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Additions to Treatment Using Biomechanics by Arena Memebrs in 2012

Discussion in 'Biomechanics, Sports and Foot orthoses' started by drsha, Dec 29, 2012.

  1. drsha

    drsha Banned


    Members do not see these Ads. Sign Up.
    Another year has come and gone and from my review, once again, on an annual basis, there have been few if any notable additions to valid, important, high level EBM when it comes to biomechanics.

    So I add 2012 to my annual call for additions to the literature and the EBM in our field that we can document.

    Can our members please take credit for their researched and published works for this year that I, once again, have failed to personally add to.

    Perhaps there are those of you who are too proud to boast by listing your accomplishments on the Internet and so, I welcome others among The International Biomechanics Community to list those additions authored by Arena Members or others.

    This continues to be a great annual thread for me and one which I predict once again, will remain thin.

    Dennis
     
  2. drsha

    drsha Banned

    EBM Additions To Biomechanical Diagnosis Technique by Arena Members in 2012

    Another year has come and gone for this annual event.

    Can we list any additions to the Peer Reviewed Literature by Arena Members or others in The International Biomechanics Community that adds any valid, high level, applicable, reproducible evidence to the diagnosis of biomechanical pathology published in 2012.

    I personally, have once again not succeeded in producing any, nor do I have any to list from my colleagues here on The Arena or The International Biomechanics Community.

    As I am sure, many of us would rather not taut their own work, please feel free to list the work of others that you have incorporated into your practices.

    I once again predict that this will be a thin thread.

    Dennis
     
  3. W J Liggins

    W J Liggins Well-Known Member

    I suspect that many of my esteemed colleagues would not like to duplicate the work of others, but especially their own.

    Happy New Year

    Bill
     
  4. drsha

    drsha Banned

    Unlike others of your posts, your suspicions do not play here as I am calling for actual additions to the valid and applicable peer reviewed literature which apparently you cannot, once again, provide here or elsewhare.

    That is what makes my end of year threads so valuable, especially for students and new members to The Arena. They level the playing field.

    Your esteemed colleagues, who have a desire to publish original work (as I do) have only produced anecdotal, rather low level non peer reviewed into publication (as I have). They have lectured around the globe (as I do). They have developed respect and titles in their communities (as I have)

    Summarily, they have not produced any valid, peer reviewed publications in almost three years now.

    So, why haven[t you listed their 2012 accomplishments or those of your own.

    Last year, on my 2011 thread, Dr. Payne posted that he was too busy to publish while apparently not being too busy to decide what is snake oil.
    What about this year Craig, or Robert, or Kevin, or Simon or Hilton or.............................any esteemed colleagues of Dr Liggins (which I suspect I am not).
     
  5. Just the one publication in a peer reviewed journal from me this year. However, I have enjoyed and learned from the published works of several other members of Podiatry Arena during 2012, including, but not exclusively: Toni Arndt, Jo Paton, Ken Van Alsenoy, Josh Burns, Hylton Menz, Karl Landorf etc. And not forgetting my own mentor and good friend: Kevin Kirby. Nor of course, the man who makes all of this possible: Craig Payne.

    Once again, your continued effort to belittle the contributions of others only serves to emphasise your own inadequacies, Dr Shavelson. You could have performed a search to see who'd published this year before making yourself look like an ignoranus yet again, but no. There really is no start to your talents. Moreover, to categorically state that no member of Podiatry Arena has "produced any valid, peer reviewed publications in almost three years now" is a complete misrepresentation of the facts and insulting to those members of Podiatry Arena who, unlike yourself, are publishing within peer reviewed journals. Wind your neck in, Dennis.
     
  6. The above reminds of a quip from Barry Gibb who said of himself "I have a huge ego and a huge inferiority complex at the same time."

    What a pity he didn't have a penis growing out of his forehead for you could well be related if he had.
     
  7. OOPS. Nearly forgot my padawan: Ian Griffiths is yet another member of Podiatry Arena who has published in a peer reviewed journal this year. Sorry Griff :eek: BTW Dennis, it's "member" or "members" not "Memebrs"; if you need a reminder of what a "member" looks like, just glance at yourself in the mirror.
     
