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Success Rates of Orthotic Therapy

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  #1  
Old 5th April 2007, 07:43 PM
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Default Success Rates of Orthotic Therapy

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I'm interested to know if any of our esteemed academians can provide a link(s) to Lit Reviews or summaries that quantify the 'success rates' of orthotic therapy. I am presuming that any such studies would be under pathology categories such as 'heel pain' or 'plantar fasciitis' but would appreciate someone telling me 'where to go!'

Thanks,

Ted
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Old 5th April 2007, 07:47 PM
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Default Re: Success Rates of Orthotic Therapy

There are 100 or so studies I have seen references to. They show 70-90% success, but it depends on what you mean by success.
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Old 5th April 2007, 07:53 PM
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Default Re: Success Rates of Orthotic Therapy

Thanks DaV, do you have list for me to explore?
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Old 5th April 2007, 08:46 PM
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Default Re: Success Rates of Orthotic Therapy

Quote:
Originally Posted by TedJed
I'm interested to know if any of our esteemed academians can provide a link(s) to Lit Reviews or summaries that quantify the 'success rates' of orthotic therapy. I am presuming that any such studies would be under pathology categories such as 'heel pain' or 'plantar fasciitis' but would appreciate someone telling me 'where to go!'

Thanks,

Ted
Here are the references I have. If you want the pdf article of the paper I was invited to write on the subject, then contact me privately (Kirby, KA: Foot orthoses: therapeutic efficacy, theory and research evidence for their biomechanical effect. Foot Ankle Quarterly, 18(2):49-57, 2006).


Quote:
Foot Orthosis Research References

Baitch SP, Blake RL, Fineagan PL, Senatore J: Biomechanical analysis of running with 25 degree inverted orthotic devices. JAPMA, 81:647-652, 1991.

Ball KA, Afheldt MJ: Evolution of foot orthotics--part 1: coherent theory or coherent practice? J Manipulative Physiol Ther, 25:116-124, 2002.

Ball KA, Afheldt MJ: Evolution of foot orthotics--part 2: research reshapes long-standing theory. J Manipulative Physiol Ther, 25:125-134, 2002.

Barani Z, Haghpanahi M, Katoozian H: Three dimensional stress analysis of diabetic insole: a finite element approach. Technol Health Care, 13:185-192, 2005.

Bates BT, Osternig LR, Mason B, James LS: Foot orthotic devices to modify selected aspects of lower extremity mechanics. Am J Sp Med, 7:328-31, 1979.

Blake RL, Denton JA: Functional foot orthoses for athletic injuries: A retrospective study. JAPMA, 75:359-362, 1985.

Blake RL: Inverted functional orthoses. JAPMA, 76:275-276, 1986.

Blake RL, Ferguson H: Foot orthoses for the severe flatfoot in sports. JAPMA, 81:549, 1991.

Blake RL, Ferguson H: The inverted orthotic technique: Its role in clinical biomechanics., pp. 465-497, in Valmassy, R.L.(ed.), Clinical Biomechanics of the Lower Extremities, Mosby-Year Book, St. Louis, 1996.

Butler RJ, McClay-Davis IS, Laughton CM, Hughes M. Dual-function foot orthosis: Effect on shock and control of rearfoot motion. Foot Ankle Intl, 24:410-414, 2003.

Chalmers AC, Busby C, Goyert J, Porter B, Schulzer M: Metatarsalgia and rheumatoid arthritis-a randomized, single blind, sequential trial comparing two types of foot orthoses and supportive shoes. J Rheum, 27:1643-1647, 2000.

Cheung JT, Zhang M: A 3-dimensional finite element model of the human foot and ankle for insole design. Arch Phys Med Rehabil, 86:353-358, 2005.

Chen WP, Ju CW, Tang FT: Effects of total contact insoles on the plantar stress redistribution: a finite element analysis.Clin Biomech, 18:S17-24, 2003.

Crenshaw SJ, Pollo FE, Calton EF: Effects of lateral-wedged insoles on kinetics at the knee. Clin Orthop, 375:185-192, June 2000.

