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More 'snake oil' as orthotics

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Simon Spooner, Jun 14, 2006.

  1. Dennis Kiper

    Dennis Kiper Well-Known Member

    =efuller;364677]Dennis, the other questions you have chosen to avoid, fine.

    [/QUOTE]


    Eric,

    We're on different wave lengths--sorry
     
  2. David Wedemeyer

    David Wedemeyer Well-Known Member

    No Dennis these are symptoms I reported to you vial email, your podiatric bioemchanical assessment from the internet was "they need more fuid". This is your standard answer and standard of care and you're attempting to denigrate my training? At least I have an office and evaluate patients in real time. Clown
     
  3. efuller

    efuller MVP


    Eric,

    We're on different wave lengths--sorry[/QUOTE]

    Did you place the sensor under, or on top of the plastic orthotic?

    Is this question that hard to answer?
     
  4. Thanks for replying to Matt here, Eric, since you basically took the words right out of my mouth.

    There are multiple joints of the body where the best function for certain activities is not at the points within their ranges of motion where the joint is at maximum congruity. Eric already gave the example of the subtalar joint which I think is an excellent example of where maximum joint congruity may be even pathologic. In addition, at the talo-navicular joint, the foot may function best when the subtalar joint is maximally pronated which will also cause the talus to rotate more medially relative to the navicular than when it is at its point of "maximal congruity" when the foot is supinated from the maximally pronated position. In other words, "maximal congruity" of a joint should not be a goal of foot orthosis treatment.

    I agree with Eric, instead of us assuming that "maximum congruity" of a joint is always the optimal position of function, rather we should be talking about an "envelope of joint range of motion" that allows optimal function, is non-pathologic, does not cause pain but which also has a variable magnitude of joint congruity which is dependent on the magnitude and direction of the internal and external forces acting at that joint during all weightbearing and non-weightbearing activities of the foot and lower extremity. This is a more realistic and accurate goal for foot orthosis therapy.

    Finally, Matt, as far as Dennis Kiper is concerned, I have long had his posts on "ignore" since he seems to not be concerned with the biomechanics of the foot and lower extremity but rather seems to be only concerned with selling more of his silicone fluid insoles. In other words, I believe the man is not worth your time or effort.
     
  5. Dennis Kiper

    Dennis Kiper Well-Known Member

    David Wedemeyer;364670]You have to ask yourself who keeps emails for nearly 8 years,![QUOTE=



    David

    You too can go to the cloud and retrieve all these e-mails.

    I do have a couple other follow up posts to when you started to acquire PF. You said that you noticed you started to develop a limp and some dermatological lesions. A week later you said the silicone orthotics caused you to developed some blood dyscrasias and that you hadn't been able to get it up either!

    It's best if you discontinue wearing them.
     
  6. Dennis Kiper

    Dennis Kiper Well-Known Member

    Kevin,

    during all weightbearing and non-weightbearing activities of the foot and lower extremity. This is a more realistic and accurate goal for foot orthosis therapy.

    Really??

    Orthosis therapy for non-wt bearing activities?????????

    Wow, this has got to be a new first for traditional orthotic technology!


    This is the problem and the way you deflect what's important. While what Eric said is true,I'm just trying to talk about what the technology can do and then discuss the anomalies that the technology can't do. Bringing in anomolous cases, before you're even agreeing to the technology?

    Kevin,

    Why don't you point out specifically where in my thesis of biomechanical loading, where the joint congruity is pathologic? I'm interested and don't see what you see.


    seems to be only concerned with selling more of his silicone fluid insoles. In other words, I believe the man is not worth your time or effort.

    As I've said before, I have no vested interests in the mfgr of SDO. I derive no financial interests from the factory. The actual product SDO is not even proprietary. Anyone with a few thousand dollars to invest in dies and a couple of handfull of silicone can compete.


    You're the one that brought money into this conversation, long ago and you keep doing that. I've never talked about selling, only technology which you're too intimidated to discuss. I don't blame you. But, you'll be ok. By the time others who find out about this technology and considering how slowly things move (at first at least), you're already financially set. You'll never need to know how work with a quantifiable Rx orthotic



    since he seems to not be concerned with the biomechanics of the foot and lower extremity but rather


    You figured that out? How?
     
  7. Franklin

    Franklin Active Member

     
  8. David Wedemeyer

    David Wedemeyer Well-Known Member

    Franklin I am used to Dennis racing to the bottom in his exchanges, his words have zero effect on me. Looking at his posts you realize the type of person he is, I have no respec for him whasoever nor do others. He is irrelevant, bereft of social skills and biomechanical knowledge and a peddler of snake oil. Thank you for your post.

    David
     
  9. BEN-HUR

    BEN-HUR Well-Known Member

    Thank you Eric & Kevin for your responses - appreciate the feedback, along with the academic & civil manner it was delivered (far better than the foul innuendo I saw within a quote from another individual).

    Yes, on the issue of joint congruity I see that looking at it via... "envelope of joint range of motion" is a better general/holistic approach... particularly on the varying (articulating) joints within the body & the varying characteristics within the (human) population.

    Thanks for providing the background context to your question... & the explanation which followed.

    Putting aside the initial issue I had with Dennis's (negative) views on Podiatry based orthotics (which didn't resonate with me in theory or practice), I also wasn't getting appropriate answers to my queries on the function of his alternative device - the Silicone Dynamic Orthotic... in relation to his adopted theory... or as he would prefer - "scientific technology" (i.e. "fluid mechanics"/"hydrodynamic pressure" based orthotic therapy) & the description thereof. The theoretical & the practical just weren't marrying together (for me)... as highlighted in post 82 [link] & post 90 [link] (i.e. fluid accommodation of the claimed "arch chamber"/"stability of the MTJ" as well as my query pertaining to the concepts ability to handle varying supination resistance forces). However I was intrigued by the concept, subsequently I felt the best solution would be for me to try the device (SDO) myself... & getting my own answers.

    Thanks for highlighting the above Eric. Understood; generalised assumptions in biomechanics isn't appropriate... joint congruity may be optimal for some joints (i.e. Calcaneocuboid, Metatarsophalangeal??) but not all (those with more than 1 articulation points?? like the STJ)... we just can't take a superficial & generalised line in this area. I also resonate with your following assessment criteria...
    This is what I endeavour to envision during an assessment - it is a primary issue (that being loads/forces... & relationship to individual's injury thresholds).

    Thanks Kevin for your views...
    Yes, Eric highlighted when there is "maximal pronation of the STJ" (potentially pathologic)... which also affects joint congruity (i.e. adverse articulation) of the Talonavicular joint...

    Putting aside the occurrence (%) of feet functioning best at "maximally pronated"... but when the STJ is maximally pronated, wouldn't this also be potentially pathologic to the Talonavicular joint (& other joints i.e. adverse articulation)? Hence the variability deemed (congruently) optimal for some individuals for one joint may not be optimal for other joints... & may not be optimal for other individuals.

    I agree... "maximal congruity of a joint should not be a goal of foot orthosis treatment"... as stated, we should be more concerned about the assessment of external & internal loads & their associated forces. Having said that, whenever I'm wondering how joints collectively/kinetically function (in real time) within a biomechanical assessment (i.e. with & without an orthotic), I often think about that x-ray scene in the 1990 film - Total Recall...



    So that film was 25 years ago... it would be interesting to have some sort of non-radiating x-ray device... maybe a handheld device (like an iPad) of which can be positioned varying angles to the foot to assess joint position/function (& dynamically). Elderly clients have told me that there use to be x-ray devices (decades ago) within some shoe stores (in Sydney) used to assess feet fit within shoes... the practise was stoped due to radiation issues.
     
