Hi all, Jeff writes:
>In my opinion, there seems to be a huge gap between the more complex
>models and the practical, functional models that clinicians require in
>order to make basic treatment decisions. You may (probably do) see things
>differently, but I think that's due to your perspective and comfort with
>the subject. My question is, how do you put it in a format that the
>typical clinician can use on a regular basis for making daily treatment
>decisions in an efficient and effective manner? What, in your opinion,
>should clinicians be doing differently than they are today?
Tissue stress is a model, Measurements of forefoot to rearfoot relationship
are a model and Sagittal plane facilitation is a model. Sometimes I have
difficulty in describing exactly what the model is, but they are all
models. The tissue stress model I find to be the simplest model to
understand and use clinically. For example, lets take that patient with
sinus tarsi pain and make an orthotic for them. In the forefoot deformity
model, if the pain does not resolve, you decide that you have made a
mistake somewhere along the line in the making of the orthosis. So, you
try again. In the tissue stress model you think, I did not add enough
supination moment, so in my next orthosis I will add more supination
moment. The tissue stress approach gives the clinician direction in how to
modify devices. I don't really know how to apply this analogy to the
sagittal plane facilitation model.
The finite element analysis comes into play when you want to prove the
model. We all use models without proof that they represent reality. You
can live pretty happily without proof that you model represents reality.
The earth is flat.
Cheers,
Eric Fuller
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