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Bearing in mind the criticisms of Prof. Brian Rothbarts work that regularly appear on this site, it's worth mentioning that this article "Vertical facial dimensions linked to abnormal foot motion"....has just been published in the latest edition
of The Journal of the American Podiatric Medical Association.

This is a prestigious publication
It's peer reviewed
The article is interesting, and has implications for podiatrists
It's controversial.
Go look at it on line

For those of us without JAPMA subscriptions, was this article mentioned on Pod Arena earlier this month with a rather becoming before-and-after photograph?

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"I'm not a fan of facts. You see, the facts can change, but my opinion will never change, no matter what are the facts."

It is an appalling piece of work. I have no idea how it got through the JAPMA review process.

To start with there is nothing on the reliability of the measuremnts by the author reported - that on its own is enough to not believe the results (This study has even showed that the FPI should not be used as a variable in data analysis).

Secondly, the data in the tables is presented as categorical, yet the author somehow managed to do a t-test on it ... thats just not possible. It is not close to being possible to work out how the author even did the data analysis based on the information provided. A t-test is done on continuous data, yet there are no means or standard deviations presented for readers to see.

The FPI only measures static foot posture, yet the author mentions "motion" in the title and "pronation" (which is a motion) throughout the paper...

There is so much more, but the data presentation and data analysis mean the results have to be considered unbeleivable.

__________________
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?

This funny:
Why the such disparity in viewpoints? I am not surprised that: Has be not bought those criticisms on himself?

Vertical Facial Dimensions Linked to Abnormal Foot Motion
Brian A. Rothbart
Journal of the American Podiatric Medical Association; Volume 98 Number 3 189-196 2008

__________________
Who is NewsBot?
Buy Admin a Beer

Good question. Perhaps a job for Interviewbot? I'm sure he/she/it could track down somebody on the Japma review board.

For myself i found it to be (as usual with Brians work) interesting but flawed. Some of the data is interesting, however i don't really see that the conclusions match the data.

The inclusion criteria also give cause for concern IMO. Of the 163 screened for the study, 47 who were aysmetric pronators were excluded because they did NOT have aysymetric VFD. Surely this group, being larger than the inclusion criteria, support the hypothesis that there is no link between VFD and AFP. After all its 47 for whom there was no correlation!

Regards
Robert

You right on that one Robert --- I was so stuck on trying to work out what he actually did that I did not even look at that.

He has rigged the inclusion criteria to get the results he wanted.

I am going to forward this information to the JAPMA editor - I think they need to give serious consideration to withdrawing this paper from publication.

__________________
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 would like to know from Alex if he did any sort of critical appraisal of this paper before posting it here? Or does a commercial interest in a product associated with Dr Rothbart blind one to doing so?

I think thats a bit harsh. I think this paper is worthy of critism. However questioning alex's integrity is uncalled for. He never actually said that he drew any conclusions from this paper, nor that he supported it. He has merely drawn it to our attention.

I was aware of this paper pre publication. I was tempted to post the abstract myself for discussion. Work like this SHOULD be examined and exposed to the scrutiny by the "community." All alex has done is hold a paper which he admits is controversial up for examination.

I think we should examine it with an open mind. Its a long way from proving anything, certainly not proof of an ascending pattern causal link, but there is some interesting data!

Robert

Further to Craig's observation regarding analyses:
Multiple t-tests; did they use a bonferroni correction on the alpha level?
http://en.wikipedia.org/wiki/Bonferroni_correction

Regardless:
"Background: Twenty-two children from Jiutepec, Mexico, were studied to determine whether a correlation...
...and tested using the one-sample t test."

t-tests to determine correlation.

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Science is the antidote to the poison of enthusiasm and superstition

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ROTHBART’s paper, which reports astonishing facts in a very condensed style, may shock certain readers ; it does not take into account the fact that many people are unaware of the developments of clinical Posturology in southern Europe. We must apologize for being much more interested in research and discoveries than in handling a language which is not ours; until now publications on clinical Posturology are written mostly in Latin and Slavic languages (see Ref.)... But Philippe VILLENEUVE and I can say that the facts reported by ROTHBART correspond to what we observe regularly in clinical posturology. A regulation of the postural tonic activity exists that it is worth knowing before criticizing articles on clinical Posturology in order to put the right statistical questions to their authors.

See : PubMed
http://pmgagey.club.fr/sitesautres.htm
http://www.posture-equilibre.asso.fr/librairie1.htm

Scientists rarely report facts; they report probabilities. In order to report probabilities accurately and thus, scientifically, accurate and valid analyses of the data and precise methodological design are quintessential. This paper fails to achieve these. Their clinical interpretation may meet with your observations, but since the methods employed are fundamentally flawed, where does that leave your observations? Are they similarly flawed due to the inherent bias you inevitably display toward your own belief system?

