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Another type of proprioceptive orthotics

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Kahuna, Dec 31, 2009.

  1. Kahuna

    Kahuna Active Member


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    Hi all

    I've read with interest all of the Arena's previous posts about Prof Rothbart...

    However I have a patient who claims much improvement to her scoliosis and lumar pain after using Healthmarque (Australia) Proprioceptive insoles (which are new to me!)

    I can't find much except their website here: http://www.healthmarque.com.au/learn.asp

    A paragraph from their site says:

    "The Healthmarque orthotic is a thin combination of rubber and suede containing pockets that can be filled with a crumbled synthetic rubber designed to stimulate but not support selected plantar muscles to produce a postural correction. We believe hard supporting orthotics will weaken the arches by taking over their muscular function. "



    Has anyone comes across these claims? (there is no discussion on the arena yet, but the healthmarque site boasts many 'practitioners' worldwide. The clinician appears to be a medical doctor - a Dr Butterworth.

    Does anyone have any experience of these proprioceptive orthotics? And the underpinning theory?

    Wishing you all well for 2010,
    :drinks
     
    Last edited: Dec 31, 2009
  2. Re: Proprioceptive Orthotics

    I prefer Spikethotics TM to proprioceptive orthotics. For your own pair of Spikethotics TM, you may send your check for $500.00 USD to:

    Spikethotic Enterprises
    107 Scripps Drive, Suite 200
    Sacramento, CA 95825

    :rolleyes::dizzy::drinks

    Happy New Year Everyone!!
     
  3. Griff

    Griff Moderator

    Re: Proprioceptive Orthotics

    Sounds suspiciously like snake oil once again.

    See here regarding the above statement in red

    Ian
     
  4. Admin2

    Admin2 Administrator Staff Member

  5. Stimulate plantar muscles huh? We seem to have a PRE root Theorist! Hurrah let's strengthen the arch muscle!

    They're coming out of the walls man! They're everywhere!!
     
  6. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    Riddle me this .... if weak arch muscles lead to a high arch foot (as in the 'intrinsic minus foot' in diabetic neuropathy and the cavus foot in CMT), surely that means strengthening the arch muscles will casue the arch to lower and that has to be a bad thing :wacko: :confused: :wacko: :confused:
     
  7. Ah but as gp s are always telling patients, picking up a pencil with your toes strengthens the plantar fascia doesn't it.

    Since when has ignorance stood in the way of medical marketing? We live in a Market economy. The truth does not stand a chance because it's less lucrative than the lies!

    It would be nice if just ONE of these guys looked up what proprioception and exteroception actually MEAN before they leap on the incorrectly named bandwagon though! At least then it would be correctly named BS.

    I fear for the future of biomechanics, I truly do.
     
  8. Kahuna

    Kahuna Active Member

    Thanks for the helpful posts...

    Many more 'medics' are out there with these insoles - some have even 'patented' a shoe insole via their own company.

    Links:
    Dr Maria Fusco (Cardiologist). Holds a patent for 'proprioceptive insoles':
    http://www.conscious-living.com.au/articles.htm?35

    Dr Rene Bourdiol (Neurologist): Trains in his 'posturology' method:
    http://www.vabene-balance.com/vabene_englisch/information/wissenschaft/hintergrund_e.html

    They keep on coming!

    SCPOD, reviewed a paper of Dr Bourdiol's (public link: www.feetforlife.org/download/5279/PRF06-main.rtf) which said:

    "Müller, G., Drerup, B., Osada, N., & Wetz, H. H. 2006, "The influence of proprioceptive insoles Bourdiol on the sagittal curvature and inclination of the trunk", Der Orthopäde, vol. 35, no. 11, pp. 1131-1136.
    Ref ID: 443
    Abstract: Proprioceptive insoles rely on the concept of Réné-Jaques Bourdiol, a French neurologist. The aim is to modulate plantar surface sensibility and to influence posture and statics of patients: it is hypothesized that the effect of modified afferent sensory input through proprioceptive stimulation of terminal muscle chains will have either a relaxing or stimulating effect on the whole body, which may be realized by affecting the posture. Small pads with a thickness of typically 1-3 mm are embedded into the insole to provide a specific stimulation. In fitting the insoles selectively to the individual patient the effect of the insoles on the trunk posture is taken as a feedback. This study investigates the influence of proprioceptive insoles on the sagittal curve in 20 selected patients. The protocol used a repeated measures research design. The measures of the sagittal curve were obtained using raster stereography. The four different conditions were: (1) barefoot, (2) convenient shoes without the insoles, (3) the same shoes with a placebo insole, and (4) the same shoes with neurological insoles. Evaluation of raster stereographs provided the kyphotic angle between T4 and T12 and lordotic angle between T12 and S1. Statistical evaluation was performed with the t- test for paired measurements. No significant differences were found in the sagittal profile. Only trunk inclination in normal posture was found to yield a significant difference (0.38 degrees) between placebo and neurological insoles. However, no clear statement on the efficiency of neurological insoles can be made."
     