Dananberg HJ, Guiliano M: Chronic low-back pain and its response to custom-made foot orthoses. 89:109-117, 1999.

D’Ambrosia RD: Orthotic devices in running injuries. Clin. Sports Med., 4:611-618, 1985.

Donnatelli R, Hurlbert C, et al: Biomechanical foot orthotics: A retrospective study. J Ortho Sp Phys Ther, 10:205-212, 1988.

Duffin AC, Kidd R, Chan A, Donaghue KC: High plantar pressure and callus in diabetic adolescents. Incidence and treatment. JAPMA, 93:214-220, 2003.

Dugan RC, D’Ambrosia RD: The effect of orthotics on the treatment of selected running injuries. Foot Ankle, 6:313, 1986.

Eggold JF: Orthotics in the prevention of runner’s overuse injuries. Phys. Sports Med., 9:181-185, 1981.

Evans A: Relationship between "growing pains" and foot posture in children. Single-case experimental designs in clinical practice. JAPMA, 93(2): 111-117, 2003.

Evans AM, Scutter SD: Prevalence of "growing pains" in young children. J. Pediatrics, 145:255-258, 2004.

Fuller EA: Center of pressure and its theoretical relationship to foot pathology. JAPMA, 89 (6):278-291, 1999.

Fuller EA: Reinventing biomechanics. Podiatry Today, 13: (3), December 2000.

Gross ML, Davlin LB, Evanski PM: Effectiveness of orthotic shoe inserts in the long distance runner. Am. J. Sports Med., 19:409-412, 1991.

Gross MT, Byers JM, Krafft JL, Lackey EJ, Melton KM: The impact of custom semirigid foot orthotics on pain and disability for individuals with plantar fasciitis. J Ortho Sp Phys Ther, 32:149-157, 2002.

Guskiewicz KM, Perrin DH: Effects of orthotics on postural sway following inversion ankle sprain. J Orthop Sp Phys Ther, 23:326-331, 1996.

Hertel J, Denegar CR, Buckley WE, Sharkey NA, Stokes WL: Effect of rearfoot orthotics on postural control in healthy subjects. J Sport Rehabil, 10:36-47, 2001.

Hodge MC, Bach TM, Carter GM: Orthotic management of plantar pressure ad pain in rheumatoid arthritis. Clin Biom, 14:567-575, 1999.

Kerrigan DC, Lelas JL, Goggins J, et al: Effectiveness of a lateral-wedge insole on knee varus torque in patients with knee osteoarthritis. Arch Phys Med Rehabil, 83: 889-893, 2002.

Kilmartin TE, Wallace WA: The scientific basis for the use of biomechanical foot orthoses in the treatment of lower limb sports injuries-a review of the literature. Br. J. Sports Med., 28:180-184, 1994.

Kirby KA: Methods for determination of positional variations in the subtalar joint axis. JAPMA, 77: 228-234, 1987.

Kirby KA: Rotational equilibrium across the subtalar joint axis. JAPMA, 79: 1-14, 1989.

Kirby KA, Green DR: Evaluation and Nonoperative Management of Pes Valgus, pp. 295-327, in DeValentine, S.(ed), Foot and Ankle Disorders in Children. Churchill-Livingstone, New York, 1992.

Kirby KA: The medial heel skive technique: improving pronation control in foot orthoses. JAPMA, 82: 177-188, 1992.

Kirby KA.: Foot and Lower Extremity Biomechanics: A Ten Year Collection of Precision Intricast Newsletters. Precision Intricast, Inc., Payson, Arizona, 1997.

Kirby KA.: Biomechanics and the treatment of flexible flatfoot deformity in children. PBG Focus, J. Podiatric Biomechanics Group, 7:10-11, 1999.

Kirby KA: Conservative treatment of posterior tibial dysfunction. Podiatry Management, 19:73-82, 2000.

Kirby KA: Subtalar joint axis location and rotational equilibrium theory of foot function. JAPMA, 91:465-488, 2001.

