#111 Practical Applications to Biomechanics of the Foot, Ankle & Lower Extremity

SUMMARY: This seminar is designed to provide an overview of the influence of lower extremity structural alignment on function and rehabilitation. Particular emphasis will be placed on the understanding of joint biomechanics of the foot and ankle, biomechanical assessment of the lower extremity and intervention through the use of exercise, footwear, and foot orthesis. A lecture format will be presented on day one and two. Optional "hands on" lab sessions will be provided on day three in order to reinforce and demonstrate practical applications of the prior lecture material.

PRESENTER: Brian R. Hoke, P.T., S.C.S., received his degree in Physical Therapy with highest distinction from Indiana University School of Medicine in 1981. His clinical experience has focused exclusively upon orthopedic and sport physical therapy with particular emphasis on the biomechanical basis for lower extremity rehabilitation. Mr. Hoke is board certified in Sports Physical Therapy by the American Board of Physical Therapy Specialties. For the past fourteen years, he has traveled extensively throughout the United States and Canada to speak on lower extremity evaluation and rehabilitation in conjunction with the seminar series, When The Feet Hit The Ground, Everything Changes, Mr. Hoke has twice traveled to present seminars to physical therapists in the U.S. Medical Command in Europe. He is currently Director of Atlantic Physical Therapy in Virginia, where his caseload consists of soft tissue injury, post surgical rehabilitation, injuries to running athletes, and biomechanical orthoic therapy.

OBJECTIVES: Lecture/Demonstration/Lab Formal

1) Discuss relevant anatomical relationships of the distal lower extremity.

    1. Define the normal components of motion at the major articulations of the foot and ankle.
    2. Describe typical closed kinetic chain patterns of motion including normal human gait.
    3. Define subtalar neutral and describe basic foot types.
    4. Evaluate both Intrinsic and extrinsic influences upon normal gait.
    5. Describe components of footwear and be able to prescribe appropriate features based upon lower extremity biomechanics.
    6. Discuss components of foot orthesis and their application to various patient populations.
    7. Evaluate subtalar joint neutral in weight bearing and non-weightbearing.
    8. Perform a technically correct biomechanical assessment of the lower extremity.
    9. Analyze normal and abnormal gait through the use of slow motion video.
    10. Fabricate a technically accurate neutral position case and recognize common casting errors.
    11. Apply basic taping techniques to assist in providing stress relief to healing tissues.
    12. Fabricate simple temporary orthotic interventions and perform basic adjustments and repairs to existing orthotics.

AUDIENCE: Physical Therapists, Physical Therapy Assistants, Prosthetists, Orthotists, Exercise Physiologists, and Athletic Trainers. This is a three day workshop.


Day One

8:00AM Anatomy and accurate terminology with emphasis on the foot and ankle

10:00 AM Joint biomechanics of the foot and ankle

11:15 AM Closed kinetic chain lower extremity function, static stance and gait

1:30 PM Subtalar joint neutral assessment and its role in delineating foot types

3:15 PM Extrinsic abnormalities: Recognition and their impact on lower extremity

Day Two

8:00 AM Intrinsic abnormalities in foot structure, recognition and closed kinetic chain function

10:15 AM Biomachanical assessment of lower extremity structure

11:130 AM Video examination of Gait

1:45 PM Overview of foot orthoses and implications for various patient populations

3:15 PM Footwear: Design, analysis, and appropriate selection for various foot types

4:15 PM Lower extremity compensation for abnormalities in alignment and structure, and use of foot orthotic device to control corrpensation

Day Three

8:00 AM Subtalar natural position assessment: *Supine *Prone *Standing

9:45 AM Biomechanical lower extremity assessment abnormalities in structure in the sagittal, frontal, and transverse planes

1:00 PM Video analysis of gait/ Neutral position casting, role in obtaining an accurate, foot orthosis

3:00 PM Taping, temporary orthopedic fabrication, and "Tricks of the Trade"