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Silicone Dynamic Orthotics

Discussion in 'Biomechanics, Sports and Foot orthoses' started by David Wedemeyer, May 7, 2008.

  1. Dr. DSW

    Dr. DSW Active Member

    Kevin,

    Thanks again for your comments, and yes I do have a not so secret identity.


    David S. Wander, DPM, FACFAS
    Advanced Foot & Ankle Center
    6911 Castor Avenue
    Philadelphia, PA 19149
    215-725-1092 fax 215-725-1095
     
  2. David:

    It will be nice to have you contributing on Podiatry Arena. I understand from what you wrote earlier that your practice is more surgically/medically oriented. Your clinical experience in these matters would greatly add to the diversity on this forum. Steve Arbes, DPM, from Green Bay, Wisconsin, also has been able to contribute many helpful surgical and clinical pearls from his practice experience to Podiatry Arena. We look forward to your future contributions.:drinks
     
  3. David Wedemeyer

    David Wedemeyer Well-Known Member

    I asked Dr. Kiper a short while back to explain how his insole would effect positive results with a flexible, compensated forefoot valgus deformity. I would like to give him the opportunity to answer that question here alongside his colleagues and share with us his research that validates using silicone as a base material in an orthosis for this condition.

    I noticed that Kevin used a rigid valgus plane deformity to ask a similar question. Since on his website he maintains that his device can be used to mediate almost any pathology I would propose he now answer Kevin's question as to how his insoles would accomplish this.

    You cannot just cut and run now Dennis, the biomechanical world is all ears. I would have thought that this was the audience that you were searching for to promote your ideas and product?
     
  4. Dennis Kiper

    Dennis Kiper Well-Known Member

    It is interesting to me, that when I discussed the value of an F-scan being able to quantify biomechanical efficiency, you pooh poohed it. Yet here you are saying you’d like to get one.

    Which is it? Do you see the value of a state of the art technology that can measure biomechanical efficiency or not? The F-scan is being used by probably every if not most every serious biomechanical lab in the world. The mat-scan while not as accurate as the F-scan can also quickly quantify biomechanical efficiency.

    The Tekscan rep spent approximately 20 minutes pointing out the results of the pre and post orthotic test done with the silicone dynamic orthotic. We reviewed peak pressure, center of force trajectory, timing, and force distribution. He also pointed out Force vs. Time, Pressure vs. Time, area of contact, and impulse.

    The conclusion at the end was that there was a 30% improvement in mechanical efficiency on the RF and 20% efficiency on the L.

    The difference between the two orthotics was that there was a discrepancy of 5 Gms of fluid between the L&R (the R had more fluid) and the difference in improvement and efficiency was seen in the values for the measurements above.

    It is apparent to me, that the presentation of my ideas and how the fluid technology works is met not only with disbelief, but disdain as well. There is no reason for me to continue this dialogue where I’m beleaguered and belittled by closed minds.

    Yours and David Wanders report of your experience with the orthotics I made was based on wearing for a “very” short time without the benefit of consulting with me OR allowing me even one adjustment. Even though I qualified at the very beginning that assessing and adjusting was a part of making this orthotic fit correctly. In addition, part of that fitting process involved transitioning to wearing time, which was also ignored.

    Jeremy’s report whether it is factual I don’t know, it certainly is surprising that the patient would come see you and not return his orthotics for a refund. Even if it is true, so what if that case was a failure, it happens to all of us. Because Jeremy refuses to acknowledge who that patient is, there is no way of knowing wheteher I truly failed or the patient failed like Wedermeyer and Wander for failing to follow directions.

    The fact is, if anyone cared to set up a time for a demonstration and comparison to patients with established traditional orthotics, Tekscan results would clearly demonstrate the power and viability of the SDO over anything you have to offer with all your measurements, angles and personal evaluations.

    A true test over time like any research project could be arranged as well, here too, the results would surprise you.

