Orthotics Q&A
Prefabricated orthoses can provide improved support and other key benefits for patients with conditions such as plantar fasciitis. In addition to sharing their insights on OTC devices, these expert panelists provide pearls from their experience on common orthotic modifications that can have an impact.
Q:
Do OTC orthotics play a role in your practice? If so, how much and what do you look for in an... Read More.
Which paradigms, teachings and studies influence podiatric physicians who prescribe orthotics? These expert panelists enumerate what factors come into play when they dispense orthoses.
Q:
Which of the more current paradigms for foot function have the most influence in your practice?
A:
“Time devoted to evaluating a patient in regard to his or her function as well as the biomechanical problem... Read More.
Our expert panelists discuss whether reducing shear in patients with diabetes is comparable to reducing plantar pressure, when to change insoles and the optimum insole depth, and the future of computer-aided design for orthoses.
Q:
What is the role of “shear” in orthoses for patients with diabetes? Is “shear reduction” the new plantar pressure reduction?
A:
As custom orthotics have evolved,... Read More.
Q:
Many studies that investigated the use of therapeutic footwear along with accommodative inserts have reported only moderate rates of efficacy in preventing diabetic ulcer recurrence. Can one attribute this to the oversimplification of the foot ulcer pathology?
A:
As Metin Yavuz, PhD, notes, well-known scholars such as Cavanagh, Armstrong, Bakker and Bus classified the evidence to support the... Read More.
When treating patients with orthotic therapy, podiatric physicians may face various dilemmas on when to prescribe devices or how to treat patients who have used over-the-counter devices to no avail. These expert panelists discuss the use of orthoses after bunion surgery, “retail” orthoses and the treatment of pediatric patients among other issues.
Q: When would you prescribe... Read More.
These expert panelists share their most commonly used orthotic modifications as well as insights on using highly inverted orthoses and the lateral Kirby skive.
Q: What are the most common orthotic modifications that you prescribe and why?
A: Joseph D’Amico, DPM, most commonly employs a deepened heel seat at a standard size of between ¾ inches and 1 inch. He... Read More.
These expert panelists expound on the use of orthotic treatment for a range of issues including hyperpronation, overuse injuries and posterior tibial tendon dysfunction. They also discuss treating pediatric patients with both flexible flatfoot and those with non-compensating equinus.
Q: What are your insights into the orthotic treatment of pediatric flexible... Read More.
In addition to discussing the most common problems they see with orthosis irritation and how they remedy these issues, the expert panelists weigh in on two recent studies and their potential impact.
Q: What is the most common orthosis irritation problem that you see in your practice and how do you solve it?
A: The most common problem that Paul... Read More.
Orthotic modifications can play a valuable role in the treatment of various lower extremity ailments. Accordingly, these expert panelists offer their insights on the use of orthoses and key modifications within the treatment plan for turf toe injuries, posterior tibial tendon dysfunction (PTTD) and lesser metatarsal stress fractures.
Q: What is the preferred... Read More.
As podiatry continues to emphasize evidenced-based medicine more and more, some of the leaders in biomechanics research share their thoughts on current studies and speculate about how future research with orthoses may eventually alter the way podiatrists practice.
Q: What orthotic-related research projects have your completed or are you currently in the midst... Read More.
While more research continues to emerge on biomechanics, some physicians feel it is not emphasized enough in podiatry and that other specialists may be gaining more of a foothold in prescribing orthotic devices. Accordingly, expert panelists discuss these controversial issues and examine the potential impact for the profession.
Q: With much emphasis in our... Read More.
Given that toe walking and other gait disturbances are common among children, these expert panelists take a closer look at these conditions, offer keys to the diagnostic assessment and share their insights on appropriate treatment modalities and physical therapy regimens.
Q: What is your treatment plan for children with diplegia and hemiplegia?
A: Mary Keen, MD, says most children with diplegia... Read More.
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