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Caleb Wegener, Katrin Wegener, Richard Smith, Karl-Heinz Schott, Joshua Burns
BACKGROUND: Charcot-Marie-Tooth disease is an inherited neuropathy causing progressive weakness, foot deformity and difficulty walking. Clinical anecdotes suggest orthoses designed on the 'sensorimotor' paradigm are beneficial for improving gait in Charcot-Marie-Tooth disease. OBJECTIVES: Investigate the effect of sensorimotor orthoses on in-shoe and lower limb biomechanics in adults with Charcot-Marie-Tooth disease. STUDY DESIGN: Randomised, repeated-measures, exploratory study...
August 2016: Prosthetics and Orthotics International
Dennis Janisse, Erick Janisse
BACKGROUND: Conservative pedorthic management of the diabetic foot has been shown to be an effective method to prevent ulcers, amputations, and re-amputations. This article exhibits why and how pedorthics plays such an important role via modalities such as footwear, shoe modifications, custom foot orthoses, and partial foot prostheses. OBJECTIVE: The objective of this article is to demonstrate how pedorthics has been shown to be an integral part of conservative diabetic foot care...
February 2015: Prosthetics and Orthotics International
Brant L McCartan, Barry I Rosenblum
The diabetic foot is more susceptible than the non-diabetic foot to collapse. This frequently leads to bony prominences followed by ulceration. Offloading of areas of increased pressure is paramount to ulcer prevention and healing. Several devices and accommodations can aid practitioners in saving patients' extremities and allow them to ambulate. A team approach works best, and patient education is a must. Regular assessment and modifications are required for longevity of each device. In this article, different therapeutic options are detailed...
January 2014: Clinics in Podiatric Medicine and Surgery
Roger Marzano
This article reviews the current orthotic and pedorthic management of adult acquired flatfoot and associated secondary pathology. Appropriate footwear, footwear modifications, custom foot orthoses, and ankle foot orthoses are highlighted for the treatment of this often seen foot disorder. As this pathology progresses through its various stages, the discussion provides conservative and postoperative alternatives for treatment of even the most affected feet.
October 2007: Clinics in Podiatric Medicine and Surgery
Dennis J Janisse, Erick J Janisse
Research as well as clinical experience has shown that pedorthic and orthotic modalities can be valuable tools in the care of the diabetic foot. The team approach is probably more beneficial to the successful treatment of the diabetic foot than nearly any other problem the physician encounters. Understanding pedorthic and orthotic principles and how to include and use the appropriate clinicians on the team can simplify the patient care process while decreasing complications such as ulcerations and amputations...
December 2006: Foot and Ankle Clinics
Vern L Houston, Gangming Luo, Carl P Mason, Martin Mussman, Maryanne Garbarini, Aaron C Beattie
Accurate, consistent measurement of foot-ankle geometry is essential for the design and manufacture of well-fitting, functional, comfortable footwear; for the diagnosis of certain biomechanical disorders; and for consistent longitudinal monitoring and assessment of pedorthic treatment outcomes. We sought to formulate a basic set of measures characterizing the principal geometric dimensions of the foot, to investigate how these measures vary with increasing weightbearing, and to explore the implications of weightbearing changes in pedal geometry for orthopedic footwear design and manufacture...
July 2006: Journal of the American Podiatric Medical Association
Thomas W Pelham, Peter R T Rowe, Michael G Robinson, Laurence E Holt
Impact loading is a major factor in the high prevalence of musculoskeletal injuries among military personnel during operational tasks. One of the therapeutic purposes of a pedorthic approach is to attenuate impact load through footwear and supportive device cushioning. The following research pilot project attempts to investigate this relationship. Vertical acceleration was collected at the fourth lumbar level in 30 members of the Canadian Forces (CF) during two ladder descents on a CF warship. Body weight, time of descent, and a description of footwear and any additional supportive appliances were also collected...
2006: Work: a Journal of Prevention, Assessment, and Rehabilitation
Robert J Snyder, Karen K Lanier
Wounds in the diabetic population represent a significant medical and economic burden. Early recognition and prompt management can facilitate healing of these wounds. The scope of potential interventions includes debridement, infection control, offloading, protective dressings, active dressings (such as growth factors and living skin constructs), revascularization, proper nutrition, and patient education, If foot pressures are to be reduced, healing to progress, and prevention of ulceration to be a realistic goal, offloading is imperative...
January 2002: Ostomy/wound Management
Denise M Demarais, Rebecca A Bachschmidt, Gerald F Harris
A noninvasive method for determining the instantaneous axis of rotation (IAOR) of the foot and ankle during human ambulation has been developed. The algorithm uses three-dimensional (3-D) external marker trajectories to describe the IAOR of the calcaneus with respect to the tibia. Multiple optimization techniques were used to fit a plane and a sphere to the marker trajectories, with the constraint that the center of the sphere lie on the plane. The IAOR was defined perpendicular to the plane and passed through the center of the sphere...
December 2002: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Ted Colaizzi
The pedorthist works from a physician's prescription, which includes a diagnosis, modality, and desired goals. The pedorthist's and the physician's combined efforts result in the patient's foot, shoe, shoe modifications, and foot orthoses working together as one unit.