  8. What kind of man attempts to build up his own ego and confidence by publicly belittling those who have in the past made, and continue to make contributions to the intellectual growth of their profession, while providing no meaningful contributions of his own?

    Answer?

    A very small man.
     
  9. David Wedemeyer

    David Wedemeyer Well-Known Member

    The narcissist enjoys being looked at and not looking back.
    Mason Cooley
     
  10. drsha

    drsha Banned

    I have learned from you and the others you quote as well but here, I am asking for peer reviewed literature that adds to or upgrades an existing treatment regemin biomechanically.

    Could you list your article and the others you mention (which was the request) so that its import can be evaluated and avoid your need to attack me personally.
    Dennis
     
  11. Go google, Dennis.
     
  12. drsha

    drsha Banned

    It seems to me that if you were producing valid, high level evidence that actually made a clinical addition or upgrade that you would want to shout it from the rooftops.

    What I maintain is that none of us has produced that as of yet and that perhaps, you are hiding behind your academic standing, education letters or your bully pulpit proclaiming that EBM should dictate biomechanics and that your opinion is more valuable than others because you taut 'The Emperors New Bioechanics EBM".

    I took your advice and googled
    kevin kirby peer reviewed articles

    there was one hit that fit:
    http://www.podiatrynetwork.com/editor_detail.cfm?id=2

    where it listed:
    Kirby, Kevin A., and Ronald L. Valmassy: "The Runner-Patient History: What to Ask and Why", Journal of the American Podiatry Association, 73: 39-43, January 1983.
    Santoro, John P., and Kevin A. Kirby: "Boot Fitting Problems in the Skier", Journal of the American Podiatric Medical Association, 76: 572-576, October 1986.
    Kirby, Kevin A.: "Methods for Determination of Positional Variations in the Subtalar Joint Axis",Journal of the American Podiatric Medical Association, 77: 228-234, May 1987.
    Kirby, Kevin A., David B. Arkin, and Wilfred Laine: "Digital Systolic Pressure Determination in the Foot", Journal of the American Podiatric Medical Association, 77: 340-342, July 1987.
    Kirby, Kevin A., Alan J. Loendorf, and Renee Gregorio: "Anterior Axial Projection of the Foot", Journal of the American Podiatric Medical Association, 78: 159-170, April 1988.
    Kirby, Kevin A.: "Rotational Equilibrium Across the Subtalar Joint Axis", Journal of the American Podiatric Medical Association, 79: 1-14, January 1989.
    Kirby, Kevin A., and Donald R. Green: "Evaluation and Nonoperative Management of Pes Valgus", pp. 295-327, in DeValentine, S.(ed), Foot and Ankle Disorders in Children. Churchill-Livingstone, New York, 1992.
    Kirby, Kevin A.: "The Medial Heel Skive Technique: Improving Pronation Control in Foot Orthoses", Journal of the American Podiatric Medical Association, 82: 177-188, April 1992.
    Ruby, Patricia, Maury L. Hull, Kevin A. Kirby, and David W. Jenkins: "The Effect of Lower-Limb Anatomy on Knee Loads During Seated Cycling", Journal of Biomechanics, 25 (10): 1195-1207, October 1992.
    Johnson, E. Ralph, Kevin A. Kirby, and James S. Lieberman: "Lateral Plantar Nerve Entrapment: Foot Pain in a Power Lifter", The American Journal of Sports Medicine, 20 (5):619-620, 1992.
    Kirby, Kevin A.: "Podiatric Biomechanics: An Integral Part of Evaluating and Treating the Athlete", Medicine, Exercise, Nutrition and Health, 2 (4):196-202, 1993.
    Kirby, Kevin A.: "Modifying Orthoses", Podiatry Today, Vol VII, No. 6, pp.42-46, October 1994.
    Kirby, Kevin A.: "Functional Design in Running, Court and Fitness Shoes", Podiatry Today, Vol VII, No. 9, pp. 37-44, February 1995.
    Kirby, Kevin A.: "How Much Are Orthotics Really Worth?", Podiatry Management, Vol 14, No. 6, pp. 73-77, September 1995.
    Kirby, Kevin A.: "Troubleshooting Functional Foot Orthoses", pp. 327-348, in Valmassy, R.L.(editor), Clinical Biomechanics of the Lower Extremities, Mosby-Year Book, St. Louis, 1996.
    Kirby, Kevin A.: "Biomechanics of the Normal and Abnormal Foot", Journal of the American Podiatric Medical Association, 90:30-34, January 2000.

