Dear All,

Can I start by thanking everybody who expressed concern during my recent
illness. I would also like thank everybody who sent me cards etc. Because
of my problem I was hospitalised for 2 weeks and was not in a position to
respond to any posting on this site at that time. I have now read most of
the postings and clearly cannot respond to them all for they are all so
varied in nature.

While I understand that people will usually defend whatever method they are
using to diagnose or prescribe orthoses, I think it is important that we do
have an objective view of what we do with regard to accuracy and
reproducibility. Several postings tend to indicate that couch assessment
with measurement of passive movement and slipper casting is a reproducible
method of assessment. I am somewhat surprised for my experience is quite
the opposite. In fact, I would be most surprised if 10 practitioners, for a
given patient, had the same diagnosis, measurements or prescription values.
I am also aware that many top Podiatrists and laboratories also hold this
view. Additionally, I have casts in my possession that beggar belief when
compared to the prescription values. If any of the authors have a method of
ensuring that this approach is consistent with accuracy, I would certainly
like to hear from them .

Treatment success is also subjective and we have no scale on which to
measure. I do not doubt that limiting unwanted compensatory movement will
improve the situation but is this success? Similar to the garden gate
syndrome, unless the gate post is perpendicular we only have an improvement
rather than a repair. Does anybody have a scale for measuring success or
failure of devices?

The F-scan is mentioned quite often in the postings and I agree that this
is a useful measuring tool should the practitioner wish to know the
vertical component of force during loading. Similar to other tools it must
be evaluated for what it does and probably more importantly what it does
not do. Having recently undergone around 15 tests during my hospital stay,
I can assure you that if one piece of equipment could do all then I would
have preferred that. By using all of the equipment available to my
Consultant, he was able to establish the problem and from other tests rule
out certain factors. Why should Podiatry be any different?

Verification of any system can only be done if an accurate and reproducible
measurement system is already in place and can be referred to. I do not
accept that traditional technology fulfils this role but the Orthoscanner
in my opinion does.

-----------------------------------------------------------------
This message was distributed by the Podiatry JISCmail list server

All opinions and assertions contained in this message are those of
the original author. The listowner(s) and the JISCmail service take
no responsibility for the content.

to leave the Podiatry email list send a message containing the text
leave podiatry
to [log in to unmask]

Please visit http://www.jiscmail.ac.uk for any further information
-----------------------------------------------------------------