Kirby KA: Foot and Lower Extremity Biomechanics II: Precision Intricast Newsletters, 1997-2002. Precision Intricast, Inc., Payson, AZ, 2002.

Kirby KA: Lateral heel skive orthosis technique. Precision Intricast Newsletter. Precision Intricast, Inc., Payson, AZ, September 2004.

Kirby, KA: Foot orthoses: therapeutic efficacy, theory and research evidence for their biomechanical effect. Foot Ankle Quarterly, 18(2):49-57, 2006.

Kogler, G.F., Solominidis, S.E., and J.P. Paul: In vitro method for quantifying the effectiveness of the longitudinal arch support mechanism of a foot orthosis. Clin. Biomechanics, 10 (5):245-252,1995.

Kogler, G.F., Solominidis, S.E. and J.P. Paul: Biomechanics of longitudinal arch support mechanisms in foot orthoses and their effect on plantar aponeurosis strain. Clin. Biomech. 11 (5): 243-252, 1996.

Kogler, G.F., Veer, F.B., Solomonidis, S.E., and J.P. Paul: The influence of medial and lateral placement of orthotic wedges on loading of the plantar aponeurosis. JBJS (Am), 81(10): 1403-1413, 1999.

Kogler GF, Veer FB, Verhulst SJ, Solomonidis SE, Paul JP: The effect of heel elevation on strain within the plantar aponeurosis: in vitro study. Foot Ankle Int, 22: 433-439, 2001.

Landorf, KB and A.M. Keenan: Efficacy of foot orthoses: what does the literature tell us? Australasian Journal of Podiatric Medicine, 32 (3):105-113, 1998.

Leung AK, Cheng JC, Mak AF: Orthotic design and foot impression procedures to control foot alignment. Prosthet Orthot Int, 28:254-262, 2004.

Laughton CA, McClay-Davis IS, Hamill J: Effect of strike pattern and orthotic intervention on tibial shock during running. J Appl Biomech, 19:153-16, 2003.

Lee WE: Podiatric biomechanics: an historical appraisal and discussion of the Root model as a clinical system of approach in the present context of theoretical uncertainty. Clin Pod Med Surg, 18:555-684, 2001.

Li CY, Imaishi K, Shiba N, Tagawa Y, Maeda T, Matsuo S, Goto T, Yamanaka K: Biomechanical evaluation of foot pressure and loading force during gait in rheumotod arthritic patients with and without foot orthoses. Kurume Med J, 47:211-217, 2000.

Lobmann R, Kayser R, Kasten G, Kasten U, Kluge K, Neumann W, Lehnert H: Effects of preventative footwear on foot pressure as determined by pedobarography in diabetic patients: a prospective study. Diabet Med, 18:314-319, 2001.

MacLean C, Davis IM, Hamill J: Influence of a custom foot intervention on lower extremity dynamics in healthy runners. Clin Biomech, 21:621-630, 2006.

MacLean CL, Hamill J: Short and long-term influence of a custom foot orthotic intervention on lower extremity dynamics in injured runners. Annual ISB Meeting, Cleveland, September 2005.

McCulloch MU, Brunt D, Linden DV: The effect of foot orthotics and gait velocity on lower limb kinematics and temporal events of stance. J Ortho Sp Phys Ther, 17:2-10, 1993.

McPoil TG, Hunt GC: Evaluation and management of foot and ankle disorders: Present problems and future directions. JOSPT, 21:381-388, 1995.

Mejjad O, Vittecoq O, Pouplin S, Grassin-Delyle L, Weber J, Le Loet X: Foot orthotics decrease pain but do not improve gait in rheumatoid arthritis patients. Joint Bone Spine, 71:542-545, 2004.

Moraros J, Hodge W: Orthotic survey: Preliminary results. JAPMA, 83:139-148, 1993.

Morton DJ: The Human Foot: Its Evolution, Physiology and Functional Disorders. Columbia University Press, New York, 1935.

Mundermann A, Nigg BM, Humble RN, Stefanyshyn DJ. Foot orthoses affect lower extremity kinematics and kinetics during running. Clin Biomech, 18:254-262, 2003a.

