a patented design, the new Nufoot indoor shoes are skid-resistant, … Continue reading

products-dictus
Dictus for Foot Drop

Pro-Tech Orthopedics introduces the Dictus, an ultralight device for patients with foot drop. It can be used in standard shoes, with no need for special depths or widths to accommodate the device. A version for barefoot use is also available. … Continue reading

products-medvet
Arch Angels Children’s Insoles

Med-Vet International announces that Arch Angels Children’s Insoles are now available in sizes Toddler 6 through Youth 5. Inspired by a mom and developed by two podiatrists, Arch Angels conform to a child’s arch as it continues to develop through … Continue reading

EquiTest
Smart EquiTest Balance System

NeuroCom, a division of Natus Medical, offers the Smart EquiTest system. Like the original EquiTest system, the Smart EquiTest system allows for objective assessment of balance control and postural stability under dynamic test conditions, but the Smart EquiTest system also … Continue reading

delcam
OrthoModel Design Software

Delcam has launched a new version of its design software for custom orthotic insoles developed specifically for accommodative foot orthoses. The new “real-time design” version of OrthoModel will benefit practitioners treating patients with diabetes and others needing insoles made of … Continue reading

Mastercare
Mastercare Therapy Table

Mastercare offers the Mastercare-CN-AH6 heavy duty professional therapy table for sports teams and athletes. The table holds individuals up to 400 pounds in either prone or supine positions. It is equipped with a 3-in thick moving divided backrest with a … Continue reading

products-cleansweep
Clean Sweep Shoe Spray

The Tetra Corporation announces Clean Sweep, a new antimicrobial shoe spray designed to conveniently eliminate 99.9% of odor causing bacteria and fungi on contact. Clean Sweep is hypoallergenic and nontoxic, and it contains no artificial color or fragrance. It targets … Continue reading

Microcel-Puff
Microcel Puff SBR

Acor Orthopaedic has added a comprehensive line of Microcel Puff SBR (soling, build ups, and repairs) to its growing family of materials. This durable blended material combines the benefits of EVA and SBR (styrene butadiene rubber) and is intended to … Continue reading

products-dmsystems
Heelift Glide Boot

DM Systems introduces Heelift Glide, the most recent addition to its family of heel offloading boots that redistribute pressure to promote healing and prevent the development of new heel pressure ulcers. A smooth exterior allows patients to move without catching … Continue reading

products-alimed
AliMed Product Sourcebook

AliMed offers the 2013-2014 Rehabilitation, Orthopedics, & Skilled Nursing Product Source­book for high quality patient care, rehabilitation, orthopedic, operating room, diagnostic imaging, and ergonomic products. AliMed now offers more than 70,000 specialty products for the hospital, long-term care, and rehabilitation … Continue reading

products-therawheel
Therawheel Roller

Therawheel is a self-use roller with more than 150 different applications. It rolls, glides, and compresses soft tissue (ligaments, tendons, muscles, and fascia) in any direction. Thera­wheel provides targeted pressure for detecting and reducing soft tissue restrictions. The thinner part … Continue reading

Sigvaris-Sleeve
Sigvaris Sleeve In New Colors

The Sigvaris Performance Sleeve is now available in two new colors: lime and orange. Part of the company’s line of sports compression products for competitive athletes, the Sigvaris Performance Sleeve provides 20 to 30 mmHg of graduated compression from ankle … Continue reading

products-orthosis
COD Ankle Joint

The Center for Orthotics Design (COD) offers the COD Self-aligning Ankle Joint, which allows for conversion of a rigid ankle foot orthosis (AFO) to an articulated AFO. The ankle joint allows four-way adjustments and continually variable range of motion in … Continue reading

PowerKids
PowerKids Orthoses

Powerstep introduces PowerKids, affordable, easy-to-use prefabricated orthoses specifically designed for children. These functionally correct orthoses are designed to improve foot alignment, posture, and balance, control excess motion, and reduce muscle fatigue. Features include dual-layer construction for cushioning and shock absorption, … Continue reading

products-kidzerts
KidZerts Heel Cup

KidZerts has released a new product, the KidZerts Heel Cup, to relieve children’s heel pain and discomfort associated with Sever disease. Each heel cup is made of ethylene vinyl acetate (EVA) semifirm foam rubber, and is contoured to comfortably hold … Continue reading