Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

Challenging the foundations of the clinical model of foot function

Discussion in 'Biomechanics, Sports and Foot orthoses' started by NewsBot, Jan 31, 2017.

  1. Stanley

    Stanley Well-Known Member

    Can you send me the study you are referencing?
     
  2. Stanley

    Stanley Well-Known Member

    Can you post a link to the study?
     
  3. Dennis Kiper

    Dennis Kiper Well-Known Member

    Are you familiar with reading a pedobarograph?
     
  4. Stanley

    Stanley Well-Known Member

    Yes.
     
  5. Dennis Kiper

    Dennis Kiper Well-Known Member

     

    Attached Files:

  6. Dennis Kiper

    Dennis Kiper Well-Known Member

    Unfortunately I cannot upload the barefoot image, how ever it was once uploaded to PA and if you can't find it, give me your address that I can send it to you directly.

    The image as I'm sure you recognize is with pronation modification.
     
  7. Dennis Kiper

    Dennis Kiper Well-Known Member

     
  8. Dennis Kiper

    Dennis Kiper Well-Known Member

    So, I was able to paste it in, how do you read it?
     
  9. Stanley

    Stanley Well-Known Member

    Hi Dennis,

    I think the first one was barefoot and the second one had some antipronation modification. In the second one the line of progression was more lateral at propulsion. I can also see that there is an untreated FnHL.

    What exactly does this have to do with neutral position?

    Regards,
    Stanley
     
  10. Dennis Kiper

    Dennis Kiper Well-Known Member

    The 2nd one is barefoot--the first one illustrates (with pronation modification) a principle of physics confirmed by the scan.

    Take a closer look at the peak press of each met and then look at the loading time and foot contact to the ground.

    Not sure of how you recognized the bio-mechanical feature (FnHL), I'd be interested in your insight
     
  11. Stanley

    Stanley Well-Known Member

    The second one shows increased pressure sub 2nd and 3rd metatarsal and at the IP joint of the hallux. That indicates a dorsiflexion of the first ray which occurs with FnHL.
    I looked at the peak pressure of each metatarsal. I still don't get what you are trying to tell me.

    Regards,
    Stanley
     
  12. Dennis Kiper

    Dennis Kiper Well-Known Member

    Neutral position would indicate joint axial congruency.
    which can be measured by the increase of mechanical efficiency (which the technical aspects of foot function falls under) in GRF. Just from the appearance of the barefoot vs pronation modification, the reduction of peak pressures is at least 50% with the metatarsals.

    To me, this represents "balance"--the distribution of wt bearing and pronatory forces.


    In the 2nd jpeg I'm looking at a reduction of proportionate peak pressures, initiation of quicker loading time and shorter foot contact to the ground.

    This is an increase in mechanical efficiency of the functioning mechanics. This is accomplished by an improvement in joint axial congruency aka neutral.

    What would you expect to see on scan?
     
  13. I hate to even wade into this discussion with you, Dennis. But, for those who may be following along and may, due to their relative inexperience with biomechanics, believe what you say, I feel I must speak up. Those podiatrists who are just learning the principles of biomechanics do not need to be confused by your gibberish.

    First of all, Dennis, please define what you mean by "axial congruency". An axis describes a line about which all the particles of a rigid body rotate in a circular fashion. A joint axis describes a line about which the bones of a joint rotate at that instant in time. Your term "axial congruency", is just another one of the terms you have made up and it is meaningless. In other words, an axis, since it represents an imaginary line, cannot be congruent or non-congruent. Maybe the next time you want to try and discuss biomechanical subjects, Dennis, you should attempt to at least use terms that are accepted by the international biomechanics community, not just ones you pulled out of thin air.

    Secondly, Dennis, how do you measure "mechanical efficiency" by looking at just the results of a pedobarograph? Answer...you can't.

    Third, your fluid-filled bags of plastic that you market on your website are nothing more than a cushion for the foot, which I could just as well provide to my patients with a 3-6 mm thick piece of inexpensive neoprene or poron in their shoes, regardless of the unsupported claims you make on your website http://www.drkiper.com/ If you have some scientific evidence that your fluid-filled bags of plastic are more therapeutic than an inexpensive flat, cushioned insole, then please provide the research evidence to all of us. I won't hold my breath.
     