Have a nice day.

__________________
Science is the antidote to the poison of enthusiasm and superstition

My location

The results reported by author may or may not be correct; its just that we can not determine that from this paper.

The author, the JAPMA reviewer and the JAPMA editor have to justify:
1) The reason for the exclusions -- it appears the inclusion criteria rigged the reults toward the hypotheses (Roberts point above)
2) The failure to conduct reliability on the authors measurements and the lack of reporting of the reliability of the data collection
3) The failure to report any means and standard deviations
4) The reporting of the data in the tables as categorical (which means a Chi squared test should have been done), yet the author somehow did a t-test on the data (let aone if the assumptions that underpin a t-test were valid - we have no means and SD's to check that)
5) If a Bonferroni adjustment was made for the multiple t-tests (Simon's point)
6) The assumption that the static FPI measures motion.

Simply, the authors conclusion in the paper can not be supported by the information reported in the paper.

__________________
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 have read the Brian Rothbart paper being discussed and am an Osteopath in New Zealand and have not contributed to this forum before. I have used the proprioceptive insoles designed by Prof Rothbart for 4 years and continue to find them a useful tool in a global approach to musculo-skeletal dysfunction.
I am no researcher, although last year I did do the data collection (video, goniometric and QVAS) for two SSRDs studying the proposed effects of the proprioceptive insoles on posture (Research Author - Rob Moran, editor of the International Journal of Osteopathic Medicine). This was selected for and presented at the Australia New Zealand Osteopathic Research Conference in Auckland last December and is hopefully on its way to publication.
The pattern to which Prof Rothbart refers and which Prof Gagey supports is also referred to a lot in Osteopathic Medicine but, as far as I know, there is no solid research to support this. Real patients are much more complicated than patterns which is one reason why research in this area is so difficult; they do have difficult births and traumatic dental work, anatomical leg length discrepancies, historical fractures, head injuries, general medical or mental illnesses etc. - hopefully not all at once! Prof Rothbart seems to try to remove many these complicating factors via the inclusion criteria which is normal practice I think.
If there is a "simple pattern" behind all this and I would suspect there may be, understanding the simple pattern can then guide the clinician to recognise the complex patient. Understanding the hierarchy of influence of mechanical dysfunction in various parts of the body is the key to making the right interventions in the right order and at the right time to be able to help get complex patients out of trouble.
I don't have the expertise to comment on the criticisms of the statistical analysis but there has to be a way of balancing the facts of experience and the voice of theory.
"Ma whero, ma pango ka oti te tuhi" A Maori proverb figuratively meaning, by working together we will get the job done.


Nigel Brooke DO

kia ora Nigel I do not know if the theory of this is right or wrong, but it does make some sort of intuitive sense and may well be correct. The real issue is the poorly conducted, poorly analysed and poorly reported research. The data can not be used to support the conclusion, let alone the theory. Prof Rothbart has a track record of doing this, which is why he gets the response that he does.

This has parallels with the discussion on ESWT. Those who believe it works and have a vest financial interest in the product go to extraordinary lengths to discredit research that shows it does not work, yet are not prepared to hold publications that show it does work up to the same standard of evaluation.

Nigel, I hope you stay around to contribute to other discussions. All our discussions on Rothbarts work are littered with single posts from users of Rothbarts products, who at his urging come and post a supportive measure and never come back to post anything else .... kinda does not look good and we all smell a rat!

__________________
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 dentist with many years research into successfully treating TMD and facial asymmetries not in every case of course but can see the relationship between functional short leg and deviation of the jaw to the pronated side as if the stress of the posture maintaining the structure is compromised.I must add that faulty jaw architecture also plays a part and there is a descending pattern especially if there is snoring or sleep apnea or sleep disordered breathing. Often Fixing the descending pattern will stop at the hip level due to the pronated foot and unless this is corrected there is no resolution in the finer issues or level of comfort in the jaws ,cranial structures neck and spine.
As for rothbart's paper he has done podiatry a big favor and given you a door to integrating other disclipines like dentistry and pain management in the big picture especially Hospital medicine.

Welcome mandible
So are you actually saying that the way the data was collected, analysed and presented actually supports the theory being tested? No one in this thread has disputed the theory.

I repeat what I said above:

__________________
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?

Watch out Craig!!!! Rothbart's Raiders are out to get you!!!

__________________
Sincerely,

Kevin

**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College

e-mail: kevinakirby@comcast.net

Private Practice:
107 Scripps Drive, Suite 200
Sacramento, CA 95825 USA
My location

Voice: (916) 925-8111 Fax: (916) 925-8136
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It is kind of amusing as its the same pattern as to what has happened in other related threads.