Mundermann A, Nigg BM, Humble RN, Stefanyshyn DJ: Orthotic comfort is related to kinematics, kinetics, and EMG in recreational runners. Med Sci Sports Exercise, 35:1710-1719, 2003b.

Mundermann A, Wakeling JM, Nigg BM, Humble RN, Stefanyshyn DJ: Foot orthoses affect frequency components of muscle activity in the lower extremity. Gait and Posture, In Press, 2005.

Nawoczenski DA, Cook TM, Saltzman CL: The effect of foot orthotics on three-dimensional kinematics of the leg and rearfoot during running. J Ortho Sp Phys Ther, 21:317-327, 1995.

Nawoczenski DA, Ludewig PM: Electromyographic effects of foot orthotics on selected lower extremity muscles during running. Arch Phys Med Rehab, 80:540-544, 1999.

Nester CJ, Hutchins S, Bowker P: Effect of foot orthoses on rearfoot complex kinematics during walking gait. Foot Ankle Intl, 22:133-139, 2001.

Nester CJ, Van Der Linden ML, Bowker P: Effect of foot orthoses on the kinematics and kinetics of normal walking gait. Gait Posture, 17:180-187, 2003.

Novick A, Kelley DL: Position and movement changes of the foot with orthotic intervention during loading response of gait. J Ortho Sp Phys Ther, 11:301-312, 1990.

Nigg BM: The role of impact forces and foot pronation: a new paradigm. Clin J Sport Med, 11:2-9, 2001.

Nigg BM, Nurse MA, Stefanyshyn DJ: Shoe inserts and orthotics for sport and physical activities. Med Sci Sports Exerc, 31:S421-S428, 1999.

Nurse MA, Nigg BM: Quantifying a relationship between tactile and vibration sensitivity of the human foot with plantar pressure distributions during gait. Clin Biomech, 14:667-672, 1999.

Payne CB: The past, present, and future of podiatric biomechanics. JAPMA, 88:53-63, 1998.

Pham T, Maillefert JF, Hudry C, et al: Laterally elevated wedged insoles in the treatment of medial knee osteoarthritis: a two-year prospective randomized controlled study. Osteoarthritis Cartilage 12: 46-55, 2004.

Postema K, Burm PE, Zande ME, Limbeek J: Primary metatarsalgia: the influence of a custom moulded insole and a rockerbar on plantar pressure. Prosthet Orthot Int, 22:35-44, 1998.

Powell M, Seid M, Szer IA: Efficacy of custom foot orthotics in improving pain and functional status in children with juvenile idiopathic arthritis: A randomized trial. J Rheum, 32:943-950, 2005.

Redmond, A., Lumb, P.S.B., Landorf, K.: Effect of cast and noncast foot orthoses on plantar pressure and force during normal gait. JAPMA, 90 (9): 441-449, 2000.

Reed L, Bennett PJ: Changes in foot function with the use of Root and Blake Orthoses. JAPMA 91(4): 184-193, 2001.

Rome K, Brown CL: Randomized clinical trial into the impact of rigid foot orthoses on balance parameters in excessively pronated feet. Clin Rehab, 18:624-630, 2004.

Root ML, Orien WP, Weed JH, RJ Hughes: Biomechanical Examination of the Foot, Volume 1. Clinical Biomechanics Corporation, Los Angeles, 1971.

Root ML: How was the Root functional orthotic developed? Podiatry Arts Lab Newsletter, 1981.

Rubin R, Menz HB: Use of laterally wedged custom foot orthoses to reduce pain associated with medial knee osteoarthritis: A preliminary investigation. JAPMA, 95:347-352, 2005.

Saxena A, Haddad J: The effect of foot orthoses on patellofemoral pain syndrome. 93:264-271, 2003.

Scherer PR, Sanders J, Eldredge DE, Duffy SJ, Lee RY: Effect of functional foot orthoses on first metatarsophalangeal joint dorsiflexion in stance and gait. JAPMA, 96:474-281, 2006.

Schuster RO: A history of orthopedics in podiatry. J Am Pod Assoc, 64:332, 1974.