  9. Full respect to them for having the guts to do a study and publish in spite of the results! 0.38 degrees is not a lot, but it's more than none. Will have to have a look at that one! Thanks for the ref.
     
  10. Kahuna

    Kahuna Active Member

    ...and in terms of Healthmarque's "proprioceptive orthotics", I have found that Dr Ed Butterworth MBChB is a member of podiatry arena aka "HealthMarque".

    A post of his in 2007 reads.........

    ________________________________________
    Re: hi

    Please see my website www.healthmarque.com.au I have produced a remote learning kit. The technique uses AK muscle testing to determine how to make the orthotics. Please contact me if you wish.

    Dr Butterworth
    ________________________________________




    So, healthmarque links their proprioceptive insoles to applied kinesiology techniques.
     
  11. David Wedemeyer

    David Wedemeyer Well-Known Member

    "No significant differences were found in the sagittal profile. Only trunk inclination in normal posture was found to yield a significant difference (0.38 degrees) between placebo and neurological insoles. However, no clear statement on the efficiency of neurological insoles can be made."

    What .38 degrees change in trunk inclination? What on earth is trunk inclination?

    I see a fair number of patients with scoliosis and if it is structural and the patient is skeletally mature and you claim to change that alignment with AK and/or proprioceptive insoles you should be flogged with a Rothbart's Insole until you become sensible.

    Applied Kinesiology is one of those practices that makes the bile rise high in my throat, fortunately stifling a scream. When I succumb please line my coffin with a proprioceptive lining because only then will I truly receive the neurological benefit of proprioceptive input via gamma motor neurons!
     
  12. healthmarque

    healthmarque Member

    Re: Proprioceptive Orthotics

    I am Dr Edward Butterworth of Healthmarque and I note your use of the word "snake oil" relating to my orthotics. The inference is that I am a snake oil salesman. Please have the courage of your conviction to call me that on this Arena. Naturally this will be followed libel defamation suite.
     
  13. Re: Proprioceptive Orthotics

    Ed:

    Since you are now a member of Podiatry Arena, please tell us how you think your orthoses work.
     
  14. Griff

    Griff Moderator

    Hi Edward,

    No courage of conviction required - I know nothing of you or your product and was merely offering my personal opinion (as we are all fully entitled to do on a forum such as this) regarding Kahuna's original post. As you can clearly see from my post which you quote above I make no direct inference that you are a snake oil salesman.

    Unfortunately we have had experiences on the Arena before of individuals with financial interests in a product behave in a similar way. As you are on here Edward - instead of taking things personally, being defensive and threatening legal action, why do you not take some time to answer some of our questions/concerns and provide us with some of the evidence behind your product (and maybe prove us wrong regarding our opinions?)

    Lets start with these two:

    (1) How does your product 'stimulate but not support selected plantar muscles to produce a postural correction'?
    (2) What evidence do you have to support your statement: 'We believe hard supporting orthotics will weaken the arches by taking over their muscular function'

    Look forward to the discussion

    Ian
     
  15. healthmarque

    healthmarque Member

    I have been a member for a couple of years and have followed the threads sporadically. I am somewhat concerned about the pettiness of some of the posted threads. I came across the enquiry about me by chance and having read the negative responses I have decided to stick my head up.. A brief explanation as to how I "think" my orthotics work can be found on my website www.healthmarque.com.au. I am preparing a more in depth article for the Arena.
    I know Dr Fusco as I used her orthotics originally with good results. However my new knowledge concerning the piezo-electric of collagen caused me to re-design the orthotics that I now promote. I have spoken several times to Prof Rothbart and have read Dr Bourdiol's book which is in French. In Europe there is a thriving profession known as Posturology where health professionals of all persuasions co-operate amicably and with respect other colleagues' knowledge in the study of holistic medicine. Sadly this is not the case in Anglophone medicine Hope this helps. Ed Butterworth
     
  16. healthmarque

    healthmarque Member

    The culture of this arena seems to spawn smart alec responses. As a chiropractor I would have thought that you would have a sympathetic attitude to AK as the founder was one of yours. It works for me. Vertebral bone deformity cannot be treated by our orthotics. We treat the deformity caused by muscle imbalance and we get results and patients should not be denied the benefits through lack of evidence based medicine. Ed
     
  17. Re: Proprioceptive Orthotics

    :
    Strong words indeed!

