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PFA Meeting Attendance Soars
By Miki Fairley "To move the profession forward and to find new effective
treatments and techniques, someone always needs to be pushing the
therapeutic envelope"-Ian Alexander, MD, FRCS(c),
orthopedic surgeon and keynote speaker at the Pedorthic Footwear
Association (PFA) Symposium and Exposition.
Alexander discussed, "Complex Foot Problems: Solutions for Daily
Living," the theme of the PFA's 44th annual meeting November 21-24
in Nashville, Tennessee. A record-breaking crowd of over 900
enjoyed a dynamic, wide-ranging program. Sessions examined the
"Five Cs" of pedorthic footwear:
- Comfort through pressure and pain relief;
- Control by managing the foot to improve
biomechanics;
- Cosmesis with appealing new looks in
footwear;
- Choices through being able to select from a
wide variety of footwear for daily living;
- Compliancethe result of comfort plus control
plus cosmesis plus choices.
Medical professionals are increasingly becoming aware that
footwear can give patients more health options by providing
conservative (non-surgical) alternatives to foot conditions, it was
noted.
Alexander pointed out that the key to effective management of
complex foot and ankle disorders lies in a team approach and
understanding a plethora of interacting factors. Complex in
themselves, these factors include pathological management of the
lower limb; focal mechanics in the problem area; predisposing
medical conditions, especially neurological conditions;
predisposing skin conditions; non-mechanical post-surgical
consequences; properties of orthotic materials; the mechanics of
orthotic design; and potential shoe design alterations.
After discussing these factors in more detail, Alexander
considered some pedorthic principles, such as noting that surgery
could be curative or significantly helpful in some cases, and that
when a treatment isn't working that reasonably should be
successful, noncompliance could be the problem. Pedorthists may
need to address mechanical or neuromuscular factors in other parts
of the body that could be causing or exacerbating the problem, he
said, adding, "Surgery or bracing may make it easier to deal with
the foot disorder." Pedorthists should know clearly at the outset
the mechanical effects they are trying to accomplish, he pointed
out.
Diabetic Foot Screenings Help Build a Practice
Diabetic foot screenings can build a pedorthic practice, as well
as being a community service, noted Erick Janisse, CPed, BOCO.
Screening involves patient foot history, physical inspection of the
feet, worn shoe analysis, Brannock device measurement, monofilament
sensory testing, plantar pressure readings, and reviewing these
findings with the patient.
What to do with the findings? Janisse said the pedorthist can a)
give them to the patient, b) forward to the physician directly, c)
and make sure the patient follows up with the physician. However,
the physician may or may not agree with the pedorthist, he
added.
How does the pedorthist get the word out about this service?
Direct mailing, free screening coupons, advertising, participating
in health fairs, and signage are all possible avenues, Janisse
said. "Adding diabetic foot screenings to your practice will not
only benefit you as a practitioner or a business owner, but will
also provide a service to your physicians that few other allied
health professionals offer and will serve as an aid in the
education of the diabetic population in your areapossibly even
saving lives and limbs."
More Highlights
Highlights of the clinical and technical sessions included
presentations on lower-extremity biomechanics, complex forefoot
disorders among athletes, the science behind pedorthics, Charcot
foot, and fabricating custom-molded shoes. A sampling of the
business-oriented sessions included using visual design to build a
practice, Medicare and licensure updates, and sales and marketing
ideas.
Next year's Symposium and Exposition is scheduled for October
30-November 2 in Dallas, Texas. 
Table Of Contents - February 2003
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