    Last edited by a moderator: Sep 22, 2016
  10. Dennis Kiper

    Dennis Kiper Well-Known Member

    Franklin,


    The science and technology behind the SDO, would be confirmed by any scientific community in the world. The real problem is political. What a change that would make for anyone who derives their income from traditional technology. What the younger docs don't realize is this new technology elevates their professional level (not to mention their professional biomechanical competence). And brings Podiatry into the 21st century. As more and more information is disseminated and the public recognizes and would even understand the concept of the technology, will be flocking to everyone who can measure the volume of an arch chamber at midstance.

    As for David Wedemeyer

    I first met David years ago at a PFOLA meeting in San Diego. I had communicated with him via the internet on another forum and then met at the meeting.

    At first our discussions on the forum were about biomechanics and he was very quickly in admiration of things I was saying. He said, no one was saying the things I was saying. He tried to come visit me, but I didn't have a comfortable feeling about him, so I declined. (I posted an e-mail of his that bears what I'm saying—and then he actually has the nerve to say that those might not be his words, the way he thinks he would have said it now).

    David is really not a nice person in my view. While we were chumming, he told me a story of how he intentionally gave one of his bike riding buddies some chemical (like syrup of Ipecac or something) that made his friend very ill and very uncomfortable on a bike ride. He laughed about it and said something to the effect “that will teach him not to screw with me.” I realized then, that this little Napoleonic complex individual was not who I want to associate with.

    If I remember correctly, I had fit him through the mail and then we were going to test the results on a matscan at the meeting. I think I recall David mentioning an anomoly . Anyway, the results showed a good fit on at least one side (testifying to his comfort in his e-mail). The other side (maybe his bad side) was close, but clearly like most orthotics, an adjustment was the next order of things, particularly if we're going to adjust for an anomoly.

    I don't recall if I discussed whether the SDO was in fact a good orthotic for his condition, but if I could get enough hydrodynamic pressure up under the proximal union, maybe I could take more pressure off the anomoly. It was worth a try. We then got together with the sales manager Bill from TekScan (I don't remember if Dr Murphy was working for them then?)

    and I asked him to comment on the with and w/o orthic scans. I pushed him a bit and pointed out some of the biomechanical features and then he finally said he saw the difference. I realize today (I didn't then) that Bill really didn't know how to read the scan, especially looking at an orthotic that works exactly the way an orthotic should, and then can be biomechanically registered on a computerized gait system. He didn't know.

    That didn't do much for my credibility with David though, so be it. He's a sales manager, not a scientist.
    We attended the final lecture by the featured speaker a Dr Ward . The first words out of his mouth were “orthotics don't work”. I turned around with a smile on my face (I'm not a good poker player) and looked at David who was glaring knives and daggers at me.

    The seminar ended, we parted and that was the last time we communicated personally, or did any further work on his SDO Rx. Today he distorts this version as he'd like you to believe. I'm very aware of what I did by posting his private e-mail, but I have zero respect for him and any such cordiality as that.

    David competes with pods on their level, and I believe he's worried that he might not be able to get this technology for himself. I can't stop him, but he doesn't want the technology to change for the better or not.

    This is supposed to be a professional and scientific forum. New ideas, new technologies are I thought what this forum was about.

    Some of the people here have their own money making agendas i.e using this site to advertise upcoming seminars and selling books etc. So if you want to take your shots at me as well, come on down!.
     
  11. David Wedemeyer

    David Wedemeyer Well-Known Member

    Actually Dennis I was being nice as I was a new contributor to the board, my interest in the SDO was actually genuine in the beginning. If Dennis actually had uncomfortable feelings about me he wouldn't have spent so much time at the PFOLA trying to convince me, he wouldn't have sent me a pair of SDO's for a trial and he wouldn't have sent me some insoles for my grandmother (forgot about that Dennis, the thread is still available publicly so watch yourself?) for her aching feet. I believe they were poron insoles? Who of you would engage someone they don't get a comfortable feeling about and send them products gratis through the mail?

    This is the second time Dennis has made this statement publicly and it is completely false, potentially libelous in fact. I feel the admin should edit this part of the post out as a libelous and despicable attack. Dennis likes to employ transference, venom, ad hominem and lies when cornered and called out on his bull****. No one really cares what you think Dennis as illustrated in every thread on PA bearing your name. You're the most dogmatic and abrasive human being I have ever encountered.

    Dennis in fact did not send me an SDO until after the PFOLA meeting, he casted me there in foam to my recollection but it's a nice story as usual. Not worthy of further comment. Dennis had to push the TekScan rep repeatedly to comment favorably about what Dennis claimed was happening. To be honest, I was not then and am not now an expert in TekScan and Bill appeared befuddled and a bit nervous.

    Sales manager of what Ed? Jesus you're thick! Yes Ed Davis and I sat next to each other, I recall Ed being completely turned off by your smugness, he is on the board if he wishes to comment?

    You mean I completely saw though your charade and chose not to waste my time with such a weird little bull**** artist

    I do not compete with pods, I do refer to a number of them and them to me actually, the two pods I have chosen to have nothing to do with (both named Dennis btw) are the same ones trying to sell a proprietary product or system down the throats of thei own profession or have attempted to utilize me to gain access to chiropractors.

    And finally Dennis challenges everyone, Napoleonic reference anyone? Again, Dennis' comments above contain a libelous statement and I for one feel the post should be edited or removed. Lastly Dennis offers nothing of value to this board, only discord and I propose a vote to remove him for the sanity of thee rest of us.

    David
     
  12. Ina

    Ina Active Member

    It's too obvious to mention, but to publish private letters of others without their consent is not a decent argument in any civilized discussion, either online or offline. I believe it is a point where the moderator steps in in most online communities. What is more, when a health care practitioner identifies the person who had sought his professional opinion and discloses their private health information without their consent - and this is tolerated as one person's folly on a professional forum - what should members of the public expect from the said profession regarding the accepted standards of handling of the clients' private health information? Personally I learn a lot of invaluable professional experiense and knowledge of many contributors to this forum, I wish it wasn't tainted with such ethically crooked practices. Although the latter may be business as usual in the snake oil orthotics industry and therefore inevitable part of our lives.

    Back to the subject, the ways of thinking of snake oil orthotics salespeople must have something in common in different parts of the world. I met one of them about a year ago, a woman walked into our shoe shop, she introduced herself as an orthopaedic technician who made custom-made orthotic insoles, her selling point was her superior method of hydrostatic correction of any foot pathology, particulalry limb length discrepancy, the scourge of civilization in her view. She told me the method was based on Pascal’s law and laws of connected vessels. Basically, it wasn't a mere mortal making an average flawed traditionally manufactured insole, but these two respectable physical laws were employed to produce the orthotic correcting your unique foot pathology. Eventually, after a 20 minutes talk on her scientifically superior approach and pathetic traditional rivals she looked at me and exclaimed "I see that you have leg length discrepancy, no less than 1 cm! You need orthotics tailored to your LLD, here's my card." When I checked her website I found her bio-podocorrectors were cure-all, advised for everyone, with a promise to improve the wearer's flow of energy.

    As a sales assistant I'm not infrequently hear from people how desperate they are for a 100 percent certainty after having been diagnosed or treated so differently by different orthopedic surgeons. The snake oil orthotics industry is here to stay and enjoy a huge client base as long as people tend to crave for certainty and someone aggressively sells them that certainty, particularly in our country it is advertised in the package of a seemingly human-error-free superior technology. The seller doesn't mention that any piece of technology which is branded as error-free was designed, is operated and interpreted by the very same flawed human beings.
     