    The fluid technology of the SDO is new although it has been around for 20 years. It doesn’t fit into your Rootian paradigms because you already after 50 years of traditional technology know all there is to know.

    PS—A flexible forefoot valgus would be an “excellent” candidate for this orthotic.
     
  5. Dr. DSW

    Dr. DSW Active Member

    As I've stated many times, it's really quite simple. Dr. Kiper is the only one that has figured this out and broken the code, and the rest of us simply "don't get it".

    In the interim, I've been providing my patients with traditional "old" technology orthoses for about 23 years, and my patients have been extremely happy and more importantly have experienced relief of their symptoms with this "old" technology that doesn't work. Go figure.......must be a statistical anomaly.
     

  6. Dennis:

    First of all, I know for a fact that the F-scan is not being used by every serious biomechanical lab in the world. I believe that the more expensive and more accurate EMED system is quite popular and the newer RSScan system is also used for biomechanics research.

    Since I know many of the Tekscan people, could you please tell me which measurement parameter from the F-Scan system the Tekscan representative used to determine that ther was a "30% improvement in mechanical efficiency on the RF and 20% efficiency on the L." I didn't know that an in-shoe pressure measuring system could measure walking speed and oxygen consumption which would be the necessary parameters to be able to measure "mechanical efficiency" of walking. How exactly did he then determine "mechanical efficiency" by only measuring the magnitudes, temporal patterns and distribution of plantar pressures?

    By the way, Dennis, I loved all the claims you make on your webpage where you sell your Silicone Dynamic Orthosis (SDO). I especially loved the banner on your webpage:

    The Silicone Dynamic Orthotic is the next generation prescription in arch support—

    the most accurate made today. Using silicone fluid, it cushions shock from your foot to your low back while absorbing the harmful effects of arch motion (overpronation).



    I also liked this nice touch:

    WHO BENEFITS FROM THE SILICONE DYNAMIC ORTHOTIC?
    --------------------------------------------------------------------------------

    Athletes - The SDO is so effective in enhancing performance and preventing injuries that both amateur and professional athletes use the device.

    Seniors - Because the SDO takes pressure off the joints, it reduces inflammation and minimizes the effects of degenerative joint arthritis, diabetic ulcers, calluses and other conditions.

    Children - As children grow, the feet can already show signs of being out of balance. Parents should be aware of these tell-tale signs of foot problems: Leg cramps, avoidance of sports, postural pain, or walking intolerance. By wearing the SDO at an early age, a lifetime of problems may be averted.

    All others - If you are beginning to experience foot pain, don't ignore it. The pain may go away temporarily, but later settle elsewhere in your body. The SDO will allow you to walk without symptoms indefinitely and may prevent surgery in the future.


    The testimonials are also very interesting. However, and no real surprise to me, is that you don't include any negative comments about the SDOs in your testimonials section of your website, only glowing positive ones. Since you claim to be scientific and you seem to come on this site wanting us to believe that you are an honest and ethical practitioner, then why don't you also include negative testimonials about your product so that people who visit your testimonials site can understand that SDOs aren't a cure-all as you suggest throughout your website?

    In fact, you could start with the negative testimonials from the three to four clinicians on this site who have already used your insole product and noted either instability or a lack of treatment response. I'll be checking in to your website every now and then to see if you are really an honest and ethical practitioner....or, what I expect to be more the case, just another podiatric snake-oil salesman that is using the internet to sell more of his insole products with unsubstantiated, unresearched marketing claims that are intended for only one purpose......to make your wallet fatter.:drinks
     
  7. Dr. DSW

    Dr. DSW Active Member

    It's very easy posting on this site, since the answers seem so simple. I particularly like the question of the day:

    WHO BENEFITS FROM THE SILICONE DYNAMIC ORTHOTIC?