    Rather than threats of legal action perhaps you would like to explain why and how these insoles are NOT snake oil. Beyond "I beleive" that is. Rather than try to stop people saying what they beleive you could try changing what they beleive.

    Because I beleive that these insoles are nothing more than an expensive placebo, much akin to others we have seen. And I find your marketing distasteful.

    Perhaps you could start by explaining on what basis you beleive orthotics weaken foot muscles? And evidence? Any science? Or is it just your "hunch".

    And for an encore, which planter muscles, when stimulated, improve posture? Specifically. Call it a nostradamas like prediction but I somehow guess you will avoid answering that one. Flexor digi brevis pehaps? Is that the muscle which "supports the arch":pigs:
     
  18. Oh and it's slander not libel. In the UK at least.
     
  19. Griff

    Griff Moderator

    Ed,

    I took a cursory glance at this page of your website and saw near the bottom:

    That says it all for me...

    I wait with excitement your more in depth article for the Arena. Please don't forget to clearly address and answer the questions that have been asked so far (by Kevin, Robert and I). To summarize for you these are:

    (1) How do you think your orthoses actually work?
    (2) How does your product stimulate but not support selected plantar muscles to produce a postural correction?
    (3) Which plantar muscles, when stimulated, improve posture?
    (4) How do you believe hard supporting orthotics will weaken the arches by taking over their muscular function?

    Ian
     
  20. healthmarque

    healthmarque Member

    Slander is the crime of SAYING something untrue that harms a person's reputation. Libel is the crime of PUBLISHING something false that is damaging to person's reputation. Oxford Dictionary. By the way I am English by birth and education. Having read the vituperation contained in the replies so far I am not prepared to continue this discussion unless I can be assured of temperate comment. Ed Butterworth
     
  21. Goodbye.
     
  22. Nope. You're a little out of date.

    Smith v ADVFN & Others [2008] All ER (D) 335 (Jul)

    However please don't let anything distract you from the valid questions Ian Highlighted

    (1) How do you think your orthoses actually work?
    (2) How does your product stimulate but not support selected plantar muscles to produce a postural correction?
    (3) Which plantar muscles, when stimulated, improve posture?
    (4) How do you believe hard supporting orthotics will weaken the arches by taking over their muscular function?

    I can only speak for myself but I will promise that my comment will be temperate.

    C'mon, You've taken the trouble to come on the arena to argue your product. Don't you welcome the opportunity to explain the science behind it?

    Regards
    Robert
     
  23. Griff

    Griff Moderator

    C'mon Ed - replies have hardly been full of 'bitter and abusive language' (Source: Oxford English Dictionary)

    Anyone would think you are looking for any available exit from this conversation in order to avoid the very basic, and un-abusive questions we have asked you (avoidance which I'm sure none of us expected or saw coming at all...). As I already said - behaviour which we have seen before from other individuals including your friend Brian. Perhaps why we made the snake oil suggestion in the first place?

    I promise to also be temperate, but only if you promise to answer the questions. You have posted 3 times since the questions were originally posed and still nothing which comes close to an answer. The questions have been re-iterated in at least 2 posts since.

    Ball is in your court fella

    Ian
     
  24. Ed see what I´ve highlighted in your response, Would be great to see. With the background ideas and the science to prove what you have produced works and why.I´m realitivly new to the Arena but have found it a great place with people willing to help me and discuss my ideas. I however would expect people to want scientific proof if I made a certain claim. That´s really what people want.
    If you look at the laser treatment of fungal nail thread

    Laser tx of fungal nails thread
    If you read this thread there may have been some strong words between people ideas But if you look at the last few pages you will see that when someone came on line and said this is the scientific review process and this is where we are at they got a lot of thanks and positive responses.

    So if you beleive in your product and have the scientific evidence why not come on and show people. You might get yourself a lot of new customers, it will also show a strong conviction in your product.

    Hope you come back with something intersting ED
     
  25. Ed:

    I think we a fairly open minded group here, as long as you can provide us with a hint of scientific evidence that your insoles do anything more than the thousands of foot orthosis designs that we all make for our patients. If you simply say "My orthoses work since a few patients got better once I gave them orthoses", then you are no better than our friend, Brian Rothbart.