  13. Dennis Kiper

    Dennis Kiper Well-Known Member

    Kevin,

    "maximal congruity" of a joint should not be a goal of foot orthosis treatment.

    I totally disagree. Joint Congruity relates to biomechanical efficiency. How can our concepts be so diametrically opposed?? Maybe, that's because the difference in our biomechanical technology. My concept revolves around the planes of motion (POM) at the tarsus.


    When the POM at the tarsus are in the foot's own natural optimal and ideal position as it relates to “neutral” and within that “envelope of joint range of motion” we have a level of functional congruity. As the joint axis deviates further and further under load, BTS increases. (potential for subluxation/instability moment also increases)


    I contend, it is the POM that dictates deficiency. The brain knows when BTS is less.

    If you can achieve this level of efficiency with a quantifiable Rx. You can then provide orthosis therapy over a lifetime with orthotics that works the same way each and every time and the Rx can be changed as necessary.

    Maybe, you're referring to non congrous joint function as more efficient with “traditional technology”?
     
  14. Dr Kiper, please explain how "joint congruity relates to biomechanical efficiency"? First define biomechancal efficiency: biomechanical efficiency is often defined as the rate of oxygen consumed at a given steady-state speed of locomotion. If an individual consumes less oxygen than another individual at a given speed, then it might be assumed that they are more biomechanically efficient than the other people. If an individual consumes less oxygen when wearing your insoles, than when they are not wearing your insoles, at a given speed, this might be seen as an improvement in biomechancial efficiency- do you have such data, published in a peer reviewed journal? Do you have data which shows that the joints are more "congruous when wearing your insoles"- no you don't. So, please explain how "joint congruity" should result in greater "biomechancial efficiency", then please provide data to support your contentions that a) your insoles make joints more congruous; b) this results in greater biomechanical efficiency. You cannot provide data to support either contention. Viz. Good night, Vienna. Except it won't be because you'll no doubt tell me that "I don't understand", "I'm an idiot" etc. Funny as funk, Charlatan.
     
  15. Dennis Kiper

    Dennis Kiper Well-Known Member

    Ina

    Ina;364753]It's too obvious to mention, but to publish private letters of others without their consent is not a decent argument in any civilized discussion, .[/QUOTE]


    You're right, I know I'm not perfect
     
  16. Dennis Kiper

    Dennis Kiper Well-Known Member

    Simon and Eric


    Why is congruity better? BELOW ARE THE ANSWERS, YOU SHOULD HAVE ALREADY KNOWN:

    Joint congruency is maximal at the closed-packed position, as maximum contact exists between the two surfaces. Congruency is the concept of "fitting well together".

    Congruency the dimension of fitting together of 2 bone parts and the smoothness of movement of the joint. Yes, a joint will have a minimal movement in a closed packed position although a perfect congruency exists.


    Congruency is when the radias of curvature of the two articulating surfaces are most coincident.

    Close pack by definition is the position of maximum stability in the joint, and the joint surfaces being congruent will also contribute to stability.


    As I replied above ,max congruency is when the radius of curvature of two articulating surfaces are most closely matched.

    Joint stability is close-pack, but congruency is a geometrical relationship of articular surfaces and its rotational axis.

    THE COEFFICIENT OF FRICTION

    The coefficient of friction is the ratio of tangential force to interbody pressure necessary to start a sliding motion between two objects. One can skate more easily on a hard, smooth surface than a soft, rough surface because the ratio of effort to body weight is smaller on the firm, flat surface. This action between the skater and the flat surface demonstrates a low coefficient of friction, where the action between the skater and the rough surface demonstrates a high coefficient of friction (Fig. 3.10).


    *** INTRINSIC FRICTION

    Friction is also a factor between flexible and rigid objects such as between a tendon and a bony prominence or between the soft tissues within the intervertebral foramen and its bony borders. Forces of friction in the body are especially important between articulating surfaces, layers of tissue, and around structures which glide upon each other. At common sites of friction wear, bursae are genetically located to decrease the effects of friction. At uncommon sites, a bursa will form by physiological demand. In acute situations, traumatic effects of friction are seen both macroscopically and microscopically.


    Angle of Pull

    Mechanical efficiency is more important than muscular efficiency in determining strength of body force. A pull at right angles to the lever gives maximum mechanical efficiency. The greater the deviation from the right angle, the less efficient is the angle of the pull. Thus, the effect of the angle of pull of a muscle upon the force imparted to the lever is generally a decrease in the efficiency of the pull because the angle made by the bones on either side of a joint is either decreased or increased from a right angle. The reason that efficiency of pull is greatest when the joint is at a right angle is that in this position the muscle is pulling directly against bone. In this position of direct pull, none of the force of the muscle is wasted in pulling the bone of its insertion either toward or away from the joint.

    A muscle that is pulling at an angle less than 90* has a stabilizing effect upon the joint. The smaller the angle of pull, the greater will be the portion of the total force which will be devoted to the stabilizing effect. This stabilizing effect relieves the stress and strain on the body, but it represents only a loss of effort in the accomplishment of external work.

    Consider the strongest pull in flexion of the forearm. The strongest pull by the forearm can be made when placed in 90* flexion, even if the flexor muscles are not stretched enough to give their most powerful contraction, for it is in its position of maximum mechanical efficiency. If the forearm, is extended to 180*, the muscle is in a position for a powerful pull, but the pull in this position is at such a mechanical disadvantage that only a small force can be applied to a load. In the flexion of the fully extended arm, considerable force is wasted by pulling the radius and ulna against the humerus.

    This principle is commonly demonstrated in professional sports when we observe the position of the body joints during different physical activities that require strong movements. See Figure 3.13.

    The Action of Synergic and Antagonistic Muscles

    If the pull of a muscle is not directly away from its point of insertion, additional muscles must be called into action to hold the lever in the desired position during the movement. Most arm movements in swimming, for example, are angular and require the contraction of synergic muscles.

    The reciprocal action of synergic and antagonistic muscles increases the steadiness and accuracy of a movement. The greater quantity of muscles engaged in a movement, the more accurate and graceful is the movement. The more complete the relaxation of the antagonistic muscles, the more rapid and powerful is the movement. The more angular the direction of pull, the greater is the importance of the action of the synergic muscles in controlling the direction of the movement.


    Joint Stability vs Mobility

    Joint stability depends primarily upon its resistance to displacement. Biomechanically, it is the opposite of joint mobility. Joint flexibility is determined by osseous structures, soft tissue bulk, restraining ligaments, synovial fluid viscosity, muscle tone, nonelastic connective tissue of muscle, and the restraint action of the skin. Joint stability, on the other hand, is determined by mechanical and anatomic factors.

    ***** BIOMECHANICAL FATIGUE AND ENDURANCE
    The process of developing structure cracks when subjected to cyclic loading is called fatigue. The magnitude of the load is usually far below that of the ultimate load of the particular structure, and thus well within the elastic range. The result is a summation effect, in which a fatigue crack reaches a size that causes the remainder of the structure to become so stressed that the entire structure fails. This factor is popularly called the time or aging factor of a body structure, and the time of failure decreases as the magnitude of the load increases. The term endurance limit refers to the least load that produces a failure from structural fatigue.