    Answer: Dr. Dennis Kiper



    After reading the comments on his website and the amazing claims, I've decided to recommend his product to ALL my patients for ALL podiatric ailments. It makes practice much easier/less complicated.
     
  8. David Smith

    David Smith Well-Known Member

    Dennis Kiper Re: Silicone Dynamic Orthotics

    The multi cell matrix pressure mat or pressure insole measures discrete vertical applied force. IE that part of the total force which is applied perpendicular to the force cell. It also logs the temporal and spatial displacements of the applied force inter and intra cell.
    The software then analyses these parameters and presents it in a form that characterises the data in such a way that it is intuitively readable by the clinician.
    The way the clinician interprets this characterisation in terms of the subject studied is entirely down to themselves. This interpretation is in fact a theory, this theory can then be tested, either by deducing a conclusion by comparing to known data and/or by doing other experimental tests. The soft ware may have the capability to make some interpretation of data also but it definentely does not measure biomechanical efficiency of gait.

    What! 20 minutes -- without a teabreak, incredible. I never known research data evaluation take so long. You both must have been exhausted.

    Did you come to that conclusion after correlating the F Scan data with 3D motion analysis and force plate data like is being done by probably every if not most every serious biomechanical lab in the world.

    Are you saying that Correlation = causation? are you sure about that were there no other confounding variables to take into consideration?

    All you need to be taken seriously is a sensible argument with some valid theories and just a smidgen of evidence to back them up. Your theories are fanciful and your evidence non existent. Have you ever studied the theory and practice of the scientific method or of inductive or deductive reasoning and logic (sorry all, now I'm just showing off cause I read a new book :cool:)

    Oh yes time Hmm! acccording to your own web info resolution may take months or even years. During which time there may need to be several adjustment and usually two or three replacements of the orthoses because the foot "ABSORBS the ORTHOTIC". So is it filled with Oil of Ulay :dizzy: Does it reduce wrinkles and make the feet look 10 years younger OOH does it have Pentpeptides theyre hot in the beauty scene --- apparently:rolleyes:
    Hardly suprising that some with a modicom of common sense lose interest.


    Dr Kiper, would you like me to explain how your interpretation of the Tekscan results is just Bollocks or would you prefer not to look even more rediculous than you do now.

    A true test - Outline your research project - theory, premise, methodology. Or just a reasonabl;e explanation based on mechanical principles. (Do not just repeat -fluid dynamics - it move from the area of highest pressure to least pressure and greatest need) I really don't think you would know a well structured research project if it hit you in the face like a -- well a wet kipper :bash:

    All the best Dave
     
  9. Jeremy Long

    Jeremy Long Active Member

    "Jeremy’s report whether it is factual I don’t know, it certainly is surprising that the patient would come see you and not return his orthotics for a refund. Even if it is true, so what if that case was a failure, it happens to all of us. Because Jeremy refuses to acknowledge who that patient is, there is no way of knowing wheteher I truly failed or the patient failed like Wedermeyer and Wander for failing to follow directions."

    Dr. Kiper, are you somehow attempting to question my professional integrity? I can assure you and any other reader on this board that any comments I make in this regard are completely factual, based on personal evaluation and observation. It's more than a bit distressing that you would feel the need to question that, particularly since there are others here who are particularly aware of my history and clinical skill and professionalism.

    And speaking of professionalism, I would certainly never divulge a patient's name (or other personal details) on a forum such as this. You have had my personal contact info for quite some time, and thus have the means to seek those answers at your leisure. Just so you and other readers here know, this individual patient made every attempt at relief through your devices and instruction. It was only after several months of unresponsive treatment that this person sought my direct care. I feel very strongly that any comment reflecting that the patient failed you is absurd in this specific case.

    Just so you don't get fooled into believing this was an isolated case, I have directly treated four individuals who have all made failed attempts through the use of your SDO product. I chose to bring forth details in this most recent case because it dealt with a biomechanical profile which I view the SDO as lacking treatment efficacy. This is a view I both provided openly in forums such as this and to you personally. It is my sincere hope that you begin to recognize the deficiencies existing both in your patient evaluations and in the product itself, and have the ethics to tell certain patient populations that they may find superior care away from your devices.
     
