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I am a complete an addict to the arena but this is my first posting,
I was wondering if any of you had any thoughts on the MOSI modification that was published in podiatry now, last mouth.
It has similar design features to the DC Wedge. Its all about getting a greater force on the medial side of the STJ axis in those that need a greater force.
__________________
Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia http://www.latrobe.edu.au/podiatry
__________________________________________________ ___________________________________ God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University This is where I am, where are you?
I am a complete an addict to the arena but this is my first posting,
I was wondering if any of you had any thoughts on the MOSI modification that was published in podiatry now, last mouth.
regards
simon
Weren't you one of the author's? Certainly Paul Harradine who you share a practice with was. Perhaps you or he could attach a PDF.
As I recall from reading the article the rationale is somewhat flawed in that it makes the assumption that STJ axis does not move position during gait and/ or in response to the orthosis itself. Also seem to remember thinking that it doesn't take into account the direction of the Centre of Force vector and assumes the vector is normal to medial heel skive of the orthosis.
Could be wrong as I only briefly scanned it when it dropped on my mat.
__________________ Science is the antidote to the poison of enthusiasm and superstition
I am a complete an addict to the arena but this is my first posting,
I was wondering if any of you had any thoughts on the MOSI modification that was published in podiatry now, last mouth.
regards
simon
Simon C:
I just read your article: Harradine J, Collins S, Webb C, Bevan L: A new method of increasing supinatory moments to a medially deviated subtalar joint axis - the medial oblique shell inclination. PodiatryNow, pp. 16-22, March 2008.
Even though I cannot agree with all of the points made in the article, I believe that you, Paul, Chris and Lawrence should all to commended for publishing a well-written paper that introduces a potentially valuable orthosis modification to all of us for use on our patients.
Here are a few points to consider:
In figure 4, it is not true that the medial heel skive will act on a straight line down the long axis of the orthosis plate. The mechanical effects of the medial heel skive on the subtalar joint (STJ), like all orthosis modifications, are best appreciated by calculating the change in orthosis reaction force (ORF) at each locus on the dorsal orthosis surface that occurs with that specific orthosis modification relative to the spatial location of that locus relative to the STJ axis. In other words, it is not the shape of the medial heel skive within the transverse plane that is so important, it is more the net change in ORF and its position relative to the STJ axis that is important in determining the kinetic effects of a varus heel wedge orthosis modification.
The frictional effects between the foot and orthosis during gait are likely also important with each of these inverted heel modifications such as the Blake Inverted orthosis, medial heel skive, DC Inverted and MOSI modification. I believe it will be difficult to judge which is the better modification until we can compare the kinetics of one modification against another using inverse dynamics. I have better appreciated these frictional effects of the medial heel skive since writing my medial heel skive paper over 16 years ago.
In figures 8 & 9, it appears there is no posterior-lateral heel cup with the MOSI modification. Is this the case??
In figure 10, the line drawn for the STJ axis is much too lateral for that foot. The STJ axis should be probably 10 degrees more medially angulated and about 2.0 cm more medially located relative to the anterior neck of the talus. The left foot of figure 11 appears to accurately reflect the STJ axis position within the transverse plane.
Anyway, Simon, good job on the paper and hope that it can be published here on Podiatry Arena for everyone to be able to read it.
__________________
Sincerely,
Kevin
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
I thought perhaps there might be a copy online- as Kevin managed to eyeball the article- so I googled it and found this....
I feel like there has been a party going on that no one told me about- the UK have their own little forum....there are a couple of pics and good discussion!
If I understand correctly, Davis Smith has the same concerns as Simon's...
Quote:
As I recall from reading the article the rationale is somewhat flawed in that it makes the assumption that STJ axis does not move position during gait and/ or in response to the orthosis itself. Also seem to remember thinking that it doesn't take into account the direction of the Centre of Force vector and assumes the vector is normal to medial heel skive of the orthosis.
Perhaps Dave can add his 2c worth here...
For what it is worth, I always feel I get the best kinetic effect when we also are applying a force which would act against calcaneal declination. I think this is one of the hidden effects of a Blake inverted device. As you are adding inversion, you are also inclining the cast quite significantly, and therfore having this effect. I know of a couple of labs in Australia who orientate the medial heel skive in a similar manner. This seems to be quite different to this modification.
From what I can tell, the MOSI (what the hell does that stand for??) does not do this at all- but perhaps that is just the example that is shown.
This is not to say it cannot help though.
It does indeed look similar to the DC wedge and also does not appear to have a heel cup- I am not a fan of this aspect of the DC wedge.
