August 2017

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Editor Message


Healthcare, mobility, and liberty

With weekly and sometimes daily chaos coming out of Washington, DC—and with the collapse of the latest efforts at healthcare reform that promised to compromise or take care away from millions of people, many of them children with ongoing lower extremity conditions—it might be tempting for healthcare providers to take their eye off the ball. Don’t do it. The voices of providers and their patients contributed largely to the last defeat of Republican-sponsored reforms.

The American Orthotic & Prosthetic Association and the Amputee Coalition, for example, held a news conference in late June outlining three priority issues for their patients who, they noted, are at risk for losing “care and the mobility and liberty that comes with that care.” (See “Amputee groups air ACA reform concerns,” LER, July 2017, page 61.)

A direct threat to children’s healthcare is up next. Authorization of the Children’s Health Insurance Program (CHIP), a long-standing bipartisan program that provides low-cost coverage for six million children whose families earn too much to qualify for Medicaid, but who cannot afford private insurance, expires in September.

Some lawmakers are considering a CHIP reauthorization bill as a potential vehicle for broader healthcare policy changes—including elements of repeal and replace, and with that, a possible reduction to Medicaid.

Failure to reauthorize the bill—or attaching other harmful legislation—will restrict children’s access to specialty care like O&P and physical therapy services. Children are among the most vulnerable of patients, but, with the right care, have many potentially mobile, healthy years in front of them.

As healthcare providers, you have an influential voice, and know firsthand that mobile, healthy children not only have a far higher quality of life, they are also more likely to become employed adults who contribute to the economic success of their communities and the country.

Use your voice to help ensure all your patients can continue to access the care that provides them maximal independence and liberty in the form of mobility.

By Emily Delzell, Senior Editor


  • Dyslexia affects ability to adjust to impaired sensory feedback

    Kids struggle to maintain balance – Children with dyslexia are unable to compensate with other available inputs when sensory feedback to the soles of their feet, their vision, or both is less informative, resulting in poor postural stability, according to research from Paris, France, which may have implications in training to help these children improve their use of sensory inputs.

    By Katie Bell

  • Parents say comfort, easy use are clubfoot compliance keys

    All devices present challenges – A recently developed pediatric orthosis for Ponseti night bracing received positive ratings from parents in a small Swedish study of children with idiopathic clubfoot who had compliance problems or relapse with one of two earlier bracing devices, a foot abduction brace (FAB) or a dynamic knee ankle foot orthosis (KAFO).

    By Hank Black

  • Weak hip extensors contribute to ankle sprains in soccer players      

    Findings support use of strengthening – Hip strengthening may be as important for preventing lateral ankle sprains in youth soccer players as it is in adults, according to a recent Belgian study.

    By Jill R. Dorson


  • ITW update: Etiological clues, collaborative care

    Researchers still haven’t unraveled the ‘I’ in ITW, or idiopathic toe walking, but studies continue to point to neurodevelopmental  and genetic links. Here, we review recent literature and experts explain how they assess patients’ history and biomechanics for information to guide treatment.

    By Larry Hand

  • Growth plates and injury in skeletally immature athletes

    In this follow-up to “Growth-plate injuries: A diagnostic challenge,” (May, page 15) we continue our look at physeal trauma, exploring growth-plate issues in anterior cruciate ligament reconstruction, and further examining these injuries’ impact on the knees, ankles, and feet of youth athletes.

    By Shalmali Pal