    ***** DEFORMATION FROM LOADING

    When articular cartilage is subjected to loading, deformation develops instantaneously according to the tissue's stiffness. This initial rapid deformation stage has a negligible matrix fluid flow, and tissue contour changes but not its volume. This stage is followed by a slower time-dependent creep that is related to the flow of water through the matrix according to the magnitude of the load, the fiber elasticity, the quantity of surface area loaded, the uniformity of force distribution, the matrix permeability which is low even when unloaded, the osmotic pressure of the matrix colloid, and the length of the flow path.

    When the load is removed during rest, the stressed cartilage begins to return to its original thickness quickly



    Recovery During Cyclic Loading. * Because fluid flow within the matrix is time dependent, cartilage response to compression depends upon the magnitude of the load, the length of time the load is applied, and if the load is applied statically or cyclically. A small amount of water is expressed through the matrix even during a briefly applied load, and its absorption is time dependent. If a second load is applied before the matrix is fully reimbibed, as during cyclic loading, the result is incomplete recovery which summates as the cyclic loading continues. In addition, all cartilage can be considered fatigue prone.





    Congruity in the foot is best served by the POM which require “dynamic engineering”--one of those materials that meets the criteria for the foot, is fluid.

    Podiatry's failure to recognize the long term need for orthoses therapy is because your present technology is not backed by science . Only a quantifiable and scientific technology capable of accurate biomechanical Rx comparable to vision is going to be recognized as a valid technology.





    Science does make assumption predicated on principles of physics. When you have the assumptions I've presented based on numerous references of science—by now if you're still asking me why it's better—you haven't gotten it. I could dissect your questions down if I wanted to specifically and scientifically point to your lack of understanding,


    It's time for Kevin to accept and at the very least challenge the technology at CCPM. Under controlled conditons and strict guidelines.

    If you brought the media into it, that podiatry was testing, not a product, but a technology.
    I'm very confident, that at the end of that test, you will bring podiatry into the 21st century. It would be good for everyone.

    No doubt those that make money from present day technology are going to get hurt.

    Consider the number of failures that are walking around out there.

    Consider the benefit to Diabetics and others with pressure ulcers. A study doing that would be pretty impressive—not necessarily 100% in every case, but where there is biomechanical pressure, treating those ulcers with this technology is impressive.

    Consider, this technology is a health benefit, think of the benefits to come.


    All your word play, critical definitions and meanings that needed to be answered, all deviated from the true topic of, look at how the technology works??

    You think you know it, but frankly I have my doubts you know it all.
     
  17. Dennis Kiper

    Dennis Kiper Well-Known Member

    David

    David

    If Dennis actually had uncomfortable feelings about me he wouldn't have spent so much time at the PFOLA trying to convince me, he wouldn't have sent me a pair of SDO's for a trial and he wouldn't have sent me some insoles for my grandmother (forgot about that Dennis, the thread is still available publicly so watch yourself?) for her aching feet

    I didn't (at the time) have a problem introducing you to a technology. I don't have to like you or spend time with you any longer than the seminar. Why wouldn't I spend time.


    Dennis in fact did not send me an SDO until after the PFOLA meeting, he casted me there in foam to my recollection



    I know for sure I did not fit you at the show with a foam box. Foam casts are what I use for my mail order business. I would have used the “calibration system” whose patent # I posted earler. That's the way we fit at a professional seminar. I'm pretty sure you remember the foam box, because I fit you through the mail as I stated.

    As for your grandmother, no, I don't remember sending her any insoles, unless they were Formthotics, I know I didn't make SDO or I would have remembered.. Why would I send her insoles when she's your grandmother and you take care of her aching feet?????

    , potentially libelous in fact. --I would take a lie detector test any time.

    You're the most dogmatic and abrasive human being I have ever encountered.

    Thank you, compliments regardless of how you meant them.

    Lastly Dennis offers nothing of value to this board,

    I offer a new hope to podiatry. To again be the doctors of the foot with better technology for the most important aspect of podiatry—functional biomechanics.

    Besides David: "If we all worked on the assumption that what is accepted as true is really true, there would be little hope of advance." - Orville Wright

    I propose a vote to remove him for the sanity of thee rest of us.

    I guess it will be interesting to see if a public and scientific group can allow the freedom to present new ideas and newer technologies to scientic and medical colleagues? But, I think this “call to arms” is exactly what I said, a Napoleonic complex. Oh yeah!



    BTW: David

    I don't “race” to to PA. I'm handling pts in between your classless act. I don't need to work “real time” when the pts are there, because of the technology I work when I choose. Just like my father said, work smarter, not harder.

    Ed Davis,

    I have no problem with him reporting to the PA.. I remember he came to me and asked me to put my differences aside with you and shake your hand, which I did.

    I know for sure I fit Ed by mail and we tested it on the scan at the meeting. In fact I'm sure I had already made an adjustment for him and the scan reflected how the Rx was for doing it being made through the mail. I recall him saying they were comfortable. True, never heard any thing more. Nice fellow.
     
  18. efuller

    efuller MVP

    So, you've just repeated the claims. You haven't explained anything. A joint can be stable when not at max congruity. (Not that stable is necessarily important for joints that are supposed to move.) You still haven't explained why congruency is relevant to pathology.





    Dennis, that is a pretty impressive amount of cutting and pasting. You forgot to paste figure 13. Did you even read any of that stuff?? Are you going to attempt to explain why the above has anything to do with joint congruity?

    A pretty lame attempt at making it look like you know anything.



    So, you haven't shown that congruity is important. Now you are adding more crap. Planes of motion? You can't explain why planes of motion has anything to do with joint congruity. Yes Dennis, you are using words used in science. However, you have not connected the concepts together.

    Or the alternative explanation is that you haven't presented anything valid. Get to work and stop ducking the questions. We know you are just bluffing. We have been pointing to your lack of coherence. See above.




    Ok lets do some science. How would we measure the difference between a bag of silicon "orthotic" and rigid plastic orthotic in terms of forces applied to the foot. Dennis do you think the mat scan would be appropriate for this? I went back to your podiatry today article and couldn't access the pressure scans that were used in figures for that article. Would you mind posting them here? If you need some help I'm sure someone would be willing to post them for you if you need help. As I recall, they appeared to be mat scans. You could clearly see the pressure from the anterior edge of the plastic orthotic in the plastic device scan.

    Was measuring device under the orthotic. Don't you think a more scientific comparison would happen if the sensor was placed on top of the orthotic?

    Eric
     
  19. What do Dennis Kiper and the other Dennis have in common?

    1. They don't understand physics, biomechanics or engineering terminology.
    2. They make up words to explain things they don't understand to make it appear as if they are more knowledgeable than they are.
    3. They are both selling products that have little value to the ethical podiatrist.
    4. They become belligerent when anyone disagrees with them.
    5. They are both US podiatrists within a year of being 70 years old.
    6. One has already been banned from Podiatry Arena. The other one should be banned from Podiatry Arena.
     
  20. Dennis Kiper

    Dennis Kiper Well-Known Member

    Eric

    Don't you think a more scientific comparison would happen if the sensor was placed on top of the orthotic?


    I don't think so, what is the data you're looking for if you did it that way?
     
  21. Dennis Kiper

    Dennis Kiper Well-Known Member

    Kevin,

    You once posted it wasn't to late for me to stand up and do the “right” thing?? It's time for you to realize you should do the same for the benefit of your colleagues, your profession and mankind.

    Podiatry is not as highly respected a profession (we've even slipped behind chiropractors), because of our inadequate orthotic technology. You must be blind to the # of failures of traditional orthotic technology.

    It's been approx 70 yrs since Root developed his theories and formulated a technology that may look like it should work, but really doesn't work well enough as a modern medical technology.

