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Selected Case Studies
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Lumbar Degenerative Disc Disease
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Low Back Pathology
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Dancer S/P Multiple Trauma
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Carpal Tunnel, Post Release
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Cervical Pathology
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Charo-Marie Tooth Disease
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Degenerative Medial Meniscus
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Femur Fracture - IM Rod
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Hip Pathology
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Knee Pathology
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Systemic Lupus Erythematosus
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Pitcher's Shoulder
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Rotator Cuff Pathology
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Shoulder Tendonitis
Functional Capacity Evaluations

CASE STUDIES - Charo-Marie Tooth Disease

History: The patient is a 46 year old female Administrator. She had complaints of right hip pain, right knee pain, and right ankle pain. Her diagnosis was Moderate Chronic Charcot-Marie-Tooth Disease.

Kinematic Gait Analysis revealed a right forward leaning gait pattern due to the right hip extension deficit of about 11 degrees [Graph I]. Comparative ground reaction force analysis revealed a slightly prolonged loading response on the right [0.235 sec.] vs. as compared to the left [0.235 sec.]. The analysis further revealed a deficient initial lateral shear force on the right [2.76 lbs.] as compared to the left [5.7 lbs.] [Graphs II and III].


Graph I
Hip Extension / Flexion



Graph II
Left Foot Stance Ground Reaction Forces


Discussion: The kinematic results of deficient right hip extension and the kinetic results of deficient right foot initial lateral shear force are compatible with the patient's complaint of lateral ankle, medial knee and lateral hip pain. The prolonged loading response may be in response to discomfort upon right heel strike.


Graph III
Right Foot Stance Ground Reaction Forces


Recommendation: Test results clearly indicate an imbalanced gait. Trial by trial testing with temporary orthotic wedging proved helpful in improving balance. A 1/8" right lateral heel wedge posting was successful in restoring a balanced initial lateral shear force [Graph IV].


Graph IV
Right Foot Stance Ground Reaction Forces - Post Wedging


Outcome: The patient experienced significant relief from the orthotic wedge. Permanent orthotics were manufactured with the specifications derived from ground reaction force analysis.



© 2008 Kinematic Consultants, Inc.