    I am not trying to reduce Dr Kirby's rightful place in biomechanics as a giant which I defend all the time. I am simply stating that producing viable, important EBM for biomechanics is very difficult and that none of us has accomplished much of it.
    Logically, this means that we should be depending on other sources a la Sackett as fuel to grow our science and stop putting so much emphasis on what cannot be produced.

    Perhaps Kevin or someone else can update this list but it would be so much easier for you to list your EBM accomplishments instead of calling me an ignoranus, (which is childish) and then thanking each other.

    I predict you have few articles to list and that next year you will once again have very few until you can find a way to reduce the variables among feet and research subject groups that share similar characteristics in the rearfoot and forefoot to start with.

    Happy 2013
    Dennis
     
  13. Ian B. Griffiths and Islay M. McEwan
    Reliability of a New Supination Resistance Measurement Device and Validation of the Manual Supination Resistance Test
    J. Am. Podiatr. Med. Assoc. 2012 102:278-289

    This one was rather useful.

    Koen L. M. Koenraadt, Niki M. Stolwijk, Dorine van den Wildenberg, Jaak Duysens, and Noël L. W. Keijsers
    Effect of a Metatarsal Pad on the Forefoot During Gait
    J. Am. Podiatr. Med. Assoc. 2012 102:18-24

    As was this one. Always nice to investigate that which we hypothesise

    Greg Quinn
    Normal Genetic Variation of the Human Foot: Part 1: The Paradox of Normal Anatomical Alignment in an Evolutionary Epigenetic Context
    J. Am. Podiatr. Med. Assoc. 2012 102:64-70

    Greg Quinn
    Normal Genetic Variation of the Human Foot: Part 2: Population Variance, Epigenetic Mechanisms, and Developmental Constraint in Function
    J. Am. Podiatr. Med. Assoc. 2012 102:149-156

    I've always found Greg's area to be fascinating. Not directly a treatment or a trial but anything that increases our understanding can only be a good thing.

    Sarah P. Shultz, Michael R. Sitler, Ryan T. Tierney, Howard J. Hillstrom, and Jinsup Song
    Consequences of Pediatric Obesity on the Foot and Ankle Complex
    J. Am. Podiatr. Med. Assoc. 2012 102:5-12

    This one certainly adjusted the way I consider paeds patients and has affected my treatments as well as having a few implications for a broader understanding.

    Michael S. Rathleff, Luke A. Kelly, Finn B. Christensen, Ole H. Simonsen, Søren Kaalund, and Uffe Laessoe
    Dynamic Midfoot Kinematics in Subjects with Medial Tibial Stress Syndrome
    J. Am. Podiatr. Med. Assoc. 2012 102:205-212

    This one, Hugely important in my view. Demonstrates the importance of DYNAMIC assessment, not merely diagnosis of a structure of foot type. ;)

    And so on.

    What you have to grasp Dennis is that while you are promoting a fixed, set protocol, most of us are not. If you have a recipe book of if X presents then do Y then a broader understanding of biomechanics avails you nothing. If, on the other hand, you are taking a tissue stress approach then each little piece of knowledge we gain of how the whole works alters how you assess and prescribe.

    Take the Nav drop velocity for MTSS for example. Granted the numbers were small, but it indicates that the speed, as well as the degree of pronation is significant. That means its something else to look for as part of an assessment and something else to consider when prescribing, so yes it is an addition to treatment.

    Personally, my clinical highlight was developing a new and, I think, better type of Hallux valgus night splint for children (along with 2 colleagues). Too early to comment on outcomes as yet but in terms of comfort, compliance and appearance, they're definitely an upgrade!

    Perhaps I should patent it ;).
     