    Last edited: Aug 23, 2018
  14. Stanley

    Stanley Well-Known Member

    How do you know that an improvement indicates neutral position rather than just an improvement?

    Time is influenced by gait speed. How do you control this?

    I do see a better functioning first ray as seen in the pressure being more even on the metatarsals (in the barefoot condition the third metatarsal had more pressure than the first, and now they are more even). Is the better functioning first ray a result of the anti-pronation modifications or did you do something to let the first ray drop?

    Very interesting stuff. I just don't know how you get to the point of saying neutral position.

    Regards,
    Stanley
     
  15. Dennis Kiper

    Dennis Kiper Well-Known Member

    I believe, mechanically, it has been established, increasing joint axial congruity, increases lever arm efficiency. So, an improvement in the efficiency of mechanical function would be a given that there would be an increase in tissue efficiency (hence--bio-mechanics). The only way I'm aware of this is to improve the “dynamic” axial congruence of stance phase—isn't at least part of what an orthotic should do?

    When you ask about “position” this refers only to midstance, let's remember that this is a continuous motion thru stance phase.
     
  16. Dennis Kiper

    Dennis Kiper Well-Known Member

     
  17. Dennis Kiper

    Dennis Kiper Well-Known Member

     
  18. Dennis Kiper

    Dennis Kiper Well-Known Member

    I don't “control” this, this is a term originated by Root. Time with hydro-dynamic technology
    is efficiently maximized, so that the time of “loading” (e.g as seen in the scan) is shortened. Therefor the gait speed may remain the same, the mechanical speed is changed. This ultimately changes the tissue efficiency.
     
  19. Dennis Kiper

    Dennis Kiper Well-Known Member

    I'm not sure if you confused the 2 images. HD technology is not an “anti-pronation” device, it assists the mechanical function thru hydro-dynamic flow. I cannot cause the the 1st ray to drop or lift.

    The action of hydrodynamic flow as a different technology compared to traditional Root theory and practical application is to:
    1. dampen the vector force at heel contact
    2. decelerate pronation motion and momentum in all three planes of motion
    3. distribute and balance wt bearing and pronatory forces through the loading and off loading of stance, and
      4) prolong balance and stability of propulsion at heel off. -I contend the stationary MTJ of a traditional orthosis, interrupts the efficient transfer and fluidity of motion and momentum and presents an unstable platform at heel off compared to a prolonged stability at the same moment in time under hydro-dynamic pressure, comparing a bare-foot against the two technologies.
     
  20. Dennis Kiper

    Dennis Kiper Well-Known Member

    If my bio-mechanical termas are gibberish to you, that's because a different technology requires
    different terminology. Frankly this is not even about biomechanics—other than the theories and conjecture you profess, this is about mechanical efficiency of human locomotion.
     
  21. Dennis Kiper

    Dennis Kiper Well-Known Member

    Why don't you search the term axial congruence—here is one example I found:
    Cited by 25 - ‎Related articles
    Mar 4, 2018 - Axial linear patellar displacement: a new measurement of patellofemoral congruence. Urch SE(1), Tritle BA, Shelbourne KD, Gray T.
     
  22. Dennis Kiper

    Dennis Kiper Well-Known Member

    the axis may be imaginary, but any scientist worth his oats can think out of the box and recognize the joint is real. Biomechanics of every joint in the body (except the foot) describes efficiency of its function in terms of congruence

    cannot be congruent or non-congruent. Maybe the next time you want to try and discuss biomechanical subjects, Dennis, you should attempt to at least use terms that are accepted by the international biomechanics community,

    maybe the int'l community should look at a technology predicated on principles of physics, instead of theory
     
  23. Dennis Kiper

    Dennis Kiper Well-Known Member

    This is where you need to “think like an engineer”--
     
  24. Dennis Kiper

    Dennis Kiper Well-Known Member

    Generic, semi-solid, silicone gel insoles can reduce peak plantar pressure asseen in a study by Serena Anthony; “A Study to Investigate the Effect of Sofsole® Silicone Gel Insoles on Plantar Pressure”, the efficacy in reducing peak plantar pressure of a semi-solid gel, as a cushion, does not demonstrate the difference and importance in mechanical efficiency of the reduction of those pressures through functional mechanical alignment for prescription purposes.

