Hi Philip,
I have been (and continuing) to traveling for the next week. If you have any specific questions regarding your protocol (set-up for data analysis) let me know.
Regarding your question:
I am hoping to show a differnce between the pressures seen in the foot in
relation to material contruction e.g. high density material at the
posterior/medial aspect of the orthoses to resist initial foot contact GRF
at the heel.
Is this then relevant to further orthoses presription? I am hoping to
prove that it is.
It does become relevant if the desired treatment outcome is for example, reduce time the heel (left only, right only, or both) is in contact (speed up heel or rearfoot lift), or increase time heel is in contact (slow down heel lift). In other words, trying to synchronize contact time between the left and the right heel (rearfoot) during contact phase (also referred to heel pivot). The opposite also holds true, the desired treatment outcome can be to have one heel spend less/more time in contact. It all depends on what the desired outcome (prescription) is to be.
Two items to take into consideration which both will affect pressure, force curve and CoF.
1) density of material, and/or
2) thickness of material.
To reduce torque (rotational/translational force) at the knee, and especially at the hip, ideally it is mechanically more efficient (and less damaging over time (5-10-20-40 years down the road) to have similar integrals (force-time relationship) during heel contact (heel pivot) between the left foot and right foot. Additionally, it is also mechanically more efficient if the integral during mid-stance (ankle pivot) are similar between left and right feet. The same applies during push-off (forefoot pivot).
Force-time is controllable for the foot with material density and thickness at heel, at mid-foot and at forefoot compartments.
Material density and thickness at heel also affect ROM the calcaneous will travel (rotate, translate) about the subtalar axis. Material density and thickness also affect ROM the subtalar axis will displace. The subtalar axis is not fixed, but instantaneous, and the amount of pro-supination about the rearfoot can affect its displacement, and the respective motion of the calcaneous about the axis. This affects the torque being generated about the knee and hip. The same applies for the mid-foot and forefoot, with both also affect the torque generated about the knee and hip.
In addition, force-time is dependant on how compliant the compartments (rearfoot, mid-foot, forefoot) of the feet are to the affect of material density and thickness.
In research, you can set the hypothesis you wish. Your data analysis (and results) needs to be such that it will either accept or reject your hypothesis. A hypothesis is based on an assumption (with viable justification) that one wants/wishes to answer, verify, confirm/deny.
Not to discredit orthotic intervention/treatment (foot problems and gait related disorders), research on orthotic intervention (effects of) based on a viable hypothesis will advance the body of knowledge. Speaking of cause and experience, orthotic intervention has allowed me to become pain free at ankle, forefoot (5th met-head) and low back. Prior to intervention, I was a basket-case, so to speak.
I need to get ready to travel. I will send you a subsequent e-mail regarding your subject groups and intervention. I have ready too many research papers on orthotics where the intervention was not applicable and or inappropriate for the subject(s), and therefore outcomes were masked, resulting in no effect or unfavorable to prescription orthotics.
Bart, Bob
Have not forgotten you both regarding CoM.
Cheers,
Norman
-----Original Message-----
From: A group for the academic discussion of current issues in podiatry
[mailto:[log in to unmask]]On Behalf Of Philip Wells
Sent: Monday, March 15, 2004 8:34 AM
To: [log in to unmask]
Subject: Re: F-Scan protocols
Thanks for the info eveyone.
The one comment I have to Bart is when doing research such as this, does
the orthoses have to be necessarily applicable to a client group.
I am hoping to show a differnce between the pressures seen in the foot in
relation to material contruction e.g. high density material at the
posterior/medial aspect of the orthoses to resist initial foot contact GRF
at the heel.
Is this then relevant to further orthoses presription? I am hoping to
prove that it is.
Thanks
Phil
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