  14. Keep looking Dennis. You didn't even manage to find any of Professor Kirby's publications in peer reviewed journals post the year 2000, let alone that which was published this year. Within that list of members of Podiatry Arena who have published in peer reviewed journals this year that I provided for you, you will find expert opinion pieces, bone-pin studies, development and testing of measuring equipment, validation studies of clinical measurement techniques, experimental assessment of orthoses modifications and controlled trials of foot orthoses; a good raft of studies which all add to the evidence base. It took me less than 10 minutes to find these, but rather than actually carry out some basic research of your own, through identifying some of the literature produced by members of Podiatry Arena during 2012 you expect to be handed everything on a plate. Worse, you make statements such as no member of Podiatry Arena has "produced any valid, peer reviewed publications in almost three years now", which is frankly just a lie to meet your own ends. If you are going to start these threads and make such statements, the very least you can do is some background reading to make sure you've got your facts straight. As I've said before, I have no real desire to communicate with you and certainly no desire to help you in any way. I only commented here to point out to others your lies and mis-truths. You have quite the most abhorrent character it as ever been my misfortune to encounter.


    Goodbye.
     
  15. drsha

    drsha Banned

    Dr Isaacs, in response:
    Ian B. Griffiths and Islay M. McEwan
    Reliability of a New Supination Resistance Measurement Device and Validation of the Manual Supination Resistance Test
    J. Am. Podiatr. Med. Assoc. 2012 102:278-289

    It tested 26 subjects, left foot only.
    The supination resistance machine was shown to have sufficient limits of agreement for the study, but improvements need to be made for more meaningful research going forward.
    Results included:"Interrater reliability of all of the measurements was generally poor".
    and "Supination resistance measurements correlated poorly with the FPI-6 and weakly with body weight".
    yet it concluded that:
    "The supination resistance machine was shown to have sufficient limits of agreement for the study, but improvements need to be made for more meaningful research going forward".
    This is a mouse study, with no control that admits to low level results needing further investigation.
    Level IV at best.

    Koen L. M. Koenraadt, Niki M. Stolwijk, Dorine van den Wildenberg, Jaak Duysens, and Noël L. W. Keijsers
    Effect of a Metatarsal Pad on the Forefoot During Gait
    J. Am. Podiatr. Med. Assoc. 2012 102:18-24

    As was this one. Always nice to investigate that which we hypothesise

    This study focused on the effect of a metatarsal pad on the geometry of the forefoot by studying forefoot width and the height of the second metatarsal head.


    Cohort: 16 primary metatarsalgia feet and 12 control feet were measured when walking with and without a metatarsal pad.

    Using the met pad resulted in a .60mm increase in width in stance and a .74mm increase in width in midstance whcih was then called "SIGNIFICANT"
    Less than 1 mm divided between the intermetatarsal spaces yet called this SIGNIFICANT!
    In addition, the authors found a .6mm increase in the height of the 2nd met.

    Conclusions: The combination of increased forefoot width and the height of the second metatarsal head produced by the metatarsal pad results in an increase in space between the metatarsal heads.
    Maybe the increase in width was at the medial and lateral soft tissue borders as the authors failed to measure the intermetatarsal spaces pre and post pad and when divided among the interspaces the spread was negligable.
    and
    The study did not conclude that the extra spread or lift actually plays a role in pain reduction produced by a metatarsal pad.

    I find this article almost useless as to validity and import.

    We know that met pads work but this article, IMHO, doesn't add meaning as to how they work which I assume was its intent.

    For the next two:
    Greg Quinn
    Normal Genetic Variation of the Human Foot: Part 1: The Paradox of Normal Anatomical Alignment in an Evolutionary Epigenetic Context
    J. Am. Podiatr. Med. Assoc. 2012 102:64-70

    Greg Quinn
    Normal Genetic Variation of the Human Foot: Part 2: Population Variance, Epigenetic Mechanisms, and Developmental Constraint in Function
    J. Am. Podiatr. Med. Assoc. 2012 102:149-156

    You yourself state:
    I've always found Greg's area to be fascinating. Not directly a treatment or a trial but "anything that increases our understanding can only be a good thing".
    Level IV or V at best and not relevant as EBM on this thread.