    You're legacy will come back to these threads eventually!
     
  22. The change in kinetics at the foot to orthosis interface as oppose to the kinetics at the orthosis to ground interface; usually an orthosis has a shoe between it and the ground too. When looking at changes at the foot (that's the important bit-right?) we need to know the changes at the foot to orthosis interface, not the orthosis to ground interface.

    As Eric said yesterday, the rest of your previous post was a cut and paste job, without giving credit to the original author- naughty, naughty. I got bored after a while, but it certainly didn't explain why increased "congruency should be more biomechanically efficient". Some of the right words, but not necessarily in the right order, Dennis- Just like your pressure mat study: not necessarily in the right order; the sensor should have been between the foot and the orthoses, as at least three people have pointed out to you on this forum now: David Smith, Eric Fuller and yours truly.
     
  23. And a great many of us have used the research from the intervening years to decide upon a different appoach to that described by Root. Some have followed science and the published research; some have just made sh!t up, in the attempt to make a buck.

    BTW, if the word "sh!t" offends you, I suggest you take a look at the world around you and grow the f@ck up.
     
  24. efuller

    efuller MVP

    I would be looking at the forces applied to the foot by the device.

    What data do you think you are getting by placing the sensor under the device?

    What do you think is more important the force applied by the floor to the device or the force applied to the foot by the device.

    Post your pictures so that we can educate others on how to read a pressure distribution.

    Eric
     

  25. He won't re-post those pressure images because he knows that "You can fool all the people some of the time, and some of the people all the time, but you cannot fool all the people all the time"- Abraham Lincoln. The people who were not fooled at any time are now speaking out... Dennis has used an erroneous methodology. There really is nothing more to add- "not fooled of Plymouth".

    Anyway, despite all of that cut and pasting, Dennis has yet to address: how joint congruency relates to biomechanical efficiency.... He is yet to provide data which suggests his insoles result in "increased" joint congruency; and he's yet to provide data which demonstrates that his insoles result in improved biomechanical efficiency.

    The moon is a balloon, that's my contention. Prove me wrong. I'll sell you a balloon. That means you now own the moon. Carry it on a stick. If anyone tell's you it's not the moon, tell them that they are "thick". Poetry on a Wednesday night, who'd have thought it?

    "blessed are the naive, for they shall be shafted by the charlatans". If you are a vegan, barefoot runner who doesn't believe in evolution, this probably applies to you; the rest of us will just breathe when the salesmen knock upon our door. Could go "breathe" U2, but I'll go "Sands of time"- Aslan https://www.youtube.com/watch?v=eNOjE8Lu7Yg

    while were in: "how can I protect you in this crazy world?"... https://www.youtube.com/watch?v=fDtVbWzZatw

    Too good to leave out: https://www.youtube.com/watch?v=nZTM3bi0wko
    Friends of mine, from back in the day. God bless you Chrisitie.
     
  26. Dennis Kiper

    Dennis Kiper Well-Known Member

    Eric

    Ok lets do some science. How would we measure the difference between a bag of silicon "orthotic" and rigid plastic orthotic in terms of forces applied to the foot


    This is not the science I'm doing with you. What principle of science is your orthotic technology based on? You need to show me that 1st-- You can't compare two technologies, when one has no valid principles of science behind it . When you can, then we can compare somes tests you've concocted..

    Eric / Simon

    you each have been asking about congruity again—a waste of time and irrelevant to what’s important., what makes it better? etc.--It's my opinion (predicated on multiple facts of science that it's better and when I asked Matt Thomas he said it in one word--”optimal”. If you have a problem with that—talk to a physicist.

    You asked me why it's more biomechanically efficient.? Too numerous to mention, but I thought I pointed it out already, congruity is “pin point”--., (therefor minimal movement—reduced BTS)-

    -Because you can't quantify your Rx, you cannot actually see efficiency. The scans show that to be so.

    motion within an “envelope of joint motion” is too much motion, overpronation and instability is what you wind up with.

    Then there's the issue of the STJ when congruity is not preferred. I totally disagree again. Multiple articulations, but it is still congruent when the facets make full contact. – In that position it is the least stressful on the surrounding tissues. (neutral—on an orthotic)

    maximum joint congruity may be even pathologic. --Really? name 2 pathologies??--


    In addition, at the talo-navicular joint, the foot may function best when the subtalar joint is maximally pronated which will also cause the talus to rotate more medially relative to the navicular than when it is at its point of "maximal congruity" when the foot is supinated from the maximally pronated position. In other words, "maximal congruity" of a joint should not be a goal of foot orthosis treatment.

    I would disagree with all of this, if this is true, how many cases have you seen? Just a lot of hypetheticals.

    joint congruity in my humble opinion is the goal at midstance. If you can point to some anomalies where this statement is true, point it out! What's the condition? What's the anomoly. Name some examples


    As for the other Dennis, Kevin mentioned. Don't know him, but if he's not here and able to defend his technology, then I can understand why .


    Now if you want to go over the scans on my front page: http://drkiper.com/animation.html

    The pedo scans at the article, I don't know how to transfer that over.
     
  27. BEN-HUR

    BEN-HUR Well-Known Member

    Previously I said I wasn't going to tolerate BS (directed my way)... which was the result of seeing the following immature trash from an "ignored" individual via an iPhone browse (yea, the "ignore" person function on this forum doesn’t kick in when one isn’t logged in)...

    Yep, Spooner... an immature frustrated little man who evidently isn’t capable of comprehending the context of a thread... who evidently has these insecure biases, by means of interpreting issues which suit his petty little world. Ironically, such immature reasoning & incompetent comprehension skills just reveals his stupidity & failings.

    BTW, I will be paying for the SDO to test... like I have done with other questionable devices (some of which I’ve dedicated a "snake oil" web page to). I’ve already stated why I want to test the SDO at least 2 – 3 times before on the thread i.e....

    The dialogue/posts between Dr Kiper & myself are here for all to see (see pages 3 & 4 of this thread). But no, Spooner here wishes to see things differently (i.e. due to probable bias & insecurity issues). Just because I intend to be objective, impartial & civil to Dr Kiper (attributes of which Spooner’s intelligence level is evidently incapable of developing/conveying), Spooner then interprets my input/dialogue in a derogatory (childish) fashion. Others here have decided to test the SDO for themselves before I have... no doubt for similar reasons I have now stated in this thread of late (albeit, long before me... as I am only recently aware of this device).

    Even Spooner himself has revealed an interest in the concept of "fluid dynamic technology". Yep, that’s right folks... where? Well if you go down to the end of Dr Kiper’s Podiatry Today article (i.e. here: http://www.podiatrytoday.com/closer-look-principles-fluid-dynamics-they-relate-orthoses) you will see his comment i.e.

    Hmmm... hypocrite per chance? Short memory? Biasness? Yea well, take your pick!
    I too believe in the possible potential for "fluid dynamic technology" for orthoses... I found it intriguing... yet wasn't familiar with it... hence my interest (is that so hard to understand - particularly when I wasn't familiar with the past history of this issue?)

    But you see, there’s a history here with Spooner (which is why I’ve ignored him)... & the following just confirms that (thanks Spooner)... it confirms his failed interpretation/comprehension skills, biasness & evident insecurities...

    I have posted material on all three of the above areas of this forum...

    - I do believe in the benefits of a plant based diet (as does the science), yet I’m not 100% vegan – hence I’m not a vegan – I’m vegetarian (& for a myriad of science based evidences). I have posted such material on diabetes & nutrition related topics... & the beneficial impact it can have (i.e. on CVD, BGL, certain cancers etc..)!

