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Study Finds Kirby's Subtalar Joint Axis Measurement "Not Reliable or Clinically Useful"

Discussion in 'Biomechanics, Sports and Foot orthoses' started by drsha, Apr 3, 2012.

  1. Kenva

    Kenva Active Member

    I think that sums it up, thank you very much...
    anybody fancy a beer???? :drinks
     
  2. Kenva

    Kenva Active Member

    PJ
    My main man! - happy you're back (hopefully in 1 piece?)
    CU next week :drinks
     
  3. Usually. :drinks
     
  4. blinda

    blinda MVP

    Yep, I`ve often fancied a pint whilst reading some recent threads on the Arena....but not this one Ken. Great research :drinks
     
  5. Jorisds

    Jorisds Member

    Yup, I'm back !!
    And ..... in one piece !!!!!

    CU next week.
     
  6. Kenva

    Kenva Active Member

    But only a tiny amount :D:D
     
  7. drsha

    drsha Banned

    Kenva:
    As your passion reflects a sense of honesty rather than a sense that you are trying to deceive us and owing to the fact that you have given me the same fraternal courtesy, I accept your conference reference as factual until proven otherwise.

    So be it.

    Kenva:
    I was fine until Simon interjected:
    "When several raters try to assign a qualitative label of axial position: medial, normal, or lateral, then the inter-observer reliability is poor as indicated by the low Kappa values".

    I don't see any double negatives in the statement and previously on The Arena, I admitted that I didn't fully understand Kappa Value so does this statement say "the inter-observer reliability is poor"?

    Dennis
     
  8. No. It says

     
  9. The work by Dr. Kirby is so useful to clinically diagnosing structural imbalances in the foot and ankle that cause deviations through the rest of the musculoskeletal system. The inability to accurately palpate and diagnose is always subject to examiner and patient variability. There are a lot of flaws in that study, and I find that there is many times a process of healing that will follow a flow based on the kinetic chain of an individual. To totally dismiss a useful system of classification to help promote a balanced structure is stupid. The porblem with the study is that the examiners probably have not used the sstem long enoudh to find it usefu
     
  10. drsha

    drsha Banned

    I understand your point thsat you believe in Dr Kirby;s work and its merit but there are those who have chosen other paths.
    So why don't those very same rules hold for the work of others like Dr Root.

    "One of the reasons why many podiatrists have moved away from the SJN Theory is due to some of the inherent problems and inconsistencies with this theory of mechanical foot therapy. One large problem with the SJN Theory relates to the reliability of the measurement procedures used within the standard biomechanical examination techniques proposed by Root.

    These examination techniques have been found to have only fair to poor intertester reliability and, therefore, can not be considered reliable from one examiner to another."

    Is this much different than the intertester reliability and the flaws you mention in Kenya's paper.

    and

    dare I say it, in mine or Dananberg's or MASS or ???.




    Please let's end this here as I'm gooing to post my own threads and try not to disagree or give different insight or question the appropriateness of any other threads for awhile.

    Dennis

    PS: I don't know if that's Kappa or not.
     
  11. No. Try Kafka instead - without the conspiracy. This is becoming embarrassingly painful to read.
     
  12. efuller

    efuller MVP

    The measurement error is just one problem with STJ neutral. Another problem is the idea of capturing the forefoot to rearfoot relationship in neutral position of the STJ and then treating the foot in the position in which the STJ stands. This position is the vast majority of the time withing 2 degrees of the end of range of motion in the direction of pronation. (unpublished data of mine) So, there is some inconsistancy within the theory of supporting the deformity and the actual treatment. However, there is at least a theory that connects the treatment and the measurement.




    Yes it is different.

    The other data that was reported found that finding the location of the axis was repeatable and the unpublished data found that it was accurate. The inter rater error was found in describing whether the position that was found was to one side of the average or the other. Obviously, if they can find the axis accurately, a little more experience would allow them to estimate whether the location was on one side of the average or the other. The testers, problably just didn't yet have a good sense of what was average.

    Eric
     
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