    Sarah P. Shultz, Michael R. Sitler, Ryan T. Tierney, Howard J. Hillstrom, and Jinsup Song
    Consequences of Pediatric Obesity on the Foot and Ankle Complex
    J. Am. Podiatr. Med. Assoc. 2012 102:5-12

    This one certainly adjusted the way I consider paeds patients and has affected my treatments as well as having a few implications for a broader understanding.

    N=20 here. It tested the ankle, knee and hip joints and concluded that fast walking was more stressful in OBESE CHILDREN than slow walking. It also concluded the same thing for NORMAL WEIGHT CHILDREN.

    So slow walking is less stressful than fast walking.
    This I rate as Level VI as in who cares.

    Michael S. Rathleff, Luke A. Kelly, Finn B. Christensen, Ole H. Simonsen, Søren Kaalund, and Uffe Laessoe
    Dynamic Midfoot Kinematics in Subjects with Medial Tibial Stress Syndrome
    J. Am. Podiatr. Med. Assoc. 2012 102:205-212

    This one, Hugely important in my view. Demonstrates the importance of DYNAMIC assessment, not merely diagnosis of a structure of foot type. ;)

    N=14.
    There was no control to show that there were or were not subjects that had a change in static or dynamic ND and NO MTSS

    This is an interesting study, I agree but it is low level and mouselike with no real power and certainly no input as to how we could change our treatment for MTSS utilizing the findings beyond vaulting (FFT Positive).

    Summarily, IMHO, none of these articles fit my request for high level EBM and are disqualified unless you disagree with my critique.

    What you have to grasp Robert is that my work, and your critique of it on this thread, has nothing to do with the fact that you have not produced any EBM of value.

    If you examined my work, I use tissue stress on both a micro and macro level as influences, just not the only ones.

    You yourself declare
    I agree but you are far too kind in your critique of this article and I'm not sure why?
    even if incredibly obvious and whether it was kinetic or kinematic, vaulting is the treatment
    Dennis
     
  16. And there's the rub Dennis. I've not seen a single other body on this forum who agrees with your opinion on what constitutes good EBM. Which leaves us with one of two possibilities. Either you're correct and everyone else is wrong, or everyone else is correct and you, alone, misapprehend what is important, useful research and what is not.

    Without wishing to be disrespectful, I'm going to go with option B.

    Your thread is misnamed. It should be

    Which may explain why everybody gets hacked off with you, because if you are the gatekeeper of what is valid, then obviously it will never go anywhere.

    It would be much akin to me saying

    "I believe no good films have been made this year"

    you reply
    "the hobbit was good"

    I come back with

    "No, the hobbit was rubbish. Clearly no good films have been made this year"

    "What about the latest batman, that was good"

    "No, Batman was also rubbish. I've proved nobody made any good films this year!"

    Pointless. Cluck.

    Tricky. Much of your critique makes no sense because you appear to be using relevant words completely randomly in a way which make no sense whatsoever. As in

    Its obvious whether Nav drop is kinetic or kinematic?! Do tell Dennis, whats the difference between a kinematic Nav drop and a kinetic Nav drop and how does one tell them apart?

    And the concern is that I'd be wasting my time trying to explain why that statement makes no sense whatsoever because you make up terminology as you go along! Its like trying to explain why purple is not the same as cheese! Surprising hard unless you divide the answer by the extinct mammal you first thought of. And only if its finished by sunset, or by Glasgow at the latest.
     
  17. True, but as with most child-like characterisation, very accurate. I would suggest sex, Dennis, only if you did you'd probably try to patent it afterwards then claim it as your own discovery.
     
  18. An elephant stands on your head creating a force of 100kg per square inch. I put a sling under him, attatch it to a crane and winch it in until the elephants foot comes 0.74mm off your head. There is now 0 kg per square inch being applied to your head. How significant was that 0.74mm of movement? Oh and they were talking about statistically significant not clinically significant BTW.

    Kinetics and kinematics Dennis.

    Why am I bothering? Someone slap me upside the head.
     
