Occam's Razon or the Law of Parsimony

So the answer you were looking for Brian is: “no, there have not been any randomised controlled trials of my foot orthoses”

 

No randomized controlled trial of your orthotic device then ?

When dealing with something as complex as pain I feel you really need to have a double- blind, randomized, controlled trial to get an idea if the intervention works at the physical level . Double blinded trials can be impractical in some circumstances . Single blinded seems reasonable to shoot for when testing orthotics but the very minimum would be a randomized, controlled trial .

 

How about Subjective Outcomes? How do they fit into your way of thinking?

 

If you are trying to find out if an particular orthotic device reduces pain ( a subject measure ) in a particular patient group, then a randomized controlled trial ,preferably with the control using a sham, is the min required.

I think that testing whether your device does what you say it does would be relatively easy to prove /disprove since you seem to be saying that it eliminates chronic pain . Completely eliminating chronic musculoskelatal pain would be easy to demonstrate . No visual scales required , just pain then no pain at all .

 

IMO, clinically, long term subjective outcomes is the Gold Standard. If the therapy fails to meet the expectations established prior to the commencement of therapy, it is a failure. And it doesn’t matter what any double blind randomized control study might say about that intervention.

 

Could you provide a link to a paper of any kind which demonstrates that your foot orthotics eliminate pain ? Pain today, gone tomorrow in 8 out of ten patients, that sort of thing.

With Hartz and Biancalana, they found 123 patients presenting with pain also had what they called Rothbart's foot structure. These pts where then treated with " the insoles I (BR) developed "
Was pain eliminated in all patients ? Surely there was some kind of follow up ? Aren't you curious to know what happened with these patients ?

 

Nearly 30 years ago, I published 2 papers which used one year follow ups to evaluate the effectiveness of therapy:

• Rothbart BA, Liley P, Hansen, el al 1995. Resolving Chronic Low Back Pain. The Foot Connection. The Pain Practitioner(formerly American Journal of Pain Management) 5(3): 84-89

• Rothbart BA, Yerratt M. 1994. An Innovative Mechanical Approach to Treating Chronic Knee Pain: A BioImplosition Model. The Pain Practitioner (formerly American Journal of Pain Management) 4(3): 13-18.

I have had several conversations with Hartz and many with with Biancalana. Their experiences using the generic proprioceptive insoles sold by a company in Tacoma is exactly as they have written. Used in the appropriate patient, with the appropriate proprioceptive signal, the therapy is very effective in attenuating or eliminating chronic muscle and joint pain.

 

Attenuating .

 

Hi Simon,

How times have changed since you made the above comment. Here we are, two years later. Multiple publications in the European Orthopaedic community have confirmed this link between talar torsion, ILA collapse and forefoot position.

Have a good day.

 

Hi Simon,

It appears that day is getting closer.