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The MOSI type foot orthoses

Discussion in 'Biomechanics, Sports and Foot orthoses' started by simon collins, Apr 4, 2008.

  1. simon collins

    simon collins Welcome New Poster

    Last edited by a moderator: Nov 26, 2020
  2. DaVinci

    DaVinci Well-Known Member

    Re: MOSI

    Never heard of it. Can you post some info from the article as Podiatry Now is a UK publication that is not online for anyone to access.
  3. Craig Payne

    Craig Payne Moderator

    Re: MOSI

    It has similar design features to the DC Wedge. Its all about getting a greater force on the medial side of the STJ axis in those that need a greater force.
  4. Weren't you one of the author's? Certainly Paul Harradine who you share a practice with was. Perhaps you or he could attach a PDF.

    As I recall from reading the article the rationale is somewhat flawed in that it makes the assumption that STJ axis does not move position during gait and/ or in response to the orthosis itself. Also seem to remember thinking that it doesn't take into account the direction of the Centre of Force vector and assumes the vector is normal to medial heel skive of the orthosis.

    Could be wrong as I only briefly scanned it when it dropped on my mat.
  5. admin

    admin Administrator Staff Member

    That would be awesome and appreciated by the community.
  6. Admin2

    Admin2 Administrator Staff Member

  7. Simon C:

    I just read your article: Harradine J, Collins S, Webb C, Bevan L: A new method of increasing supinatory moments to a medially deviated subtalar joint axis - the medial oblique shell inclination. PodiatryNow, pp. 16-22, March 2008.

    Even though I cannot agree with all of the points made in the article, I believe that you, Paul, Chris and Lawrence should all to commended for publishing a well-written paper that introduces a potentially valuable orthosis modification to all of us for use on our patients.

    Here are a few points to consider:

    In figure 4, it is not true that the medial heel skive will act on a straight line down the long axis of the orthosis plate. The mechanical effects of the medial heel skive on the subtalar joint (STJ), like all orthosis modifications, are best appreciated by calculating the change in orthosis reaction force (ORF) at each locus on the dorsal orthosis surface that occurs with that specific orthosis modification relative to the spatial location of that locus relative to the STJ axis. In other words, it is not the shape of the medial heel skive within the transverse plane that is so important, it is more the net change in ORF and its position relative to the STJ axis that is important in determining the kinetic effects of a varus heel wedge orthosis modification.

    The frictional effects between the foot and orthosis during gait are likely also important with each of these inverted heel modifications such as the Blake Inverted orthosis, medial heel skive, DC Inverted and MOSI modification. I believe it will be difficult to judge which is the better modification until we can compare the kinetics of one modification against another using inverse dynamics. I have better appreciated these frictional effects of the medial heel skive since writing my medial heel skive paper over 16 years ago.

    In figures 8 & 9, it appears there is no posterior-lateral heel cup with the MOSI modification. Is this the case??

    In figure 10, the line drawn for the STJ axis is much too lateral for that foot. The STJ axis should be probably 10 degrees more medially angulated and about 2.0 cm more medially located relative to the anterior neck of the talus. The left foot of figure 11 appears to accurately reflect the STJ axis position within the transverse plane.

    Anyway, Simon, good job on the paper and hope that it can be published here on Podiatry Arena for everyone to be able to read it.
  8. CraigT

    CraigT Well-Known Member


    I thought perhaps there might be a copy online- as Kevin managed to eyeball the article- so I googled it and found this....

    I feel like there has been a party going on that no one told me about- the UK have their own little forum....there are a couple of pics and good discussion!

    If I understand correctly, Davis Smith has the same concerns as Simon's...
    Perhaps Dave can add his 2c worth here...

    For what it is worth, I always feel I get the best kinetic effect when we also are applying a force which would act against calcaneal declination. I think this is one of the hidden effects of a Blake inverted device. As you are adding inversion, you are also inclining the cast quite significantly, and therfore having this effect. I know of a couple of labs in Australia who orientate the medial heel skive in a similar manner. This seems to be quite different to this modification.
    From what I can tell, the MOSI (what the hell does that stand for??) does not do this at all- but perhaps that is just the example that is shown.
    This is not to say it cannot help though.

    It does indeed look similar to the DC wedge and also does not appear to have a heel cup- I am not a fan of this aspect of the DC wedge.
    The rational for not having the cup on the DC wedge is similar to one I heard on my favourite UK comedy series- 'People Like Us'...
    'Zenotec are restructuring their in-house transport system by not having one'
    could read... 'We are addressing the problems people are having with heel cup irrition by not having one'

    Sorry- rambling on here... it is Sunday morning which is like Monday morning for the non Middle Eastern world :morning:
  9. Sorry Craig. You WOULD have been invited if you lived in the land of drizzle and decent beer.:boohoo:;)

    Its only a little forum, it ain't pod arena and never will be, but it IS homey.

    As you say we've been chewing over the Mosi for a while. Interesting stuff...

  10. Sorry, i'm late in on this so I'm just going to jump in!

    I've contacted the editor from 'Podiatry Now' to check this would be ok. If not, she has told me previously i can send PDF individually as long as i mention copyright. If anyone would like this, please message me with an address i can send it to.