  19. You might want to check the above Robeer and stop playing chess with chickens. The man clearly has a poor grasp of the concept of employing the appropriate research design to answer the question being posed- the fact that he critiques Griff's study for having no control group is demonstrable of this. As you said: words which sound good, but when scrutinised are completely out of context. I'm also getting a little hacked off with people, not just Dennis, dismissing studies as having too small a sample size, when they have no knowledge of the effect size or the actual power of the study. I think maybe a thread on research design and sample size calculations might be useful in the future... but not tonight.

    Have a good new year, Rob.
     
  20. Ta. Edited.
     
  21. Griff

    Griff Moderator

    Dennis,

    Re: the supination resistance article you refer to... I would be delighted to engage with you and discuss my work. However before I do may I suggest you actually read the full paper please. An interaction with someone who has just read the abstract on the JAPMA website is likely to prove fruitless.

    Ian.
     
  22. Even if he reads it, the interaction will still prove fruitless my friend, as well you know.

    BTW, for anyone following this thread, the great thing about Greg Quinn's two articles that Robert cited above is that they explain, amongst other things, some of the problems with reductionist foot-typing systems and an "ideal alignment" as a therapeutic goal. Greg is to be commended for these works and I recommend you all to read and understand them. Do they add to the evidence base regarding treatment of foot and lower limb pathology using mechanics and biomechanics? Of course they do.
     
  23. Cluck. Shuffle. Clatter.
     
  24. Go on then, since it's New Year's eve...

    http://www.youtube.com/watch?v=IeHDnF7MU90

    Although you're probably too young to remember people in discotheque outfits: piper jeans, jazz-funk belts, spandex, crimped hair and open shirts with medallions all sitting on the floor doing the "rowing boat". I bet Mark Russell knows what I'm talking about though...and Twirly ;)
     
  25. Simon, Robert, Ian, Mark, David, Bill and Others Following Along:

    Pam and I are spending our last day of 2012 vacationing in our motorhome at Doran Beach in Bodega Bay, California. I went for a long walk with my dog this morning and this was the beautiful sunrise I saw on this last day of 2012.

    Life is too short to be pounding one's head against the wall trying to teach someone who doesn't want to be taught. My new year's resolution? Worry less, enjoy each day more, and don't let the bozos of this world affect the positivity in my life.

    Happy 2013!:drinks
     
  26. Oh yes. Still got mine although the Demis Roussos garb is more in vogue these days as the lycra borders on the obscene!

    All the best to one and all for 2013 and here's a little taster to get you in the mood tonight from my wee pal Paolo Nutini. Eagle-eyed readers might just spot a rather handsome chap in the background - filmed at my local a couple of years ago.

     
    Last edited by a moderator: Sep 22, 2016
  27. drsha

    drsha Banned

    Simon: I am not saying that these additions to the literature are not important or useful or should not be fostered and continued. I am simply stating that they are not high level and therefore lack validity and applicability scores when pondering them for incorporation in an Evidence Based Practice of Biomechanics a la Sackett and
    That these articles do not make those who produce them and elevate them beyond their just merit to be the judges and juries of biomechanics.

    Isn't that exactly what you have done with Functional Foot Typing... (Dr. Fellner has admitted that on his postings elsewhere).
    I should edit that by adding "high level" in between valid and peer reviewed, sorry. As written that is a lie..
    You should add "and no desire to examine your work fairly".
    There are others on this site with seemingly abhorrent character. The difference is they share your views,
    Dennis
     
  28. drsha

    drsha Banned

    Robert:
    Agreed but that doesn't change the level of evidence or the validity of a peer reviewed additions to the literature which is what this thread annually calls for.
    I have critiqued your papers as to this pyramid which I am sure you all attest to:
     

    Attached Files:

  29. http://www.jfootankleres.com/content/pdf/1757-1146-5-31.pdf Where does this study (which for the record was published by a member of Podiatry Arena in a peer reviewed journal during 2012) sit on Sackett's hierarchy of evidence? Now, critique this study and then critique Sackett's hierarchy of evidence... spot the problem with rigidly applying Sackett's hierarchy yet?

    Dennis, "your work" has been examined "fairly" and found wanting. I feel sorry for you, you are the man who stole some plans then went into a shed and built a piston driven bi-plane, only to emerge to find the world had developed the jet plane while you were in your shed. Time to let it go and move on. Really.