    - Being a former national class runner (still training about 100km a week – yet not competing at the moment) I do post on running related threads on this forum. Being biomechanically efficient I do run in neutral &/or minimalist type shoes – have been doing so well before the controversy/trend that ensued about 10 years ago (been doing so for about 20 years). In a similar context as the vegan/vege issue above... I have done some barefoot training in the past – but I am not a “barefoot runner”. In fact I speak out against such stupidity when done on hard surfaces (i.e. roads – particularly racing on hard surfaces (as backed up by the science i.e. "cost of cushioning" hypothesis). I likely have similar views on this as other running interested members of this forum (i.e. Kevin Kirby & Craig Payne – yet we may differ on views with regard to the heel - forefoot pitch issue).

    - Yes, I don’t believe in evolution (well, that’s 1 out of 3 Spooner)... I am an advocate of an intelligent design premise (as do many scientists, including Nobel Prize winners - due to the bankruptcy of Neo-Darwinian conjecture)... with no religious underpinnings (as is often erroneously associated with this)... I am agnostic. Once again, I go where the evidence leads (as with the above two areas); the empirical science has been showing many problems with the major tenets of evolution (Neo-Darwinian) "theory" i.e. the source of information (i.e. the ultimate cause of the genetic code) & subsequently the acquisition of the required masses of information within lifeforms (we’ll leave Abiogenesis alone) to develop & diversify in uphill complexity to the evident mass of (categorised) species we see within the present fauna & flora (including the history of extinct) on this planet.

    But hey folks, if Spooner’s above failed erroneous & bias ‘logic’ doesn’t convince... just listen to the immature diatribe that comes from the guy’s mouth... you’ll catch it at about 2:43 of the following video...



    Yes Simon Bartold... #iknewishouldnothavelethimontheprogram... ;) (besides, posting this will boost up the vid. view count :D)

    In the mean time Spooner, take some of your own foul unprofessional advice!...

    Yep... you do that!

    Anyway, I’m travelling at the moment... & have far better, positive & enjoyable things to do than to waste my precious time on this forum with a topic I’m now finished with... & to have a battle of wits with an evidently unarmed individual (that being Spooner) – good bye!
     
    Last edited by a moderator: Sep 22, 2016
  28. Never had a problem with incorporating fluids into foot orthoses. Read what I said: "not in it's current iteration". Have worked with Non-Newtonian fluids in foot orthoses. So not hypocritical, just unconvinced by Dennis and his product. Which I have seen for myself BTW.
    A comedic piece which Simon Bartold asked me to do. He actually requested for me to use far more colourful language, but I opted to tone it down, I come in at about 1:48 BTW.

    No comedy in your life-style, I'm sure. Just long rambling, patronising, hollier than thou posts. Bye-bye.
     
    Last edited by a moderator: Sep 22, 2016
  29. Dennis it's statements like the one above which mean I cannot take you seriously: "This is not the science I'm doing with you"- really? What is the "science" you are "doing" with us?. Newtonian mechanics is the science that "traditional" foot orthoses are based upon; reasonable science one might assume. Hmmm, let me think how one might compare forces at the foot-orthosis interface using two different kinds of foot insole. It's a mystery :rolleyes:
    You are right, joint congruency is not necessarilly important to biomechanical efficiency. it was you that stated that it was, which is why we have been trying to explore why you think joint congruency is related to biomechanical efficiency. So do you agree that joint congruency is not important now?
    That's right, it is your opinion, the opinion of someone trying to sell a product. I don't need to ask a physicist, I'm asking you- you are the one with the knowledge about your product, surely? Matthew Thomas is a relatively inexperienced podiatrist with no publications nor research background, tell me why we should take the view of this individual as being of significance? Because he seems to support you? Here you go: P = G + E + (GxE) + i, where P = a given optimal biomechanical function; G = genotype; E = environment (all non-genetic factors and; i= measurement error. This tells us that "optimal biomechanical function" is subject and environment specific, end of story.... next?

    Again you are not answering the question. "Too numerous to mention", so list some of the reasons. Don't know what BTS means.

    Dennis, you are going around in circles here. The effect of what you call "traditional" foot orthoses can and has been quantified in terms of 3D kinematics, kinetics and EMG activity, patient outcomes, patient satisfaction and perhaps most importantly to this discussion in terms of biomechanical efficiency, etc etc. How else would you quantify their effects? We can quantify foot orthoses in terms of prescription variables. We can even quantify the surface geometry, the stiffness characteristics and the frictional characteristics at the foot-orthosis interface- since mechanically foot orthoses can only ever alter these three primary factors to exert a direct mechanical effect, I'm not sure what else you would have us measure to "quantify our Rx". You keep saying this, but it's just not true. It's like someone once said this to you, you believed it and have continued to espouse this notion, without thinking it through. How should we measure "biomechanical efficiency"? Traditionally this has been measure by oxygen consumption/ distance travelled; how would you have us measure it?

    This statement just doesn't make any sense, nor does it stand up to the scrutiny of published data. We've been here before, stability is not desirable in dynamically moving system- when joints don't move because they are by definition "stable" we wind up with problems- see hallux rigidus for example.

    too many assumptions here, Dennis a) You assume that "neutral" is the position of least stress, I used to concur with this, I don't believe this now- I can explain if you wish. b) You somehow believe that the orthotic will place the STJ in neutral c) you are neglecting dynamic function.


    Let's go back a step and see if we can reach concordance. At what position are the articular facets of the subtalar joint most congruent? This study might help us: Yan-xi Chen, Guang-rong Yu, Jiong Mei, Jia-qian Zhou, Wen Wang: Assessment of subtalar joint neutral position a cadaveric study: Med. J.
    Chin Med J (Engl) 2008 Apr;121(8):735-9:
    Abstract
    "Subtalar joint (STJ) neutral position is the position typically used by clinicians to obtain a cast representation of a patient's foot before fabrication of biomechanical functional orthosis. But no method for measuring STJ neutral position has been proven accurate and reproducible by different testers. This study was conducted to investigate the STJ neutral position in normal feet in cadavers.
    Twelve fresh-frozen specimens of amputated lower legs were used. Pressure-sensitive films were inserted into the anterior and posterior articulation of STJ. The contact areas for various foot positions and under axial loads of 600 N were determined based on the gray level of the digitized film. The STJ neutral positions were determined as the ankle-foot position where the maximum contact area was achieved, because the neutral position of a joint was defined as the position where the concave and convex surfaces were completely congruous.
    In ankle-foot neutral position, the contact area of STJ was (2.79 +/- 0.24) cm(2). In the range of motion of adduction-abduction (ADD-ABD), the maximum contact area was (3.00 +/- 0.26) cm(2) when the foot was positioned 10 degrees of ABD (F = 221.361, P < 0.05). In the range of motion of dorsiflexion-plantarflexion (DF-PF), the maximum contact area was (3.61 +/- 0.25) cm(2) when the foot was positioned 20 degrees of DF (F = 121.067, P < 0.05). In the range of motion of inversion-eversion (INV-EV), the maximum contact area was (3.14 +/- 0.26) cm(2) when the foot was positioned 10 degrees of EV (F = 256.252, P < 0.05).
    Joints, such as STJ, therefore, are not necessarily in neutral position when the ankle-foot is placed in the traditional concept of neutral position. The results demonstrate that the most approximate STJ neutral position was in the foot position of 10 degrees of abduction, 20 degrees of dorsiflexion and 10 degrees of eversion."