Sgarlato TE (ed): A Compendium of Podiatric Biomechanics. California College of Podiatric Medicine, San Francisco, 1971.

Slattery M, Tinley P: The efficacy of functional foot orthoses in the control of pain and ankle joint disintegration in hemophilia. JAPMA, 91:240-244, 2001.

Smith LS, Clarke TE, Hamill CL, Santopietro F: The effects of soft and semi-rigid orthoses upon rearfoot movement in running. JAPMA, 76:227-232, 1986.

Stackhouse CL, Davis IM, Hamill J: Orthotic intervention in forefoot and rearfoot strike running patterns. Clin Biomech, 19:64-70, 2004.

Thompson JA, Jennings MB, Hodge W: Orthotic therapy in the management of osteoarthritis. JAPMA, 82:136-139, 1992.

Tomaro J, Burdett RG: The effects of foot orthotics on the EMG activity of selected leg muscles during gait. J Ortho Sp Phys Ther, 18:532-536, 1993.

Walter JH, Ng G, Stoitz JJ: A patient satisfaction survey on prescription custom-molded foot orthoses. JAPMA, 94:363-367, 2004.

Whitman, Royal: Observations of forty-five cases of flat-foot with particular reference to etiology and treatment. Boston Med. Surg. J. 118:598, 1888.

Williams DS, McClay-Davis I, Baitch SP: Effect of inverted orthoses on lower extremity mechanics in runners. Med. Sci. Sports Exerc. 35:2060-2068, 2003.

Woodburn J, Barker S, Helliwell PS: A randomized controlled trial of foot orthoses in rheumatoid arthritis. J Rheum, 29:1377-1383, 2002.

Woodburn J, Helliwell PS, Barker S: Changes in 3D joint kinematics support the continuous use of orthoses in the management of painful rearfoot deformity in rheumatoid arthritis. J Rheum, 30:2356-2364, 2003.
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Old 6th April 2007, 03:29 AM
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Default Re: Success Rates of Orthotic Therapy

I am frequently perplexed with the responses I see to orthotic therapy. I have had patients do wonderfully with them and others fail miserably- many times the outcomes surprise me either way. I also have patient come in with orthoses from previous practitioners where the response surprises me as well. Some come in with device that were prescribed and made appropriately (something that I would have issued), and report zero response or sometimes a negative response. On the other hand, I had a woman yesterday that I treated for a toe fracture. She was obese and had 3/4 polyprop orthoses that had a completely flat shell, zero posting in the rearfoot and no discernible intrinsic ff posting. She stated these were a miracle and she could not live without them. I would have prescribed something different and would probably not have had as good as a result.

I do consider other issues- calf tightness, weight, activity, foot-type, shoes - but I must admit my prognostic skills with respect to orthotic outcomes are not as good as my diagnostic skills.

Any thoughts??

Nick
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Old 6th April 2007, 06:15 AM
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Default Re: Success Rates of Orthotic Therapy

Quote:
Originally Posted by Scorpio622
I am frequently perplexed with the responses I see to orthotic therapy. I have had patients do wonderfully with them and others fail miserably- many times the outcomes surprise me either way. I also have patient come in with orthoses from previous practitioners where the response surprises me as well. Some come in with device that were prescribed and made appropriately (something that I would have issued), and report zero response or sometimes a negative response. On the other hand, I had a woman yesterday that I treated for a toe fracture. She was obese and had 3/4 polyprop orthoses that had a completely flat shell, zero posting in the rearfoot and no discernible intrinsic ff posting. She stated these were a miracle and she could not live without them. I would have prescribed something different and would probably not have had as good as a result.

I do consider other issues- calf tightness, weight, activity, foot-type, shoes - but I must admit my prognostic skills with respect to orthotic outcomes are not as good as my diagnostic skills.

Any thoughts??

