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Q & A with Podiatrist: Dr. Lee Reiter

Q & A with Podiatrist: Dr. Lee Reiter

How can a podiatrist diagnose CMT? When examination reveals characteristics of CMT such as the presence of a cavus foot type (a high arched foot as opposed to a flat foot), muscle weakness, reduced light touch sensation, reduced protective sensation and reflexes, and an awkward gait, it can point to the need for a neurology consult.  By implementing the tools of a patient’s history along with the physical examination, a podiatrist can help point the patient toward a working diagnosis.   Gene therapy plays a role in so many studies and treatments of neuro-muscular disease. What type of research is occurring now for CMT?    Transgenic mouse models have led to the identification of an enzyme, histone deacetylase 6, as a potential therapeutic target for inherited peripheral neuropathies (d’Ydewalle C, et al, 2012) of which CMT is one. This enzyme is important in the regulation of axonal transport. Nerves fire messages through axons.   In what way can a podiatrist address the CMT patient’s walking ability or comfort? A study in Muscle Nerve 2012 (Ramdharry et al) supported the use of a brace called AFOs (ankle foot orthoses) to reduce foot drop, which may be seen in CMT gait patterns. Orthotics may also help early stage CMT. In general, orthotics have benefitted many patients due to the improved biomechanics of the foot when wearing them.  AFOs and orthotics are generally made by podiatrists since podiatrists can not only make an appropriate mold of the foot and ankle but also examine the gait and posture in a way that most specialties cannot. Bracing higher than the ankle usually is fitted...