    I went on your website and see that you think that the collagen of the body is sending electrical messages around the body via the piezoelectric effect. Here is a segment that I cut from your website:

    I see the words, however they make no sense to me. I was an animal physiology major at UC Davis before entering podiatry school, so I am quite familiar with endocrine and neural physiology. However, what you write above looks like pure conjecture that has been fabricated out of thin air with no basis in scientific fact. Please provide references which show that this piezoelectric effect in collagen somehow can transfer neural messages to the central nervous systems of animals.
     
  26. Kevin, this paper seems oft cited:
    Lipinski B: "Biological significance of piezoelectricity in relation to ... Medical Hypotheses 1977;3(1):9

    http://www.ncbi.nlm.nih.gov/pubmed/577004
     
  27. If ed can explain what he means, and I hope he will, it could be real science we don't understand.

    But it sounds a bit "pseudoscience" to me. Lots of scientific sounding ideas loosely tied together to impress the unsuspecting and uneducated.

    Ben Goldacre descibes it well...

     
  28. Try this: lets say we have a flexor hallucis brevis that is in "spasm", this might result in an increase in plantarflexion moment about the 1st MTPJ, resulting in a functional hallux limitus, now go via sagittal plane theory to get to altered lower back mechanics. Lets say we "stimulate" our flexor hallucis brevis and relieve the "spasm"......

    Just playing, Robert.
     
  29. You scamp ;-).

    That would have to be some bad ass FHB!

    The whole sagittal plane facilitation -> curing lower back pain (much less correcting a socking great scoliosis) is something I still don't entirely buy into. But that's another thread.

    Regards
    Robert
     
  30. Now try getting from the foot to the TMJ :D
     
  31. David Wedemeyer

    David Wedemeyer Well-Known Member

    Ed,

    Applied Kinesiology is not a core course in any chiropractic program in the U.S., therefore my knowledge of it is through my colleagues who use it in their practice. I had explored it early in my professional career and found it wanting. I don't believe that it is important for me to be sympathetic to the myriad ancillary techniques created by my colleagues unless I can find some observable and objective evidence of the technique's efficacy.

    One very good example of why I have such a visceral response to AK can be provided by two examples, one a case previously managed by an AK practitioner local to me:

    A 50 year old woman with a severe scoliosis presented to my office with a high level of low back and radicular pain of two months duration. Upon viewing her films I noted a very advanced curve, spondylosis due to degeneration etc. Previous 'treatment' had zero effect on her and I felt that manipulation could only make her worse, so it was my opinion that she be referred to an orthopedic spinal specialist. She underwent emergency surgery (she was beginning to have root signs) and the leg pain was relieved. The AK doctor had been treating her for over two months with AK and some other technique where he merely waved his hand over her body and chanted (yes she claims he actually chanted). No exam was ever performed (I ordered the films) and he charges three times what I billed her insurance CASH. I would characterize his care of her as reprobate, substandard and avaricious.

    The second is a guy across the street that treats some patients with an adjusting gun via telephone. But wait; it gets better! He performs the adjustment on a teddy bear while the patient is on the phone and charges them for this. The founder of this despicable type of snake oil (opinion but sue me anyway because someone has to call this BS the turd that it is!) is an AK practitioner.

    So there you have it. I have zero sympathy for AK as a science and healing modality although I am sure I will quickly be excoriated for standing up for my beliefs. Many of the AK practitioners that I have encountered appear not to observe standard protocols in patient care and to mingle pseudoscience and non-standard protocols as their primary form of treatment. If your experience is different I am all ears. I realize that I have strong opinions and convictions but I have never been called closed minded. Oh, and bear in mind that I was a scoliosis sufferer in my teen years who was cured by a particularly caring and competent chiropractor. So, for me the leap that a structural insult can be affected by a manual osseous technique such as chiropractic is not only a simple one but an objective truth. On the flip side I have never encountered any studies or claims until now that insoles can affect a scoliosis through the musculature via orthotics.

    Now let's move on and discuss the questions pertaining to how your insoles affect the body please. As a chiropractor and a pedorthist I am very curious as to the mechanism by which your insoles have an effect on proprioception and treat the muscles in scoliosis. I am likewise curious as to what evidence there is that “hard supporting orthotics will weaken the arches by taking over their muscular function” and about the soft-tissue piezoelectric effect of collagen. I have so many questions Ed but await your initial responses to the questions posted by the others.
     
    Last edited: Jan 10, 2010
  32. Don't bloody start me on that!:bang:

    For our international colleagues, I dared question that link (insoles being used to treat TMJ / orthodontic problems) in my last pod now column.