    So, if we want to shoot for maximal joint congruence at the subtalar joint, your insoles need to be holding the foot in a position of 10 degrees of abduction, 20 degrees of dorsiflexion and 10 degrees of eversion. Do they? BTW 10 degrees eversion was maximal pronation according to Root.

    During midstance the bones of the midfoot are all in motion, the motion is subject and environment specific, how many joints are congruous at this time and in whom?
     
  30. efuller

    efuller MVP

    You are doing more marketing than science with me. Both of our technologies are based on Newtonian Mechanics. If you actually used any principles of hydrodynamics you would know that fluids apply forces. Your fluid device applies a force to the arch of the foot. A rigid plastic device applies a force to the arch of the foot.

    You avoided the question about what data you were getting with the scan with sensor under the mat.


    Yes, congruity is a waste of time.

    So, you can't think of an explanation. More Marketing.

    I can quantify my Rx. I can say that I want the arch of my orthotic to 22 mm high. This measurement is more accurate an relevant than your measurement consisting of ml of fluid silicon. Your marketing claim that your product is more quantifiable is quite week. Does your measurement have any validity. The fluid moves.


    You are just repeating the claim. Which is not adding to the discussion. If you don't have an explanation you shouldn't just get to repeat the claim over and over and over again.

    Sinus tarsi syndrome





    If you have that scan in a picture file on your computer, it is quite easy to post.

    Dennis, I am not going to click on a link to your website. The sole reason you are here is to increase traffic to your website. You aren't a very good marketer. Most hucksters know when their sales pitch isn't working and just move on to the next rube.

    Eric
     
  31. Dennis Kiper

    Dennis Kiper Well-Known Member

    Kevin

    I'm aghast that you would ask me to be banished. I bring spirited conversation about new technologies and more science to the world of biomechanics. Where else do you have such a heated discussion over the benefits to mankind?

    Hopefully we'll have a breakthrough and man will grow, technologies will grow. Ain't that right guv?
     
  32. All yours, Dennis. When you are ready...
     
  33. Dennis Kiper

    Dennis Kiper Well-Known Member

    Simon/ eric

    I'm reminded that Simon said he was in favor of fluid technology concepts, but he had another idea. How do you propose to use the technology and in what format?

    What principles does yours work and mine doesn't?

    Eric

    Your questions on force, figuring how much force?? why? I don't need that information. You keep using your technology as a basis for data, you want. I don't need to waste my time with that, unless there's some anomoly your thinking about? You seem to be looking for the anomoly first, instead of looking for what works best over-all and most of the time.



    Newtonian mechanics Please describe the loading and unloading of the foot through stance phase , .Let's see how it interfaces with Root technology and theory?

    Your distortions are priceless, Congruity is not a waste of time, “why congruity is better” is a waste of time. Another answer you can wrap your head around is that, “dynamic congruity” : is paramount.
    (fluid technology- requires some new terminology) another example: BTS—biomechanical tissue stress

    It's true the foot is in motion through midstance EXCEPT for the plantar surface of the foot from when the leg is just pre-vertical to just after the leg is post vertical. And at the moment of MS, is when the MTJ should remain stable. There is a momentum and transference of energy anteriororily. Please explain how the foot maintains its stability.
     
  34. efuller

    efuller MVP

    ;)

    Dennis, I'm not sure exactly what you are claiming about your devices. What are you saing your the mat scan, that is between the orthotic and the ground, shows when comparing rigid devices to silcon devices? Why do you think placing the mat between the ground and the orthotic would tell you anything about what the orthtoic is doing to the foot? Why wouldn't you place the sensor between the orthotic and the foot to figure out what the orthotic is doing to the foot?

    Dennis, I've used a silcon device. It was OK for walking straight ahead. It was bodering on dangerous for side to side sports. So, I am looking for works best most of the time.



    Using the EMED you can see how a barefoot foot is loaded and unloaded through stance phase. Using an in shoe sensor on top of an orthotic you can see how the foot is loaded through stance phase. When I was looking at roll over processes I could not mesh that with Root theory. That was one of the things that led me to abandon the Root theory that I was taught in school. However, the Root technology of plastic orthoses with intrinsic forefoot valgus posts, when indicated, is still good technology.

    Only if you choose to believe stuff that salesman are trying to tell you. Dennis, quit wasting our time. Knowing why something is better, or not, is not a waste of time.

    Eric
     
  35. As I said previously, I was more interested in employing Non-Newtonian fluids as oppose to silicone.
    Dilatent fluids as oppose to fluid displacement. Tissue stress reduction as oppose to "ideal position", "joint congruence" etc.


    Dennis once again you are avoiding the moot point: as I pointed out, research suggests that maximal congruency between the articular surfaces of the subtalar joint occur at maximal pronation...

    To reiterate: At what position are the articular facets of the subtalar joint most congruent? This study might help us: Yan-xi Chen, Guang-rong Yu, Jiong Mei, Jia-qian Zhou, Wen Wang: Assessment of subtalar joint neutral position a cadaveric study: Med. J.
    Chin Med J (Engl) 2008 Apr;121(8):735-9:
    Abstract
    "Subtalar joint (STJ) neutral position is the position typically used by clinicians to obtain a cast representation of a patient's foot before fabrication of biomechanical functional orthosis. But no method for measuring STJ neutral position has been proven accurate and reproducible by different testers. This study was conducted to investigate the STJ neutral position in normal feet in cadavers.
    Twelve fresh-frozen specimens of amputated lower legs were used. Pressure-sensitive films were inserted into the anterior and posterior articulation of STJ. The contact areas for various foot positions and under axial loads of 600 N were determined based on the gray level of the digitized film. The STJ neutral positions were determined as the ankle-foot position where the maximum contact area was achieved, because the neutral position of a joint was defined as the position where the concave and convex surfaces were completely congruous.
    In ankle-foot neutral position, the contact area of STJ was (2.79 +/- 0.24) cm(2). In the range of motion of adduction-abduction (ADD-ABD), the maximum contact area was (3.00 +/- 0.26) cm(2) when the foot was positioned 10 degrees of ABD (F = 221.361, P < 0.05). In the range of motion of dorsiflexion-plantarflexion (DF-PF), the maximum contact area was (3.61 +/- 0.25) cm(2) when the foot was positioned 20 degrees of DF (F = 121.067, P < 0.05). In the range of motion of inversion-eversion (INV-EV), the maximum contact area was (3.14 +/- 0.26) cm(2) when the foot was positioned 10 degrees of EV (F = 256.252, P < 0.05).
    Joints, such as STJ, therefore, are not necessarily in neutral position when the ankle-foot is placed in the traditional concept of neutral position. The results demonstrate that the most approximate STJ neutral position was in the foot position of 10 degrees of abduction, 20 degrees of dorsiflexion and 10 degrees of eversion."

    So, if we want to shoot for maximal joint congruence at the subtalar joint, your insoles need to be holding the foot in a position of 10 degrees of abduction, 20 degrees of dorsiflexion and 10 degrees of eversion. Do they? How can you know this, when you never see the patient? If congruence is good, then by your reasoning, functioning at somewhere near end of range proantion is good... is it?


    Stop just making stuff up, Dennis.
     
  36. Dennis Kiper

    Dennis Kiper Well-Known Member

    Simon--Eric

    Dilatent fluids as oppose to fluid displacement. Tissue stress reduction as oppose to "ideal position", "joint congruence" etc.

    Let's hear more about it.