No one is disputing the criticisms directed at the research.

I would hold any publication up to the same standard of evaluation. Its just this one is one of the worse and will be added to the pool of papers we use with the students to teach critical appraisal (interesting almost all the papers in the pool are from JAPMA).

__________________
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 Craig for your reply.
I have never used eau de rodent aftershave and understand your concern about single posters. Like Alex Catto I became the distributor for the PCIs in to make them available in NZ. If I get criticism for that as being a vested interest so be it, but my concern in practice has always been to get people off the treatment treadmill, whatever the modality.
That was the reason for the SSRDs as a first step to try to confirm if what I was seeing over 3 years in practice actually stood up under a more critical spotlight. It did, and the results cannot define cause certainly warrant further investigation. The question is who is going to do that?
I do not have the training many of you have in being able to critically appraise research articles at a high level and appreciate your expertise in this area. It also seems a shame that you have one journal that you say is publishing material that does not meet your exacting standards. That needs addressing with the Journal as has been stated but care needs to be taken not to throw the baby out with the bathwater.
I am merely a pragmatic osteopathic clinician but I am happy to contribute if that is useful. I am not happy though, having read the terms of the forum, to be referred to as a Rothbart Raider, that is simply unprofessional.

Nigel Brooke DO

Pierre, Nigel & Mandible

As an unfortunately regular recipient of Rothbart's 'newsletters' can I ask who encouraged or suggested posting your supportive comments in regard to this paper - was it Brian himself? Seems very coincidental that three new contributors post comments within 24 hours - and as Craig has remarked, this follows Brian's recent strategy of having the monkeys do the shouting. Where is the organ-grinder these days?? Has he lost his tongue?

You may care to read some of the other threads Brian has contributed to in the past - in particular, those relating to fertility and diabetic feet and the relationship with his rubber insoles. Do you support his assertions that these devices improve fertility in women and reduce the risk of amputations in diabetic foot syndromme - if so can you explain how?

'Rothbart's Raiders' is certainly an interesting (and fairly accurate) sobriquet in my opinion, for this has been the pattern in recent months - an abstract or claim is published online in a professional forum followed by several, hitherto unknown disciples with a distribution contract shouting in support. Seems more of a cult really and begs the question - is Brian the new L Ron Hubbard?

Kindest

Mark Russell

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"citing an indisposition due to special circumstances"

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Not Co-incidental at all. I received an Email from brian saying that his work and he personally were being attacked on the arena and asking me to go defend it if i thought it had value. I suspect i was not alone. Does that mean i'm a Raider?

To be fair to Brian i think that the reason he does not come do his own arguing is that we do tend to get a bit personal in our attacks. That may be appropriate, as a relative minnow in the global podiatric pond i would not presume to say, however it seems to me that the work should stand or fall based on its own merits rather than the background of the author.

Perhaps Brian should grow a thicker skin, Perhaps we should limit ourselves to discussing the paper rather than the author and supporters thereof. But there it is.

Regards
Robert

Nigel, you need to appreciate that this is the way Rothbart works - just look at all the other threads we have had. He has done a poorly designed, analysed and written up piece of research that has quite rightly been bagged and he has asked others to come here to do his bidding!: That is very very funny.

I do notice that this thread is about a bad peice of research that not one of the Rothbart cronies has yet been able to defend. Since when did this become about proprioceptive insoles?

I think CP summed it nicely with this comment: I smell a rat too. Why can't those purported to support Rothbart stick to the topic of this research project and not parrot on about how wonderful the proprioceptive placebos are.

Dear Mark
If I shouted I apologise although I don't think I did.
I accept the observation "when did this become about proprioceptive insoles" but as I have been directly asked questions by you I shall respond.
I saw the article pre-publication and Brian made me aware of the thread as he has done in the past when I have just observed. This is the first time I have felt moved to comment.
I have seen most of his work and I use the insoles designed by him to assist with postural change when the PMS foot type is present. I have objectively measured lumbo-sacral, dorsi-lumbar, and cervico-dorsal angles in response to this intervention for four years. I have been more interested in functional movement and pain related to posture than any of the claims you refer to. As I said before they are a useful tool, they are not the be all and end all.

As regards fertility many Osteopaths and other bodyworkers specialise in Obs/gyn and there have been many claims made over the years for adjustments in pelvic position affecting position and tonicity of the reproductive organs thereby allowing passage of sperm to allow fertilisation. Suffice to say, as far as I am aware, I have not made any of my patients pregnant!!!