    Your research output in peer reviewed journals during 2012 was zero, lets keep that in sight. If you want people to take you seriously, you might want to address that in 2013. But be ready for the critique by your peers. Just as you sow, you shall reap.
     
  30. drsha

    drsha Banned

    Ian:
    Your work seems to focus on The Suoination Resistance Test and its clinical import when diagnosing and treating feet, biomechanically.

    As I read Kevin's original work at its inception, I understand it to be a test of rearfoot pronation moments that you have expanded to present rearfoot "pronated" feet as the etiology for most (or many or all) of the pathology in biomechanics. I disagree by stating that clinically, most pathology that we encounter biomechanically is supinatory pathology of the forefoot and not pronatory pathology of the rearfoot.
    Summmarily, IMHO, the flexible rearfoot type (pronated) is not the major culprit in collapsed feet, it is the flexible forefoot type (supinated) that is the clinical source of biomechanical tissue stress related pathology in the foot and posture.

    Hence, your supinatory test whether manual or by the device you are developing (It should be very helpful for those that are profiled flexible foot types in the reafoot) deserves inspection, development and marketing but it doe not apply to the rigid or stable or flat functional rearfoot foot types that most feet test as and not to any of the functional forefoot types when FFTing.

    Summarily, The Supinatory Stiffness Test is not critical when diagnosing and treating tissue stress related pathology of the foot arising from a suoinated forefoot posture. As a matter of fact, it may actually be a red herring in these cases.
    Dennis
    PS: I hope we can keep this engagement civil and impersonal.
     
  31. Yep, and make sure you count up all the straw-men and other logical fallacies in the above post before you reply, Griff.
     
  32. Griff

    Griff Moderator

    Just to repeat my earlier comment Dennis; once you have actually read my paper then let me know and we can go from there...
     
  33. drsha

    drsha Banned

    I agree. However, you seemed to intimate that your 2012 additions to the literature was one. You failed to document it here so that it could be appraised.
    My comfort is that I am not far behind you when it comes to research and that one paper does not make your position as strong as you seem to promote it.


     
  34.  


  35. No it isn't; it's another tiresome platform for you to spout your continual and futile frustrations in the only way you can - by trying to belittle, antagonise and humiliate your collegues. It is New Year's Day and instead of spending it enjoying your family or reflecting on the passing and prospects of another year, you find nothing better to do than engage the lowest common denominator by climbing back to that same old platform.

    Good show, Dennis.
     
  36. Griff

    Griff Moderator

    Dennis,

    Just a couple of things to mull over in the mean time...

    There is a very good reason only one foot was tested - it helps reduce the chance of a certain type of statistical error - this is discussed in the paper.

    Remember that research is not about "proving" something that you may feel to be the case. It is about formulating a research question, and designing a study to answer that question as well as you can, then reporting your findings. There are no such thing as bad results!

    Do you know what limits of agreement are Dennis?

    Sorry Dennis, I like to think I have a reasonable grasp of research but I confess this is not a term I am familiar with. Could you explain what it means please?

    Why would a control group be necessary for what is essentially a reliability study?

    Research is not and will never be perfect. That's just the nature of the beast. There is no shame in suggesting further investigation may be necessary. Personally I'd be wary of any research which categorically stated that it wasn't, but that's just me.

    That's enough for now. I fear from some of your comments that your research methodology knowledge is perhaps not where it should be. That said, let's pick this up again once you have read and digested my paper. I'm far from being above critique, but usually I would expect the person doing so to have at least a feint grasp of what I have actually written.
     
  37. drsha

    drsha Banned

    Very fair Ian.

    I will have my APMA password when I return to practice 2morrow, so I can access your entire article unless you can post a link to it.

    and thank you for engaging me here.
    Dennis
     
  38. drsha

    drsha Banned

    I agree to the shortcomings of my knowledge base in performing or understanding research as I am a clinician and not a research scientist.

    As we engage, I will become more educated in that direction as I have been educated about physics, engineering, tissue stress and so many other subjects here on The Arena.