June 2002: Foot and Ankle Clinics
M S Pinzur, H C Dart
Foot ulceration in diabetic patients is a resource-consuming, disabling morbidity that often is the first step in the downward spiral to lower extremity amputation. The best treatment is prevention. Prevention of foot ulcers requires a coordinated program of foot-specific patient education, prophylactic skin and nail care, and protective footwear. The goal of prescription footwear is to keep individuals ambulatory, while protecting them from ulcer formation. The complexity of pedorthic prescription increases with decreasing protective sensation and increasing structural deformity of the foot and ankle...
June 2001: Foot and Ankle Clinics
M S Pinzur, M P Slovenkai, E Trepman
Foot infection is the most common reason for hospital admission of patients with diabetes in the United States. Foot ulceration leads to deep infection, sepsis, and lower extremity amputation. Prophylactic foot care has been shown to decrease patient morbidity, decrease the utilization of expensive resources, and decrease the risk for amputation and premature death. The Diabetes Committee of the American Orthopaedic Foot and Ankle Society has developed guidelines for implementing this type of prophylactic foot care...
November 1999: Foot & Ankle International
D J Janisse
The Board Certified Pedorthist can be a valuable member of the team of healthcare professionals involved in the treatment of arthritis of the foot and ankle. In addition to providing prescription footwear, the pedorthist can assist in educating the patient, postoperative care, and long term monitoring of the patient's progress. The objectives in the pedorthic care of arthritis of the foot and ankle are to reduce shock and shear; to relieve excessive pressure from sensitive or painful areas; to accommodate, correct, and support deformities; and to control or limit painful motion of joints...
April 1998: Clinical Orthopaedics and related Research
J K Grifka
Pedorthic devices (shoes, modifications, insoles) are alternatives to, and, complementary with, operative procedures for patients with rheumatoid foot disease. The practical use of insoles and shoesole rolls (rocker soles) to diminish pressures and shearing stresses, and to support load bearing, is described. Criteria for prescribing such devices are described. The requirements for orthopaedic shoes are listed and a special technique of using test shoes with transparent thermomoldable stiff plastic materials is introduced to reveal pressure spots in advance of finishing the definitive shoe...
July 1997: Clinical Orthopaedics and related Research
Z O Abu-Faraj, G F Harris, A H Chang, M J Shereff
Scaphoid or longitudinal arch pads are frequently prescribed pedorthics for foot and ankle rehabilitation. These pedorthics are reported to be effective in mechanically supporting the medial longitudinal arch while reducing plantar and medial soft tissue strain. The objective of this study was to measure alterations in ambulatory plantar pressure metrics in a group of adults secondary to scaphoid pad application. The biomechanical rationale of this study was that the geometry of foot contact would be altered secondary to foot inversion...
December 1996: IEEE Transactions on Rehabilitation Engineering
E R Slavens, M L Slavens
Current literature on the treatment of patients with neuropathic ulcers generally does not fully consider pedorthic treatment. To evaluate pedorthic treatment of patients with neuropathic ulcers, an ongoing treatment and tracking program was developed. This program consisted of regularly scheduled visits, footwear inspections, and orthosis replacement, repair, or adjustment. Our intent is not to suggest that therapeutic footwear be used as a primary treatment to close foot ulcers, but to highlight the place of education, proper shoes, and orthosis in the healing process...
October 1995: Foot & Ankle International
C Emmel
Dorland's Medical Dictionary defines pedorthics as the art concerned with the design, manufacture, fit, and modification of shoes and related foot appliances as prescribed for the amelioration of painful or disabling conditions of the foot and limb.
May 1993: Foot & Ankle
J S Gould, S M Shi
Microsurgical procedures for coverage of foot and ankle defects now are undertaken with a better understanding of biomechanical requirements, and concern for durability, aesthetics, donor site morbidity, and shoe fit. Well-contoured muscle flaps including the latissimus dorsi, rectus abdominis, and gracilis muscles frequently are used along with thin cutaneous flaps, especially from the lateral arm. When good local options are absent and exposed nerves, tendons, and bone, and surgical hardware are present, acute free flaps and delayed primary procedures are done frequently with excellent success rates (> 90%)...
May 1995: Clinical Orthopaedics and related Research
J S Gould
Microsurgical reconstruction for injuries of the foot and ankle includes, in addition to repair of small nerves, vessels, and tendons, coverage of soft tissue defects. Local transpositional and island pedicle flaps are ideal when available and adequate. The choice of free vascularized flaps is based on its potential durability, contour, bulk, and appearance. Thin cutaneous flaps, fascial flaps, and muscle flaps covered with split thickness skin grafts are appropriate in specific areas. Neurosensory flaps and methods of reinnervation may have a place in extensively denervated feet...
January 1987: Orthopedics
J S Gould
Restoration of the plantar surface of the foot demands an appreciation of the unique requirements of this area. Local tissues should be used when available. Otherwise, if recipient vessels are adequate, free-tissue transfer is the treatment of choice. Durable tissues include cutaneous flaps with thicker skin, such as the scapular flap, and muscle flaps covered with split-thickness skin graft. Each method has advantages and deficiencies. Tailoring of the flap can decrease the need for later modifications. Adjunctive procedures, to increase sensibility, and pedorthic devices, to accommodate and moderate imperfect surgical methods, complement the efforts of the reconstructive surgeon to restore maximum function to this critical area...
1990: Instructional Course Lectures
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