    With the mechanics of alignment, the proper proportionate amount of reduction and balance is attained. With a cushion there is a disproportionate amount of peak pressure, which still contributes to the imbalance and pathology.
     
  25. Stanley

    Stanley Well-Known Member

    It seems you did not understand the question. If someone walks faster, the stance phase will be shorter in duration. If you could show the swing phase time, that would be helpful.
     
  26. Stanley

    Stanley Well-Known Member

    You said "I think the first one was barefoot and the second one had some antipronation modification." in an earlier post. I am confused.
    The hydrodynamic flow sounds like a cushioned insole. I remember as a fellow in biomechanics and orthopedics in 1976 learning about a device the "old-timers" made of a material called Molo which would compress half of its thickness and the rest would remain as a cushion.
     
  27. Dennis Kiper

    Dennis Kiper Well-Known Member

    Stanley, the swing phase is not an issue, except for traditional orthotic technology. If someone walks at a different pace barefoot or with pronation modification, the hydrodynamic effect is the same. This is a different technology, you need to rethink what effect biomechanically it has instead of looking at what you'd look for with traditional technology.
     
  28. Dennis Kiper

    Dennis Kiper Well-Known Member

    It is the TNJ's ROM, which allows for a principle of physics that “displaced fluid seeking the path of least resistance”- makes it so. This is supported by several articles on the ROM of the talo-navicular joint and digital technology has also confirmed the TNJ has the primary movement in overpronation of the medial longitudinal arch .
     
  29. Dennis Kiper

    Dennis Kiper Well-Known Member

    PS--the 1st image posted was with the HD technology, the 2nd image was barefoot.
     
  30. Dennis Kiper

    Dennis Kiper Well-Known Member

    Stanley,

    I want to repeat, this is not a cushioned insole, it is a Rx.
    Hydro-dynamic orthotic technology as an orthopedic/ bio-mechanical tool, addresses arch motion and mechanical efficiency, predicated on principles of physics in all three planes of motion and its accurate effect on bio-mechanical function. Unlike the external dynamics of traditional shell orthotic technology, HD flow allows the orthoses to adapt bio-mechanically to the structure, rather than the structure adapting to the orthosis. This increases bio-mechanical efficiency and comfort, and can provide a reliable treatment methodology that is both effective, and verifiable.
     
  31. Stanley

    Stanley Well-Known Member

    Now I am more confused. Are you saying it doesn't matter what the speed of gait is on the time of the stance phase?
     
  32. Stanley

    Stanley Well-Known Member

    Actually the joints are interdependent when the foot is in contact with the ground.(Hicks wrote that).
     
  33. Stanley

    Stanley Well-Known Member

    Dennis,
    The more I read what you write, the more confused I get.
    We were discussing finding neutral position by palpation. Then you started writing about your HD insoles putting the foot in neutral, by looking at a pedobarograph.
    You showed one step on a pedobarograph with no biomechanical examination and made astounding claims.
    If someone has a long leg and compensate by pronating and hence shortening the long leg. What will your device do?
    I don't see how your device is much different than any cushioned insole after reading what you wrote.
    So far I have to agree with Kevin on this one (which is a rarity). Sorry!!

    Stanley
     
  34. Franklin

    Franklin Active Member

    Hi Everyone,

    Starting from post #661 onward, this excellent thread has taken a nosedive. Just a thought, but perhaps it might be more appropriate to transfer the posts from #661 onward into the Classifieds area and insert it into Marketplace section as a thread on, say, 'In-shoe Fluid-filled Bags of Plastic [aka 'fluid-filled cushion insole'] or some such title. I feel the conversation would be far better carried on there. From post #661 through to #671 - all postings by the same poster - and then more of the same as the thread continues [e.g.: post #695 - #704], which in terms of volume is almost tantamount to spamming. Very frustrating! To be honest, my eyes have glazed over.

