Jeff,

> Jeff replies: Simon, orthoses cause a change in the shoe to foot
interface.
> The individual contour and physical properties of an orthotic device
> determine the resulting influence created by the presence of the device in
> the shoe.

Agreed.

> It is not possible or necessary for an orthosis to create an
> identical redistribution of forces with each and every step.

Agreed (this was the point I was making).

>But it is
> possible and desirable for an orthosis to change the average distribution
of
> forces over a series steps over a period of time.

Agreed.

>The average change in the
> forces acting on the foot over a period of time is a consistent influence
> that results directly from wearing the orthosis. This is the salient point
> I was attempting to make.

What do you mean by "consistent". From the Shorter Oxford Dictionary we get
Consistent: "constantly adhering to the same action"? Given that you've just
stated that, "it is not possible for an orthosis to create an identical
redistribution of forces with each and every step" if we measured the mean
and 95%CI's for a given variable over the first 100 footsteps of a walk down
the street, would the mean and its 95% CI's of that variable for the next
100 footsteps be the same?


Some cut:
> You wrote:> Orthoses work, but I think I'm on fairly safe ground when I
say
> that we do not have enough evidence YET to conclude that Orthotics have a
> consistent or
> predictable effect on a given individual in a given environment and that
> wearing orthoses result in zero step-to-step variability in the
individuals
> kinetics and kinematics.
>
> Jeff replies: I'm not aware of anyone ever stating that orthoses should
> result in zero step-to-step variability.  Where did this idea come from?

The word "consistent".

Best wishes,
Simon

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