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Frontal plane vs. transverse plane

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Petcu Daniel, Aug 19, 2011.

  1. Petcu Daniel

    Petcu Daniel Active Member

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    There is any article who try to quantify and compare the action of a device (FO , AFO) around STJ in frontal plane vs. transverse plane ?

    Thanks ,
  2. Craig Payne

    Craig Payne Moderator

    I not sure there is exactly a lot, if any good literature on this, but if you do want to control motion, and most of the motion is:

    -in the transverse plane --> you need things up the side of the foot
    -in the sagittal plane --> you need things under the foot
    -in the frontal plane --> you need things to angle the foot
  3. efuller

    efuller MVP

    Why do you want to do this? Forces and moments are three dimensional. If you want to alter motion about a joint, you need to think about creating a moment at that joint. Moment is force times distance. So you need to think about the distance from the line of action of the force applied by your device is from the joint axis.

    In the case of foot orthoses, most of the time you are altering the location of ground reaction force which is different than applying an additional force to the foot. For example the additional force applied by an AFO with a medial strap that would apply a force to the navicular.

  4. :good: Good shout, Eric. I had a private message earlier this week regarding skives and posts with the intimation that one worked in one plane whilst the other worked in another:confused: (who's teaching this sh!t?). It's all 3, if not 4 dimensional at the end of the day. In fact, I'll put the crux of the pm'ers question up as a new thread- it's worth discussing...

  5. Petcu Daniel

    Petcu Daniel Active Member

    To answer this question I'm thinking at two quotes:
    -"They understand that their chances of obtaining treatment success by only wearing the foot orthosis without the hiking boot, or only wearing the hiking boot without the foot orthosis will be much less than if they wear the foot orthosis with the hiking boot together at all times" [Kirby KA Soes and therapy in the treatment of posterior tibial dysfunction"]
    -"Many popular high-top athletic shoes with uppers extending above the ankle joint are quit effective at improving the control of the excessive pronation by foot orthoses and improving shoe fit of the orthoses in pes valgus deformities" [Kirby KA, Donald Green " Evaluation and Nonoperative Management of Pes Valgus]

    There are some practical situations when the hiking boots or high-top athletic shoes are not accepted [being rejected] by the patients especially for two reasons :
    -1. girls who doesn't accept the design of the footwear [especially when the prescription is for orthopedic boots/custom made shoes]. The same perception like in the case of diabetic footwear !
    -2. point 1 + summer time !

    As there is the option for Sandal Orthotic [like Root Sandal Orthotic - including the FO prescribed for that pathology] my problem is to understand -at list theoretically- for a pathology the limits where the Orthotic Sandal became ineffective and the footwear [hiking boots, etc.] has to be prescribed !

  6. efuller

    efuller MVP

    What you are pointing out here is the concept of net joint moment. Or net moment from corrective/treatment sources. Essentially, the quotes from Kevin's writings, are saying that sometimes you need more moment than you can get from the orthoses alone. You don't really care what plane that moment is in, just that it affects the joint you want in the direction that you want. Specifically, if you want an increase in supination moment, and it doesn't get better with just a medial heel skive orthosis, then you need to add more supination moment from some other source to make it better.

    It's the patient's decision if they only want to wear the orthotics and not the high tops. It's your job to inform them that their choices may lead to return of, or increased, pain.

  7. Petcu Daniel

    Petcu Daniel Active Member

    Thank you all for your answers !
    If we define :
    Tsm = total supination moment,
    Osm = supination moment generated by orthoses,
    HBsm = supination moment generated by hiking boot [or other sources]

    Tsm = Osm + HBsm

    How can we predict the ratio [or the contribution of each kind of supination moment] between Osm and HBsm for a given foot condition and devices [ ex. approximately 70% Osm and 30 % HBsm] ?

  8. efuller

    efuller MVP

    It's not really a prediction it would be more of a measurement. You'd have to calculate the center of pressure of the medial to lateral forces and the center of pressue of the lateral to medial forces, accurately assess their direction and calculate the moment about the STJ axis. I doubt that this is techniquely feasable at this time. It is certainly not something that you would be able to do in a busy clinic.

    However, our outcome measure is not net supination moment, but rather does it stop hurting. You could even add, does the the pain stay away. You try one increased supination moment treatment and if the pain goes away the supination moment was high enough. If it doesn't, and you still think it's a pronation related problem, you add more supination moment. It's going to be really hard to attach numbers to the amount of moment created by each source. In terms of resource allocation you could start with the least expensive. In terms of patient satisfaction you could offer them a device that fits in their shoes before you make them wear the ugly shoes.


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