    I've had letters.... And not polite ones. :eek:


    Make a note. Contender for quote of the year 2010! We could all take note. :drinks

    AK is a whole other thread.

    Agreed. Lets stick to Ian's list

     
  33. healthmarque

    healthmarque Member

    Many thanks for your friendly reply. You are the first. I have an article that I wrote for the Scoliosis Association of Australia but I have yet to work out how to download it. I am on holiday in Dubai. Please note that this discussion is the result of an Arena member reporting that a patient of his had had a good result with our orthotics. Your Orville quote is apt. However science has yet to uncover the ultimate secret of life that is why we are looking for the Higgs boson. Thus science based medicine is not the panacea.
    My article contains references to the information that has allowed me to develop the hypothesis that on which my orthotics are based. My critics have about ten years of reading ahead of them. I think that I have just notices how to download my article. Heres hoping. If so most of your queries will be answered. For the record I have been an speaker at International Conferences in Colorado Springs, Prague, Romania and Portugal.
    ED
     

    Attached Files:

  34. I thought my Post was nice as well, but I guess not.

    If you have time.

    What research did you get this bit of information from ?

    Can you explain this bit Is it similar to reflexology in it ideas? How does this stimulation travel up the body?
     
  35. Not quite.

    Which 5 plantar muscles?

    And this

    was not really covered by

    Do please continue. It's fascinating.

    Regards
    Robert
     
  36. healthmarque

    healthmarque Member

    Our discussions are now taking on a pleasant tone. Some history. I first saw Dr Fusco's orthotics at a conference in Italy in 1994 where she demonstrated her orthotics. I was unable to believe that something so simple could treat a scoliosis. But we have a daughter who some years earlier at the age of 15 required Harrington rods inserted for her severe scoliosis so naturally I had to listen. At the age of two she had a cerebellar astrocytoma removed and relies on a shunt. I now know that there is an association between cerebellar tumours and later scoliosis. My wife was given an injection of Stemetil for hyperemesis gravidarum and I now know that there is an association between that drug and cerebellar tumours. My passion is understandable. I had never seen muscle testing before being then well inside the square however because I was impressed with Dr Fusco's results I bought the rights for Australia. I used her product with considerable success for a number of years. In spite of the good results I was unhappy with the lack of information as to how they worked. By chance I came across the work of Prof Mae Wan Ho relating to the piezo electic effect of fascial collagen and the transmission of information carried by protons down to individual cell level. Knowing also the work of Philip Dudal and muscle chains I was able to redesign the orthotics to underlie the particular plantar muscles that are the first links in his muscle chain system. The evidence based medicine can be seen in the photos on my website. I do not use Xrays as to expose pubescent breasts to ionising radiation is associated with later breast cancer. The plantar muscle targeted are the short flexors of the first and fifth toes, the abductors of these same muscles and the adductor of the big toe. This is from the work of Dudal. As the short flexor of the big toe has 2 bellies I have split the underlying pocket into two parts so that by stimulating the medial belly only we seem to prevent the progression of a bunion. My own idea. No science. Much of what I claim is based on observation, original thought, considerable study and commonsense. I cannot prove that hard orthotics weaken arches but it makes sense. When a podiatrist takes a cast of each foot and makes orthotics they are different for each foot. Those arches are thus supported differently. My concept is to stimulate them equally so that the muscle chain effect is equal on both sides and musclar balance is obtained. I am holiday that is enough for now. ED
     
  37. How interesting! How do you distinguish between the Abductor digiti minimi and the flexor digiti mimimi brevis? Do they not both lie pretty much in the same place? (beneath the 5th met?).

    Like the Evidence Based Medicine in the photos. That is indeed compelling evidence!

    Regards
    Robert
     
  38. It an assumption which when looking at it with reasearch does not make sense. Muscle still work when the foot is supported by an orthotic. The orthotic is changing the load placed on it, not removing the load completely. Also with Davis law there will be many positive changes to the ligaments that also help support the medial longitudial arch.
     
  39. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    We have proved that hard foot orthotics DO NOT weaken muscles:
    Do foot orthoses weaken "arch" muscles?
    Mayer et al actually showed an increase in muscle strength with foot orthotics!

    ...and a weakness of the intrinsic muscles actually cause the arch height to increase!! (think motor neuropathy in diabetes etc)
     
  40. Ed - was this you at a recent posturology fair marketing Auld Reekie Foot Supports? Now what would Dr Trotter make of this???
     

    Attached Files:

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