Dear Kevin and other enthusiasts,
Kevin, judging from your frantic activity on the mailbase, the Spanish air
and diet did some miracles. What was the place and the main dish on the
menu you and Pam were enjoying the last two weeks ? Or was it a secret
gray cell stimulating tapas that did the trick. Unfortunately, I guess this
topic is for a different mailbase
As for you reply on this mailbase, I agree with you when one is working
in a research oriented environment. But my point is that in a clinical
situation and in discussions with fellow podiatrists, it is necessary to
have easily understandable and conveyable concepts and terms. The
non-linear nature of stiffness does not fit this picture because it cannot
be represented by a single figure but requires a more elaborate
representation with curves and diagrams ( as engineers and physicists do)
and because it needs sophisticated measurement tools.
But that is maybe the direction podiatry and other medical professions have
to evolve in the near future: using more elaborate measurement equipment
and a more technical oriented language enabling more accurate and
quantitative exchange of information.
Or do we have to adhere to the KISS principle, where with a minimal of
technology a maximum of clinically meaningful information can be
encapsulated in an intelligible and easy format that can be understood by
most well educated clinicians, In this sense the FootPostureIndex system
from Anthony Redmond was a good example
So choices will have to be made. I thinks it would be worthwhile to chew on
the the pro`s and the con`s of both approaches mentioned. Or is there any
way of combining both strategies ?
I think we have another interesting mailbase topic emerging here.
> Bart and Colleagues: Bart wrote: <<I think that the basic problem
>is not so much a semantic one, but a methodological one. In science a
>term is only useful when, besides exactly expressing a certain quality,
>it can also be quantified reliably.
> We all know that first ray mobility (according to Root) has a low
>measurement reliability. Scientifically (not necessary clinically, Jeff)
>this makes it a poor variable, not because of its meaning but because of
>its low measurement precision. As for stiffness or compliance, I am afraid
>it may be even more difficult to precisely quantify it. Comparing to
>motion, forces and pressures, and thus also stiffness and similar
>variables, may be harder to measure because they require more
>sophisticated and elaborate equipment, as force dynamometers, force
>plates etc. A further complication is also that the force is not a
>linear function of displacement and, therefore, stiffness of a joint
>icannot be expressed as a constant and will itself depend on the
>magnitude of the force applied. In general stiffness will be rather low
>for small joint displacements and will increase sharply when approaching
>the limit of the joint range of motion. So expressing joint stiffness in
>an simple and accurate way will not be an easy task.
> So, the addition of the concept of joint stiffness is a very useful one
>to characterize the functional quality of a joint. But as far as
>quantifying it, I am afraid Kevin, you are opening a box of Pandora. But
>the latter is not so much the podiatrist's concern, that is why we have
>researchers for, isn't it ?>> These are good points, Bart. However, I
>don't see why the experimental measurement of metatarsal ray stiffness or
>compliance will be difficult especially considering the current
>availability of three dimensional motion analysis systems and force
>plates or pressure mats. In addition, it is well known that
>viscoelastic materials of the body are not linearly elastic and therefore
>the stress-strain curve will have different stiffnesses depending on the
>force applied or displacement achieved. This is, however, one of the
>most beautiful and potentially most rewarding aspects of considering
>stiffness of a metatarsal ray....it will allow us to step ever closer to
>the true biomechanics of the foot, and not constantly be treading in the
>muddy waters of crude clinical approximations of the biomechanics of the
>foot. As far as Pandora's box, I am familiar with its contents.
>However, Bart, I'm certain that you, for one, can not be against a
>podiatrist expressing a desire for his profession to use terminology that
>is precisely defined and quantifiable and that may possibly lead to a
>more clear and deeper understanding of foot biomechanics. I would think
>that this would make your job even easier as a biomechanics researcher.
>;-) Cheers, Kevin
>**************************************************************************** >Ke
>vin A. Kirby, DPM
>Adjunct Associate Professor
>Department of Applied Biomechanics
>California School of Podiatric Medicine at Samuel Merritt College
>Private Practice:
>107 Scripps Drive, Suite 200
>Sacramento, CA 95825 USA Voice: (916) 925-8111 Fax: (916) 925-8136
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Bart Van Gheluwe
Laboratory of Biomechanics
Vrije Universiteit Brussel -Fac. LK
Vakgroep BIOM
Pleinlaan 2, 1050 Brussel, Belgium
Tel.: 02/629.27.33 (31)
Fax: 02/629.27.36
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