November 2015

Click on image to Download the complete supplement in its original form PDF

Click on image to Download the complete supplement in its original form PDF

Editor Message

emily-delzell-196x198Adding experts to care team

True multidisciplinary care can yield great benefits for patients, but despite all the emphasis that makes the statement almost a cliché, it’s not always what patients receive. I first realized this when I was interviewing the heads of various departments and divisions of a large academic medical center, where for many years I was an editor publishing on the faculty’s clinical work and research.

At some point most said something like, “We want to emphasize that we provide specialized, multidisciplinary care.”

I’d give a little mental editor sigh—because this applies to almost everyone in a major tertiary care center—and ask for specifics. Then I’d hear about the cardiac nurses, exercise physiologists, dietitians, diabetes educators, pharmacists, and psychologists involved in cardiac rehabilitation or the team of medical oncologists, radiation oncologists, surgical oncologists, radiologists, oncological nurses, social workers, and others providing care and support to patients in the cancer center.

I’m also reminded about the advantages—and the challenges—of a collaborative approach by articles in this issue of LER: Pediatrics.

In “Biomechanical care for juvenile idiopathic arthritis” (page 15), for example, experts interviewed by writer Shalmali Pal discuss a number of ways in which podiatrists, physical therapists, and other lower extremity practitioners can reduce pain and improve mobility and function for children with this most common form of childhood arthritis. The experts also note these specialists aren’t typically on treating physicians’ radar.

This theme is echoed by orthopedic surgeon Amy Yin, MD, in “Biomechanical stress, overuse raise young dancers’ injury risk” (page 6), a research news article reporting on her epidemiological study of pediatric dance injuries. She says, too often, these dancers don’t seek care from physicians with training in dance or sports medicine and rely on dance teachers or general physicians who may not be aware of the potential for the injury—and continued practice—to cause long-term problems.

To bridge the gap, experts suggest lower extremity practitioners with interests in these areas reach out to treating clinicians and explain what they have to offer. Patients, they say, will benefit. That may be a cliché—but I couldn’t agree more.

By Emily Delzell, Senior Editor


  • O&P teams treat limb loss, deformity in developing world

    Donating parts, funds aids efforts – Each year, Dino Scanio, CO, LO, and his five-member team of pediatric O&P specialists arrive in Guatemala City to perform a challenging task. In just four days in their most recent clinic in August, for example, they fit nearly 50 young patients with custom devices and…

    By Brigid Galloway

  • Biomechanical stress, overuse raise young dancers’ injury risk

    Prevention requires team approach – The inclusion of physicians, including specialists in pediatric orthopedic surgery and sports or dance medicine, in a team with teachers, physical therapists, parents, and others could help identify and prevent injuries in growing young dancers, according to…

    By Hank Black

  • Foot disability in Down syndrome linked to hallux valgus, narrow shoes

    Regular foot checks may curb problems – A recent study published in the Journal of Foot and Ankle Research found that hallux valgus and too-narrow footwear contribute to foot-specific disability in children with Down syndrome. Interestingly, the study found foot posture wasn’t associated with foot-specific disability in the same children.

    By Erin Boutwell


  • Barefoot running: Debate moves to developing feet

    The most public battles about barefoot running and minimalist footwear have been fought over their use by adult athletes and the clinicians who treat them. There is, however, a separate discussion underway regarding barefoot and minimally shod running in children.

    By Cary Groner

  • Biomechanical care for juvenile idiopathic arthritis

    Juvenile idiopathic arthritis (JIA) affects nearly a quarter of a million US kids younger than 16 years. The hallmarks of the autoimmune disorder include joint inflammation, stiffening, and damage, as well as changes in joint growth, all of which can prove painful.

    By Shalmali Pal