MONDAY, May 26 (HealthDay News) -- Using a cane may help reduce the risk of knee osteoarthritis (OA) progression, according to a study by researchers at the University of Melbourne in Australia.

The study included 16 men and 24 women, mean age 65, with knee OA, an incurable joint disease that's the leading cause of disability in elderly people. All the participants walked in their bare feet and then in their own shoes. Then, 20 of the participants walked wearing their own shoes and using a cane in the hand opposite to the knee with OA.

During these tests, the participants walked over sensors that recorded ground impact. The researchers also gathered data on limb movement.

Overall, the peak knee adduction moment -- an indication of weight placement while walking -- was 7.4 percent higher when wearing shoes than when walking barefoot. Use of a cane resulted in a 10 percent average decrease in the knee adduction moment. Some of the participants had a more than 20 percent decrease when using a cane.

While the participants tended to walk more slowly while using the cane, they had greater stride length and improved pelvis control, which alleviates the damaging load on the knee with OA.

The study was published in the journal Arthritis Care & Research.

While canes are already widely recommended for patients with knee OA, this study confirms their therapeutic value, at least in the short-term, the researchers said.

"Further studies are required to establish whether knee loading remains lower with ongoing use of a cane and whether the reductions in loading translate to a reduced risk of disease progression," study author Dr. Rana S. Hinman said in a prepared statement.

It's not clear why wearing shoes increased the peak knee adduction moment, but heel height, sole thickness, and arch supports may all be factors.

"Because it is potentially dangerous as well as impractical to advise patients with knee OA to walk about in bare feet, further research is needed to determine which types of shoes least increase the knee adduction moment or, ideally, reduce it," Hinman said.

More information

The Arthritis Foundation has more about osteoarthritis  .

FRIDAY, May 9 (HealthDay News) -- Telemedicine is a cost-effective way to replace more than a quarter of all visits to the pediatric emergency department, according to a community-wide study conducted in New York.

Ailments, such as ear infections or sore throats, that virtually always prove manageable by telemedicine made up almost 28 percent of all pediatric ER visits in Rochester, N.Y., during one year, according to investigators from the University of Rochester Medical Center.

Their findings were presented recently at the 2008 Pediatric Academic Societies annual meeting, in Honolulu.

"We learned that more than one in four local patients are using the pediatric emergency department for non-emergencies," lead investigator Dr. Kenneth McConnochie, a professor of pediatrics at the University of Rochester's Golisano Children's Hospital at Strong, said in a prepared statement. "This mismatch of needs and resources is inefficient, costly and impersonal for everyone involved."

McConnochie and his colleagues, who direct a Rochester-based telemedicine program that provides interactive, Internet-based pediatric health-care service to the area, analyzed data for all pediatric visits to the largest emergency department in the city. Based on their experience, they determined at least 12,000 visits were ones they routinely treat with success via telemedicine.

The other visits were either problems that sometimes are treatable through telemedicine, such as asthma attacks; or ones beyond the scope of the technology, such as a serious wound or injury.

"This would've not only freed up emergency resources to people who needed them more, it would have afforded smaller co-pays for parents and more timely, personalized care," McConnochie said.

In related research presented at the meeting, McConnochie suggested that telemedicine could also help insurers and the community by providing better quality care at a lower price -- saving insurers more than $14 per child per year in that local community.

The conclusion was reached by studying two groups of children that were almost identical, but one had access to their doctor's office, the emergency department and telemedicine technology for care, while the second had only the first two options.

"We found that the first group of families, which had access to telemedicine for their children, did in fact access care for illness overall nearly 23 percent more often than the second group," McConnochie said.

But since children with telemedicine access had 24 percent fewer ER visits, which cost about seven times the cost of a doctor office or telemedicine visit, the telemedicine group ultimately still cost insurers less per child over a year.

More information

The Nemours Foundation has more about children's health  .

WEDNESDAY, May 7 (HealthDay News) -- A new clinical guideline on screening for osteoporosis in men has been developed by the American College of Physicians (ACP), which notes that osteoporosis rates among men are expected to increase 50 percent over the next 15 years.

Osteoporosis-related fractures in men result in substantial disease, death and health costs, and the one-year death rate in men after hip fracture is twice that of women.

"Older men, especially those over the age of 65, need to be assessed regularly for risk factors for osteoporosis," Dr. Amir Qaseem, senior medical associate in ACP's clinical programs and quality of care department, said in a prepared statement. "Osteoporosis is not just a woman's disease. It is significantly under-diagnosed and under-treated in men. Not enough older men are being screened."

Risk factors for osteoporosis in men include: older age, low body weight, weight loss, physical inactivity, previous fractures not caused by substantial trauma, low-calcium diets, and ongoing use of certain drugs, such as corticosteroids like prednisone or drugs that are sometimes used to treat prostate cancer.

The new guideline says doctors should periodically assess older men for osteoporosis risk factors and should order a DEXA (dual-energy X-ray absorptiometry) scan for men who are at increased risk for osteoporosis and are candidates for drug therapy.

The guideline, based on a review of previously published studies, was published in the May 6 issue of the Annals of Internal Medicine.

Current U.S. rates of osteoporosis are estimated to be 7 percent in white men, 5 percent in black men, and 3 percent in Hispanic men. However, osteoporosis rates among U.S. men are expected to increase almost 50 percent in the next 15 years, and hip fracture rates could double by 2040, according to background information in a news release about the new guideline.

The National Osteoporosis Foundation recommends a bone mineral density test for men aged 70 and older. The U.S. Preventive Services Task Force doesn't have an osteoporosis screening recommendation for men.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about osteoporosis in men.