  10. David Wedemeyer

    David Wedemeyer Well-Known Member

    Dennis you really need to face facts and reality here. The repeated threads both here, on the previous website and on your own where you denigrate the “old technology” and favor your (or was it Dr. Krinskys?) silicone insert are inaccurate and unfounded. You have zero research behind this product, zero clinical trials and zero peer-reviewed studies supporting your claims and you are rapidly losing your credibility amongst your peers making these assertions.

    To continue to deflect the biomechanical questions posed and instead engage us about our failure to follow your instructions is the same banal, tired rhetoric and deflection of the pertinent issues that we have exhaustively met with when dealing with you. Dr. Smith pointed out the fact that we were exercising our common sense, as reasonable and educated people do. Dr. Wander and I repeatedly told you that we simply do not have months or years to have you email us daily about how the insert feels, mail the inserts to and fro and hope that one day our feet will accommodate to the fluid technology. We live and practice in the real world where patients expect outcomes and reasonable resolution of their symptoms.

    I propose that the reason that you utilize this system is that very few patients have the time or inclination to see this all the way through with habitual email, fluid volume changes and email office visits and simply give up. I wonder how many patients have actually been afforded a refund at the time that they ask and how many just acquiesce to your flurry of email, questions and modifications over lengths of time.

    I told you that I did not understand all of the data that an F-Scan provides nor how it is determined. Yes I do believe that pressure pad analysis as I understand it can help clinically to determine if certain goals are being met with orthoses. What is your point in calling me out on this? Grab at a more intelligent straw and direct your criticisms to the more accomplished biomechanical minds here addressing you since that was the purpose of you coming here in the first place wasn’t it? Or was it just to initiate another round of arguing over how “we just don’t get it?

    Since you consider yourself such an expert at F-Scan analysis (and given the fact that you do not perform these scans on your patients and practice by mail and email) try and explain to Drs. Kirby and Smith how you arrive at the claims that you have made in establishing improved biomechanical efficiency shown on F-Scan. I will sit back and read this train wreck with rapt interest.

    I am aware of several patients from the other site who would qualify your device as a complete failure so your acrimonious rancor that traditional orthoses are rife with failure is not validated by the reputed overwhelming superiority of the SDO. We all have successes and failures and as Dr. Kirby pointed out not revealing such when you make such grandiose and unverifiable claims to your patients (sic) renders your integrity suspect.

    The fact that Jeremy will not reveal the identity of the patients that he has seen wearing your device and who was not satisfied is to his benefit. He observes ethical practices and HIPPA laws and you seen to want to ignore them. Divulging patient information is not an ethical practice befitting your education and license. For that matter neither is practicing podiatric medicine via the mail and internet.

    I am surprised that you have not brought up the “clinical trial” that you conducted on three (3) patients on that other website. I’m afraid to view you alluding here to this crowning professional moment of yours that you regurgitate so effluently. I can imagine the responses from the posters here who actually do conduct clinically valid trials that are designed within the accepted standards and I believe that they too will overwhelmingly find your mention of this professionally reprobate.

    Face facts; it is time for you to rethink why so many professionals are resistant to your materials, methods and ideas, not the other way around. Answer the questions posed by the experts and refrain from continuing this personal diatribe of yours. Maybe if you conduct appropriate clinical research trials and publish your results you will gain a modicum of respectability. Until then your entire professional model consists of opinions not based in fact and unsubstantiated marketing. Period.

    One last thing Dennis, my last name is spelled Wedemeyer not Wedermeyer. There is one r, it is on the end and I know that you already know this. I don’t type ‘Kipper’ instead of Kiper or Denise instead of Dennis now do I?
     
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