    "traditional" foot orthoses can and has been quantified in terms of 3D kinematics, kinetics and EMG activity,

    Simon, you're so tricky. When you can quantify this with a scientific calibration that affects the functional biomechanics, then you've got something to say--


    I can explain if you wish. b) You somehow believe that the orthotic will place the STJ in neutral c) you are neglecting dynamic function.

    Really?So you really don't understand the bio/fluid loading at the rearfoot.--The RF loads into optimal position without overpronating!! –you may need to read the loading assessment again.

    But no method for measuring STJ neutral position has been proven accurate and reproducible by different testers.--

    What? A Newtonian based orthotic and you can't get be accurate? And can't be duplicated by others?--sounds like an Unscientific technology—not good, because it's not accurate.

    So, if we want to shoot for maximal joint congruence at the subtalar joint, your insoles need to be holding the foot in a position of 10 degrees of abduction, 20 degrees of dorsiflexion and 10 degrees of eversion. Do they? BTW 10 degrees eversion was maximal pronation according to Root.

    You “hold” the foot in position Simon? That's intersting, it's a “dynamic” function and position is at the POM.--You're obsession with RF control has made you lose sight of what is a better idea.

    Why do you think placing the mat between the ground and the orthotic would tell you anything about what the orthtoic is doing to the foot?

    Newton's 3rd law--

    Why wouldn't you place the sensor between the orthotic and the foot to figure out what the orthotic is doing to the foot?--

    the sensors register GRF and accompanying data, one can use the pressure plate system or the individual sensors. They both give the same info.--an inshoe measurement is the same, biomechanically. The shoe has little to no orthotic influence.

    Dennis, I've used a silcon device. It was OK for walking straight ahead. It was bodering on dangerous for side to side sports. So, I am looking for works best most of the time.

    We've gone over this before-for side to side sports, use a different orthotic. You wouldn’t use a cleated shoe on concrete, would you?--orthotics are not all universal—they can act as a specific piece of equipment.

    Using the EMED you can see how a barefoot foot is loaded and unloaded through stance phase.

    That's not a description, that's a statement—what about the EMED results of the same foot with your orthotic? why don't you post an example and we'll discuss it.

    Knowing why something is better, or not, is not a waste of time.
    For a scientist trying to think like an engineer—it's a total waste of time.
     
  37. See Non-newtonian fluids in a google search.
    When you say I'm "so tricky", I presume you mean that I am not fooled by you, Dennis. It's not tricky, it's very simple: we have numerous stuides that have measured 3D Kinematics, Kinetics, EMG etc, with what you call "traditional orthoses" in-situ. Every aspect of such "traditional orthoses" can be quantified. Viz. your contention that traditional foot orthoses prescriptions are un-quantifiable, is frankly crap.
    So, what was that optimal position again? You don't get it do you? Optimal positions are subject, environment and time specific. So what is the single optinmal position you are shooting for? Maximal congruence? Which as I've pointed out, at the subtalar joint is likely to be maximally pronated. You don't get it do you?

     
  38. efuller

    efuller MVP

    Dennis, you really have not been paying attention to what Simon and I have been saying. Neither of us believe that an orthotic made from a foot casted in neutral position will hold the foot in neutral position.

    I do wish you explain. I don't believe that you can explain the answers to the questions that we have been asking. See below.


    Newton's 3rd law: For every action there is an equal and opposite reaction. So, tell us how Newton's 3rd law would answer the above question. Hint, it won't.

    You are just wrong here. What justification do you have for that statement.

    A plate under the orthotic does not give the same info as a sensor placed on top of the orthotic. An orthotic that applies force to the foot in the arch will show force with a sensor placed on top of the orthotic. When you look at a force mat you will see the force applied to sensor by the orthotic at the anterior and posterior contact points of the orthotic.



    That comment was in response to your comment about how we should use an orthotic device that will be effective for more of the time that it is used.


    I can see why you are campaigning for ignorance. The ignorant will buy your device. The educated that can see through your sales pitch won't.
    Another example of where you promise to explain something that you can't explain. More bluffing and calling the people who see through you stupid.

    Eric
     
  39. Eric and Simon:

    Even though I commend your continued discussion with Dennis Kiper, the silicone insole salesman, you have to wonder if this is what you are actually doing....he simply won't be convinced because he is only interested in selling more silicone insoles...not learning more biomechanics...
     
  40. Dennis Kiper

    Dennis Kiper Well-Known Member

    Simon-Eric


    Dennis once again you are avoiding the moot point: as I pointed out, research suggests that maximal congruency between the articular surfaces of the subtalar joint occur at maximal pronation...

    What research? I'd like to see that article.

    stability is not desirable in dynamically moving system-

    You mean in every moving system on earth? Wow.


    when joints don't move because they are by definition "stable" we wind up with problems- see hallux rigidus for example.

    I don't understand what you're saying? I'm talking biomechanical stability and balance. When the POM are in their optimal position---stability and biomechanical efficiency is the result.


    Matthew Thomas is a relatively inexperienced podiatrist with no publications nor research background, tell me why we should take the view of this individual as being of significance? Because he seems to support you?


    Are you saying that Mat is unqualified to look at the science?

    Is he in your opinion, not smart enough to assess a functional biomechanical orthotic, because he's unpublished?

    Simon, is that what you're saying? You're accusing him of being unable to say something of significance? You say he's looking at this to support me? he may be looking to support the technology? Frankly you'd have to ask him.


    too many assumptions here, Dennis a) You assume that "neutral" is the position of least stress, I used to concur with this, I don't believe this now- I can explain if you wish. b) You somehow believe that the orthotic will place the STJ in neutral c) you are neglecting dynamic function.


    a--Yes, I believe optimal position through stance phase and neutral are the position and dynamic positions of least BTS.

    b—YES , you got that statement correct—the orthotic will decelerate and pronate the STJ into neutral (at MS) —the first fluid/biomechanical loading of stance phase

    c—what dynamic function am I neglecting?


    Never had a problem with incorporating fluids into foot orthoses -"not in it's current iteration"

    What format?

    . I don't need to ask a physicist, I'm asking you you are the one with the knowledge about your product, surely?

    I don't have all the answers a physicist would, so when I tell you it's time to ask the physicist, go talk to a physicist. He'll more fully explain what you refuse to get about the technology, and then if you want to buy the product that can help you achieve the bio-mechanical/fluid technology, I'll give you the # to call.


    "traditional" foot orthoses can and has been quantified in terms of 3D kinematics, kinetics and EMG activity, patient outcomes, patient satisfaction and perhaps most importantly to this discussion in terms of biomechanical efficiency, etc etc. How else would you quantify their effects? We can quantify foot orthoses in terms of prescription variables. We can even quantify the surface geometry, the stiffness characteristics and the frictional characteristics at the foot-orthosis interface-, I'm not sure what else you would have us measure to "quantify our Rx".

    You've got a lot of “quantification” going on up there, so how come clinical trials between your quantifiable technology and prefab and generic orthotics are on a level of around 50/50 efficacy????
    That's terrible results.

    Here is a difference in our technologies, because the sdo has 4 areas of biomechanical loading, the entire foot first moves into a stable structure at midstance and holds that “equilibrium state of stability for a moment longer through propulsive stage.--w/ Newtonian mechanics—the foot moves into, what? one area of load and stability, (why don't you describe how your technology places the STJ?? in its dynamic evolution )

    your Rxs are not clinically accurate enough, and casts are not even reproduceable amongs your colleagues???? Results in efficacy and this is your quantification Rx? Something is wrong—better relook it.

    since mechanically foot orthoses can only ever alter these three primary factors to exert a direct mechanical effect--

    Perhaps you'd like to say those 3 factors?
     
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