The rational for not having the cup on the DC wedge is similar to one I heard on my favourite UK comedy series- 'People Like Us'...
'Zenotec are restructuring their in-house transport system by not having one'
could read... 'We are addressing the problems people are having with heel cup irrition by not having one'
Sorry- rambling on here... it is Sunday morning which is like Monday morning for the non Middle Eastern world
__________________
Craig Tanner
Podiatrist ASPETAR-
Qatar Orthopaedic and Sports Medicine Hospital
Doha
QATAR http://www.aspetar.com/
I thought perhaps there might be a copy online- as Kevin managed to eyeball the article- so I googled it and found this....
I feel like there has been a party going on that no one told me about- the UK have their own little forum....there are a couple of pics and good discussion!
Sorry Craig. You WOULD have been invited if you lived in the land of drizzle and decent beer.
Its only a little forum, it ain't pod arena and never will be, but it IS homey.
As you say we've been chewing over the Mosi for a while. Interesting stuff...
Sorry, i'm late in on this so I'm just going to jump in!
Quote:
Quote:
Originally Posted by Simon Spooner
Weren't you one of the author's? Certainly Paul Harradine who you share a practice with was. Perhaps you or he could attach a PDF.
That would be awesome and appreciated by the community.
I've contacted the editor from 'Podiatry Now' to check this would be ok. If not, she has told me previously i can send PDF individually as long as i mention copyright. If anyone would like this, please message me with an address i can send it to.
Quote:
the MOSI (what the hell does that stand for??)
Medial Oblique Shell Inclination. The orthoses pictured don't have a lateral heel cup. However, this is not what the MOSI is about. It's simply taking the medial heel shell incline and angling it to 'theoretically' increase the applied moments. You can add a lateral heel cup to that if you want, or forefoot posting, first ray dells etc etc. It's not an appliance 'on its own', so to speak.
Quote:
I believe it will be difficult to judge which is the better modification until we can compare the kinetics of one modification against another using inverse dynamics
We've started a relatively basic study (initially at present for repeatability data) using Craig Paynes rearfoot motion JAPMA paper as a methodology guidline. Because of the materials we use we've been able to change the rearfoot modification on a pair of orthoses 3 times in runners with a clinically diagnosed medial STJ axis. The mods were no shell incline but 4 degree rearfoot post, a medial heel skive with 4 degree rearfoot post, and a MOSI with a 4 degree rearfoot post. From the results we have (on 8 feet only, so i'm not pretending this is statistically significant in any way) the pronation angle has shown a trend to decrease each time. The decrease between the skive and MOSI was small, but between the post alone and the skive or MOSI it was much larger. Hopefully we should have this completed by the end of the year. We are also hoping to do a comparative outcome study using patients with post-tib dysfunction, but this is still at the planning stage.
Quote:
Even though I cannot agree with all of the points made in the article, I believe that you, Paul, Chris and Lawrence should all to commended for publishing a well-written paper that introduces a potentially valuable orthosis modification to all of us for use on our patients.
Paul - it would be great if you can get permission to attach a pdf. It would be good for the world to see.
__________________
Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia http://www.latrobe.edu.au/podiatry
__________________________________________________ ___________________________________ God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University This is where I am, where are you?
The editor has just got back to me and said as long as i also supply the original ref and state copyright then i can attach it here as a pdf.
So, the original ref is:
Harradine P, Collins S, Webb C, Bevan L. A new method of increasing supinatory moments to a medially deviated subtalar joint axis - The Medial Oblique Shell Inclination. Podiatry Now. Vol 11, No. 3. 2008.
I'm just in the process of working out how to attach it, so hopefully it will be available today.
This orthoses modification has just been brought to my attention again and so I've had a check back to the original article and a look on here to see what people thought, but, after the Youtube clip posting, no-one has yet got back with their opinion, so, if possible, could anyone let me know what they think?
I like it! It is just another alternative option to use when more force is needed medial to the putative subtalar joint axis.
__________________
Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia http://www.latrobe.edu.au/podiatry
__________________________________________________ ___________________________________ God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University This is where I am, where are you?
Thanks. There wasn't too much perspective in the images and given the arch height it would have been difficult to tell if it was a left or right orthosis without the STJ line. If I'm reading it right, there's an exponential warp to vertical medially in the heel perpendicular to the STJ. with an unknown starting point laterally, but that too is easy enough to emulate should there be a call for it. Thanks for saving me the trouble of googling in ellipsoids for it.
The MOSI type foot orthoses
Linear Mode