    Medial Oblique Shell Inclination. The orthoses pictured don't have a lateral heel cup. However, this is not what the MOSI is about. It's simply taking the medial heel shell incline and angling it to 'theoretically' increase the applied moments. You can add a lateral heel cup to that if you want, or forefoot posting, first ray dells etc etc. It's not an appliance 'on its own', so to speak.

    We've started a relatively basic study (initially at present for repeatability data) using Craig Paynes rearfoot motion JAPMA paper as a methodology guidline. Because of the materials we use we've been able to change the rearfoot modification on a pair of orthoses 3 times in runners with a clinically diagnosed medial STJ axis. The mods were no shell incline but 4 degree rearfoot post, a medial heel skive with 4 degree rearfoot post, and a MOSI with a 4 degree rearfoot post. From the results we have (on 8 feet only, so i'm not pretending this is statistically significant in any way) the pronation angle has shown a trend to decrease each time. The decrease between the skive and MOSI was small, but between the post alone and the skive or MOSI it was much larger. Hopefully we should have this completed by the end of the year. We are also hoping to do a comparative outcome study using patients with post-tib dysfunction, but this is still at the planning stage.

    Thank you Kevin.

    Hopefully i'll get the paper up soon.


    Paul Harradine
  11. Craig Payne

    Craig Payne Moderator

    Paul - it would be great if you can get permission to attach a pdf. It would be good for the world to see.
  12. Hi

    The editor has just got back to me and said as long as i also supply the original ref and state copyright then i can attach it here as a pdf.

    So, the original ref is:

    Harradine P, Collins S, Webb C, Bevan L. A new method of increasing supinatory moments to a medially deviated subtalar joint axis - The Medial Oblique Shell Inclination. Podiatry Now. Vol 11, No. 3. 2008.

    I'm just in the process of working out how to attach it, so hopefully it will be available today.


    Paul Harradine
  13. jb

    jb Active Member

    Thanks for the extra legwork Paul

    We await in earnest...
  14. admin

    admin Administrator Staff Member

    Paul, after you hit the reply button, scroll down and you will be the 'manage attachments' button.
  15. Hi

    Please find the MOSI paper (hopefully!) attached.


    Paul Harradine

    Attached Files:

  16. admin

    admin Administrator Staff Member

    Awesome ... thanks!; now others can comment.
  17. admin

    admin Administrator Staff Member

    Here is one way of applying it:

    3D 2D Foot Scan Subtalar Joint STJ Axis MOSI CAM Orthotics

    Last edited: Sep 22, 2016
  18. nicpod1

    nicpod1 Active Member

    This orthoses modification has just been brought to my attention again and so I've had a check back to the original article and a look on here to see what people thought, but, after the Youtube clip posting, no-one has yet got back with their opinion, so, if possible, could anyone let me know what they think?

    Has anyone used the skive?

    Any info would be great!

  19. Craig Payne

    Craig Payne Moderator

    I like it! It is just another alternative option to use when more force is needed medial to the putative subtalar joint axis.
  20. joejared

    joejared Active Member

    Thanks. There wasn't too much perspective in the images and given the arch height it would have been difficult to tell if it was a left or right orthosis without the STJ line. If I'm reading it right, there's an exponential warp to vertical medially in the heel perpendicular to the STJ. with an unknown starting point laterally, but that too is easy enough to emulate should there be a call for it. Thanks for saving me the trouble of googling in ellipsoids for it.
  21. whols

    whols Member

    THe orthotics look interesting. If anyone could help me on determining the STJ Axis by palpation. I have read the Kirby article about equilibrium theory and the physical way that the axis can be determined. Is the patient prone or supine? and how easy is it to actually feel the axis when pushing on the calcaneus (do you push perpendicular to the). Any tips on improving this would be great, as I have some patient thta may benefit from the MOSi device.

    Cheers Aaron
  22. joejared

    joejared Active Member

    On the surface, seems not too different than a blake inverted device, except that the blend (diminishing into the original surface) begins closer to the proximal edge of the heel instead of the distal edge. From a software perspective, if a system can make a blake inverted device, it should also be capable of making a MOSI device. While I really am not one to speak of its usefulness, it's given me an idea. :drinks
  23. NewsBot

    NewsBot The Admin that posts the news.

    The Medial Oblique Shell Inclination Technique
    A Method to Increase Subtalar Supination Moments in Foot Orthoses

    Paul Harradine, Simon Collins, Chris Webb and Lawrence Bevan
    JAPMA November/December 2011 vol. 101 no. 6 523-530

  24. Hi, I just came along this post. Is the offer still standing to receive a copy of the article? I would like a copy please, if you still have it.

    Kind regards.

    Pierre Oosthuizen, podiatrist and lab.
  25. It's attached at post no. 15 above. Click on the .pdf attachment.
  26. brackenpluckrose

    brackenpluckrose Welcome New Poster

    I am relatively new to the field and am trying to increase my knowledge base. Has any more work been completed since the original 2008 study on MOSI posting? Or are any studies currently being undertaken?

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