Foot Orthoses in the Prevention of Injury in Initial Military Training: A Randomized Controlled Trial
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Andrew Franklyn-Miller, Cassie Wilson, James Bilzon, Paul McCrory
American Journal of Sports Medicine (in press)
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Thank God. Not read the full article, but on the surface this appears to be a long overdue quality study that looks at "outcomes" and avoids the perennial distraction of "but how do they work". Who cares? We don't understand how half of the most common drugs in the world truly work.
Please, academic podiatry researchers,...follow this lead.:D
LL -
While a step forward how many people make their clinicial orthotic design decisions from pressure plate recordings?
So while again positive not really ready to start the old orthotic prevent injury discussions with patients. But maybe it´s just me -
If we collectively pulled our heads out of out proverbials and stopped worrying so much out how/which type/which theory/ etc, and put our energies into more meaningful clinical outcomes studies, the profession would be enternally grateful.
Clearly there are multiple approaches/theories etc. Same goes for our medical colleagues who approach renal failure, diabetes control etc all from slightly varying philosophies. You don't see the drug companies and research labs worrying endlessly about they why. They get to the point to clear regulatory hurdles, then just get on with proving in population studies wether new drug B is better than old drug A or placebo.
I'm sorry, but the endless debates on this website arguing in circles about my theory is better than yours is tiresome, redundant and now about 30 years old.
Time to spin it around.
LL
ps I couldnt care less if this research concluded a negative response to orthoses. I just personally want to see much, much more research of this nature from our research colleagues. Only this kind of stuff can guide clinicians such as myself. -
Nonetheless this study demonstrates that it may be a reasonable tool to base orthotic protocols on... although you cannot say that the result would have been any different to using a standard OTC device. That would have been an interesting sub group.
The study clearly shows less injuries- particularly MTSS and ITB syndrome- in the group that used orthoses. Now... why?;) -
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I have not read the full paper so perhaps some one can tell me how they "risk assessed" the subjects?
I find these kind of trials interesting, can someone explain to me how we "know" that the reduced injury rate in the study group was a result of the foot orthoses and not to some other factor? -
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Jozsa, L., Balint, J. B., Kannus, P., et al. (1989). Distribution of blood groups in patients with tendon rupture. An analysis of 832 cases. The Journal of Bone & Joint Surgery Br, 71(2), 272-274.
Kujala, U. M., Jarvinen, M., Natri, A., Lehto, M., et al. (1992). ABO blood groups and musculoskeletal injuries. Injury, 23(2), 131-133. -
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If I flip a coin ten times how may times will it turn up heads and how many times will it turn up tales? How many times do I need to flip it, until the number of heads equal the number of tails? Twice? Sometimes. Two hundred? Sometimes, A thousand? Sometimes.
So lets say we recruit 400 subjects of which 200 have gene X (which we know causes injury in military recruits), for each subject we flip a coin to decide whether they go into the treatment or control groups (with pure randomisation we could end up with all of them in the control group BTW), what's the probability that the two groups will have an equal number of subjects with gene X within them when all subjects have been assigned?
Back to the paper that is the point of this discussion, 400 subjects (I love round figures). Lets assume that the only cause of injury in military recruits is eating cheese. How do we know from the study whether 21 individuals in the intervention group and 61 individuals in the control group were cheese eaters, and the rest were not?
To answer your question: no I haven't carried out this kind of study, for the reasons I'm outlining. Does the fact that I haven't performed one, preclude me from discussing them? -
p.S. Indeed, how do we know whether those that did get injured in the study group, got injured as a result of the orthotics? And if they hadn't been assigned the orthotics would they have got injured?
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Wow-
orthotics help soldiers avoid injury?
As a podiatrist and a soldier, I already knew that.
Perhaps I will do a study- "helmets help soldiers avoid head injuries..." -
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Lower limb injuries in soldiers: feasibility of reduction through implementation of a novel orthotic screening protocol.
Baxter ML, Baycroft C, Baxter GD.
Mil Med. 2011 Mar;176(3):291-6.
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For thoses interested there is more detail on the study on the website of the company that markets D3D: http://www.rightstride.com/d3d_orthotics_research.html
Cheers
Brett
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