    If the purpose of our debate is to prove that I am not well educated when it comes to research terminolgy and protocols, lets not begin.

    As to a Mouse Study. In the clinical world, when debating an addition to EBM in a forum such as "Grand Rounds", a mouse study is stereotypically used to describe a study with a small cohort that lacks longitudinal results, is funded or researched towards a goal rather than from the nil, one that comes to conclusions that goes beyond the size, scope, power and applicability of the research and one that is presumptive because it realizes that on its own, it cannot justify changing to in an EBP.
    Unfortunately, for the most part, using Simon's quote "that is what we sow and that is what we reap" when it comes to researching biomechanics.

    Dennis
     
  39. Argumentum ad misercordiam AKA the appeal to pity fallacy: http://atheism.about.com/library/FAQs/skepticism/blfaq_fall_pity.htm

    N.B. this was the man who saw himself fit to critique the research which Robert cited, including Ian's (despite having not read it, by his own admission- see above); to start this thread and to argue over the value of evidence produced within the published work of the members of Podiatry Arena during 2012- despite the fact that some members of Podiatry Arena produced very high levels of evidence during 2012 (as rated by Sackett's hierarchy), he still hasn't conceded that he was wrong in this! To state point blankly that: "Summarily, they [the members of Podiatry Arena] have not produced any valid, peer reviewed publications in almost three years now"; he agreed that this was a lie on his part, but has not yet apologised for stating this. Yet, when challenged now, all of a sudden he admits to "the shortcomings of his knowledge base in performing or understanding research". Go figure.

    Oooh these slippery people... http://www.youtube.com/watch?v=lnu3TqDKXZY

    "What about the time?
    You were rollin' over
    Fall on your face
    You must be having fun
    Walk lightly!
    Think of a time.
    You'd best believe
    This thing is real

    Put away that gun
    This part is simple
    Try to recognize
    What is in your mind
    God help us!
    Help us lose our minds
    These slippery people
    help us understand

    What's the matter with him? He's alright!
    I see his face The lord won't mind
    Don't play no games He's alright
    Love from the bottom to the top
    Turn like a wheel He's alright
    See for yourself The lord won't mind
    We're gonna move Right now
    Turn like a wheel inside a wheel

    I remember when
    Sittin' in the tub
    Pulled out the plug
    The water was runnin' out
    Cool down
    Stop acting crazy
    They're gonna leave
    And we'll be on our own
    Seven times five
    They were living creatures
    Watch 'em come to life
    Right before your eyes
    Backsliding!
    How do you do?
    These slippery people
    Gonna see you through"

    Or... right through you, Dennis. A quote from Sir Arthur Harris springs to mind... and you have sown the wind, Dennis.
     
  40. Ian is being asked questions about the supination resistance test which is a test that I experimented with and developed during my CCPM Biomechanics Fellowship in 1985. After using the test clinically for five years, I first wrote about it and had a description of the test published in the chapter I coauthored with Don Green in 1992 (Kirby KA, Green DR: Evaluation and Nonoperative Management of Pes Valgus, pp. 295-327, in DeValentine, S.(ed), Foot and Ankle Disorders in Children. Churchill-Livingstone, New York, 1992).

    For those that are interested, and for historical purposes (since I won't be around forever), the reason that I began to experiment and develop the supination resistance test over a quarter century ago is that, at the time, I was trying to come up with a way to quantify the internal forces/moments within the foot that resist supination of the subtalar joint during relaxed bipedal standing .

    I thought that it made the most sense to use the insertion point of the strongest supinator of the subtalar joint (i.e. posterior tibial muscle) on the medial navicular as the point where the examiner would manually exert an upward pulling force on the foot in order to get a better sense of the magnitude of internal resistance present within the foot that prevented it from being supinated. In effect, by developing the supination resistance test, I was trying to approximate the magnitude of tension force that the posterior tibial muscle needed to pull upward on the medial navicular in order to supinate the foot. The ultimate goal in developing this test was to gain more insight as to how various functional and structural factors within the human foot and lower extremity may affect the ability of the posterior tibial muscle, and other supinators of the foot, to supinate the foot during weightbearing activities.....nothing more, nothing less.
     
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