CEP
The use of custom foot orthoses is a conventional
therapy for a multitude of lower extremity
pathologies. Patient satisfaction with these devices
can be problematic and frustrating for both
practitioner and patient. The underlying conflict
lies with the amount of required correction
not tolerated by the patient. The source of the
complaint is frequently attributed to the orthoses
itself, be it the amount of correction or arch
height. The fact of the matter is that rarely is
the orthoses the root of the problem. There is
not too much correction, and the arch is not
too high. The problem lies on the patient side
of the equation if the form of untreated equinus
deformity.
DiGiovanni et al. described equinus as ankle
joint dorsiflexion of less than 5° of ankle joint
dorsiflexion with the knee extended.1 Proper
evaluation technique is critical in this definition.
Barouk and Barouk described the correct method
to examine ankle joint dorsiflexion by either
placing the hindfoot in a neutral position or in
varus to eliminate dorsiflexion at the midfoot
level allowing for primarily dorsiflexion to occur
in the hindfoot while applying the proper amount
of dorsiflexion force to the forefoot. 2 See figures
1-6 for correct deformity evaluation technique.
Hill in his landmark article on the frequency of
equinus made some fascinating comments on
the relationship between equinus and orthoses. 3 I
would like to look at some of these statements and
address them individually.
Read This Article,
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Education Points
The Pedorthic Footcare Association
(PFA) offers Continuing Education Points
(CEPs), approved by the American Board
for Certification in Orthotics, Prosthetics
& Pedorthics, Inc. (ABC) and the Board
of Certification/Accreditation (BOC), via
specially designated articles within Current
Pedorthics magazine.
To take advantage of the program,
thoroughly read the adjacent CEU article
and then visit: www.pedorthics.org
and click on the Continuing Education
Opportunities tab to purchase the
10-question quiz associated with this article.
CEP quizzes cost $25 for members and $50
for non-members. The quizzes are worth 1.0
Scientific or Business CEP, depending on
the content. Successful completion of the
quiz will result in 1.0 CEP reported directly to
ABC and BOC at the end of each quarter.
Look for additional CEP-eligible articles in
future issues of the magazine; previous
articles are available in the magazine archive
at www.pedorthics.org.
If you have any questions, contact
PFA, at (229) 389-3440 or e-mail:
[email protected].
“Treating apparent biomechanical problems
that have an underlying equinus deformity with
Current Pedorthics January/February 2017
43