    This thread began as a commentary on the following paper:

    Challenging the foundations of the clinical model of foot function: further evidence that
    the Root model assessments fail to appropriately classify foot function

    Hannah L Jarvis, Christopher J Nester, Peter D Bowden, Richard K Jones
    JFAR 2017 (accepted publication)

    What's happened?

    Franklin.

    P.S.: Post #693 - very well said, Kevin!
     
    • Agree Agree x 1
    • Winner Winner x 1
    • List
  35. Nice to see you back commenting here, Eric. Too bad there is not more close observation of these threads. The good threads, where people are actually commenting, vanish within a day or two due to the 20 new posts by Newsbot every day. Then there also the spammers like Dennis Kiper taking over a thread, using his made-up terminology and pseudo-science to attempt to convince others that his fluid-filled plastic in-shoe cushions are some sort of biomechanical marvel. Sad to see Podiatry Arena go down this way since it was so good for so long.
     
  36. Dennis Kiper

    Dennis Kiper Well-Known Member

    Stanley

    It is unfortunate that you are confused. Maybe you're confused because you're unable to separate mechanical function from tissue function. Maybe you're confused because you couldn't recognize barefoot function from “anti-pronation” function? Is it that you've never seen a scan of accurate, efficient mechanical stance function and you don't know what to expect?

    I asked if you're familiar with reading a pedobarograph, yet you couldn't recognize reduction of proportionate peak pressure as a function of mechanical efficiency. Maybe you don't recognize the functional difference between HD flow and a cushion? How did you confuse quicker loading time and shorter foot contact to the ground as gait speed? Why did you ask about swing phase when it has nothing to do with stance function? How is it, you didn't recognize or ask about the principles of physics you were seeing? Maybe your scientific foundation is weaker than you realized?

    Biomechanics and the entire int'l community who deal with this are stuck in their paradigms which are about 70 years old. Back in 2006, Dr. Karl Landorf, stated in an article in JAPA “there is still a lack of scientific evidence that is of suitable quality to fully inform clinical practice” . This holds true, still today, predicated on current standards in practice.

    The real confusion to me is why a profession (podiatrists and allied foot care health professionals) are adamant about practicing guesswork, instead of scientific bio-mechanical medicine? There is no consistency, reliability or accuracy with a technology that lacks one shred of scientific support to the foundation of traditional orthotic technology. This is probably why there are so many unanswered questions in the field.

    So, you're confusion is noted.
     
  37. Dennis Kiper

    Dennis Kiper Well-Known Member

    Neil deGrasse Tyson commented on a series of the cosmos, that individuals who use the term pseudo science where science was in evidence as being simply ignorant.
     
  38. Dennis, I just wish you could generate just one good argument as to why podiatrists should use your squishy, fluid-filled pieces of plastic in order to treat the myriad of mechanically-related foot and lower extremity pathologies that you claim your product treats. All you do is throw up straw man arguments, provide us with no good scientific research as to why your fluid-filled in-shoe cushions represent some "new breakthrough" in foot orthosis technology, other than the mumbo-jumbo marketing from your website.

    For those who have not visited Dennis Kiper's website, here is some of the pseudo-science he is promoting in order to sell more of his fluid-filled in-shoe cushions:


    Looks like a lot of bull-dung to me. Anyone find any references to any of the remarkable claims made by Dennis Kiper on this page? You won't because there are none.

    Dennis, why don't you go peddle your foot cushions somewhere else. This is an ACADEMIC podiatric website, we aren't interested in your spam.
     
  39. Dennis Kiper

    Dennis Kiper Well-Known Member

    What are you scared of?
     
  40. I am not "scared". I am, however, irritated that you continue to spam us here on Podiatry Arena. If you have something, other than your non-scientific drivel, such as a scientific study that shows your cushioned, fluid-filled plastic insole actually cause any therapeutic, kinematic or kinetic effect, then please provide it to us. If not, why don't you go try to push your fluid-bag insoles on someone who is more gullible than we are. We are becoming tired of your unscientific nonsense.
     
    • Like Like x 1
    • Agree Agree x 1
    • List
Loading...

Share This Page