Nick
Nick:

Join the club. Any podiatrist (or other foot-health professional) who says they know what the best orthosis is for every patient doesn't know what they are talking about. I am surprised nearly every week at some of the responses I see to foot orthoses. However, the more years and the more orthoses I do, the more confident I become since I can predict orthosis responses much better now (due to improvements in theory and improvements in my knowledge) compared to when I first started over 20 years ago. I still am surprised every now and then, but am not as confused as I previously was. Becoming a successful biomechanics clinician is a lifelong learning pursuit.
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Old 6th April 2007, 07:55 AM
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Default Re: Success Rates of Orthotic Therapy

Put up your hand if you have ever had a patient return for an orthotic review, heaping praise on you for the miracle you have performed, only for you to find out they are wearing the devices the wrong way around....
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Old 6th April 2007, 01:43 PM
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Oh! Me Me but not for a long time since now I alway make a point of showing the correct fitting and marking the orthoses left and right.

Yeah - Nice one CraigT

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Old 8th August 2009, 02:48 PM
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Default Re: Success Rates of Orthotic Therapy

Thanks for that very honest reply kevin. I issue many orthotics to patients, and am constanly surprised at the range of results. Despite if their from casted orthoses or semi-bepsoke.
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Old 10th August 2009, 06:21 AM
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Default Re: Success Rates of Orthotic Therapy

Hi Guys

Craig you are so right and David i go thought the same precedure of fitting the insole and marking and some IQ's must be low as they still come in with them in the wrong shoes.
The other issue i find with results is that the patient has issues remembering what their pain is and how bad it has been from the start to the review stage and this comes down to note taking

Regards

Dave
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Old 11th August 2009, 12:48 AM
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Default Re: Success Rates of Orthotic Therapy

Quote:
Put up your hand if you have ever had a patient return for an orthotic review, heaping praise on you for the miracle you have performed, only for you to find out they are wearing the devices the wrong way around....
Hand up.

Worse, I had a patient with simples once who had them in back to front! .

Simon gave a good definition of how orthotics work on another thread but as we are presently arguing, there are elements of how orthotics work we don't fully understand! Not least the placebo effect!

Something I played with a while back was something I called Iatrogenic Malignant Hypertonia. I noticed that some patients, particularly the "chronic pain" types had abberactions to ANY kind of orthotic. They would tense up all their intrinsic muscles and find walking painful as a consequence. I have had patients for whom a 3mm poron sheet with a cavity for a corn was "to harsh" and which caused tibialis pain.

I wonder if their is a reverse of that, a mechanism by which people relax more and walk more fluidly if they THINK that a problem has been fixed.

There is probably a funky experiment using an F scan and hypnosis there! Does background muscle tone affect gait? Any volunteers?

Regards
Robert
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Old 11th August 2009, 11:20 AM
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Default Re: Success Rates of Orthotic Therapy

Robert

very interesting point.

I work closely with some friends of mine who are personnel trainers and employ a method from the states founded by a gent called Gary Gray.

He works on the methodology and has shown good success with it that the area of dysfunction is antagonised with a specific set of exercises for each body segment and looking for the planal dominace and in somecases is using techniques that we would deam as contrary to our clinical aim with an orthotic.
That may tie into similar grounds as to what you were mentioning

regards

Dave
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Old 11th August 2009, 11:34 AM
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Default Re: Success Rates of Orthotic Therapy

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Originally Posted by Robertisaacs View Post
There is probably a funky experiment using an F scan
I doubt it, but that's another story due to be told.
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Old 11th August 2009, 01:14 PM
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Default Re: Success Rates of Orthotic Therapy

Quote:
There is probably a funky experiment using an F scan

I doubt it, but that's another story due to be told.
Or kinetic or kinematic measurement tool of dealers choice
Quote:
I work closely with some friends of mine who are personnel trainers and employ a method from the states founded by a gent called Gary Gray.

He works on the methodology and has shown good success with it that the area of dysfunction is antagonised with a specific set of exercises for each body segment and looking for the planal dominace and in somecases is using techniques that we would deam as contrary to our clinical aim with an orthotic.
That may tie into similar grounds as to what you were mentioning
Are we talking proximal stuff here? Do you have any links for bedtime reading?

Regards
Robert
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