The diabetic foot is something that could relatively easily be studied and maybe it should be rather than just poopooing it as an outrageous claim. Suggestions that exercise may be useful in the treatment of heart disease were considered outlandish, if not malpractice, in the 1930s.

I stand by my previous comment that calling people names is unprofessional and so far I have been called a Rothbart Raider, a monkey, a disciple and possibly a member of a cult. I have a reasonably thick skin, don't care for defending anyone's reputation or anyone's product, and if this forum is serious about discussing issues and not people with a mix of research input and clinical input then just do it.

Nigel Brooke

Regarding the level of peer review by the JPMA, Mr Craig Payne must realise, that he is also discreditng his professions journal.

Global posturology has been on the frontier in Europe and now across the world, both in the orthopaedic profession (McGee) and both in musculoskletal work along with holistic dentists.

It seems that Mr Craig is solely a lecturer who sits and writes and critises other people's hypothesis (especially people like Rothbat from his own profession), instead of offering real clinically assistance to people in need (like private practitioners).

For years cranio-orthodentists and chriopractic and sacral occiptal practitioners along with holistic dentsist know the importance of the proprioceptive ipact via mechanorcptors of deep antigravitational muscles via exorecpetors and intero-recptors (TMJ, EYES, FEEt, vestibular appararus and strect receptors).

It seems MR Craig is more keen in critising than exploring the field of global posturology.

As a professiona health practitioner and international lecturer, it seems you have a personal ambition against a member of your community. How many famous inventors and scientists of our time were discredited and thus then prasied from their own profession.

-

Of course I am. Are you suggesting that just because a journal comes from ones own profession it not be held up to scrutiny? In your profession do you beleive everything that is published in your professional journals (if you do, then I pity you). Are you expecting me (or anyone else) to not criticise research that is published in ones own professional journal? You are really making a fool of yourself with that claim....perhaps you should have done a bit of looking around before stating that. What an absolute load of rubbish you are talking. All I have done in this thread is do a critical appraisal of the design and analysis of a piece of research. Not once in this thread have I said anything about what you are claiming (have you actually bothered to read the thread before commenting? Wrong again. I am only holding his research up to the standard I would hold anyones research up to. The issue is that his research does not stack up and this particular publication is one of the worse.

Perhaps you could explain to me how the design of the study in question, the method the data was present as, the analysis done as was presented in the study actually supports the theory?, which is the actual topic of this thread!

If you read what was is written above, I have not once criticised the theory (I even suggested that it might be right!). All I have done is show that the methods and data analysis do not support the conclusions.

Maybe in your profession you like being blindly led and worship false prophets, but fortuantly we hold things up to critical appraisal (both positive and negative).

__________________
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 too would really like one of the above posters who have just joined to post in this thread, answer that question, after all that is the actual topic of this thread!

I will add to the chorus: Me too! Come up all you "Welcome New Posters", tell us how the design, conduct, analysis (and all those other big words) of the study actually support the theory. From what I have read, the study is fatally flawed (that does not necessarily mean the theory is wrong). Come on and convince me otherwise.

Where's Donna when you need her?

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"I'm not a fan of facts. You see, the facts can change, but my opinion will never change, no matter what are the facts."

Nigel

And as we have read from Robert, this is how Brian operates. On the few occasions he has been persuaded to answer directly, his replies have been evasive, obsfuscative and nonsensical.
I have no problem with that. What I do have a problem with is the exploitative tactics and outlandish claims that his "invention" cures all ills from infertility to toothache - whilst the supporting evidence is usually no more than a series of before and after photographs on a website. Claiming that a medial forefoot wedge on a simple insole is Rothbart's groundbreaking technology is simply stupid - podiatrists have been using this and many other insole modifications for decades - but this seems to be the mainstay of his followers. Personally I give more credence to thetans, but hey, what do I know! Neither have I and that has nowt to do with them not wearing Rothbart's Insoles. Just as an aside, when do you suppose the infertile patient should wear the insoles if she wishes to conceive - before, during or after intercourse - and if during, should she be standing to have any chance of success? I think you have just made a fool out of yourself for that comment on this site. What really hacks me off about Brian is his suggestion that these insoles might prevent diabetic amputation. To give false hope to those vulnerable unfortunate patients who may be facing the loss of a limb is quite despicable, in my opinion. By should we really expect anything else from a convicted fraudster and charlatan? I suggest you read all the other topics regarding Rothbart - perhaps Admin can list them for you - and maybe you will begin to understand why the overwhelming majority of the podiatric profession regard him as a conman and a potential disaster for podiatry. It may be that there is less professional rigour in osteopathy and more focus on sales and marketing using ambiguous anecdotal "research" - but please remember that not all professions are the same. Thankfully.

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"citing an indisposition due to special circumstances"

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