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Comments?......yes, UNBELIEVABLE!!.........I feel sorry for those poor Italian people with potentially limb-threatening diabetes that have been given false hope that their pedal arterial inflow will somehow increase because of wearing your "proprioceptive insoles".
__________________
Sincerely,
Kevin
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
Obviously Brian has approached this scientifically and measured blood flow pre and post insoles and compared with a control. Obviously ethical approval for a large scale trial was granted on the back of promising early results from a pilot study. And clearly, heaven forbid, Brian wouldn't be using this as an opportunity for free advertising.
But whats good for the gander........
Visit Peninsula Podiatry Plymouth UK Tel 01752 241442, For all your foot and leg care needs.
Sooner or later everyone will catch on to this technique. Maybe then someone will do something about it.
__________________ Science is the antidote to the poison of enthusiasm and superstition
Obviously Brian has approached this scientifically and measured blood flow pre and post insoles and compared with a control. Obviously ethical approval for a large scale trial was granted on the back of promising early results from a pilot study. And clearly, heaven forbid, Brian wouldn't be using this as an opportunity for free advertising.
But whats good for the gander........
Visit Peninsula Podiatry Plymouth UK Tel 01752 241442, For all your foot and leg care needs.
Sooner or later everyone will catch on to this technique. Maybe then someone will do something about it.
Simon. thanks for the advert. I checked it out on the web and found you there. Very handsome picture too!
(pi-TAHRD) To be caught in one’s own trap: “The swindler cheated himself out of most of his money, and his victims were satisfied to see him hoist by his own petard.” A “petard” was an explosive device used in medieval warfare. To be hoisted, or lifted, by a petard literally means to be blown up. 1
A diabetic study to investigate the effectiveness using the technology I invented was initiated at the Istituto Superiore di Sanita in Rome Italy. Comments? Prof Brian Rothbart
Brian
If I hadn't had the experience of your previous claim regarding infertility and the effect your insoles have on retroverted uteri, I might just be minded to ask how an vascular flow with an inverted foot could be improved by using hard flat rubber insoles with a 3-6 degree wedge to the 1st MTP Joint. Assuming (and I don't believe it for a moment) pedal diabetic angiopathy is related to positional abnormality of the hind foot and midtarsus, how do you suppose your "technology" corrects this dysfunction?
If this video is your evidence of a study into diabetic foot ulcers rather than just a promo film for the Istituto Superiore di Sanita in Rome, I would have to concur with the views of my colleagues in this thread and also add, with much regret, that it is not just the patients with diabetes and infertility that may be damaged by your inventions, but the profession of podiatry generally.
The Istituto Superiore di Sanita is analogous to the National Institute of Health in the United States. It is the major research facility in Italy. I was the first American to be offered a Research Fellowship (Guest Researcher) in the Department of Biomedical Engineering. This position was offered to me based on my prior research on proprioceptive insoles and the Metatarsus Supinatus Foot type.
So please, stop the perjoratives about my research, and now, your venting towards the ISS. It is very unbecoming and unprofessional.
Incidentally, the coresearcher on this project is Claudia Giocomozzi PhD, an international known and respected researcher on the diabetic foot.
Brian R
Last edited by Brian A. Rothbart : 19th July 2006 at 02:43 AM.
Reason: for completion
I don't think I wish to comment further on your research or the Italian Institute where you now work as I have made my thoughts quite clear on this already. You emailed me privately to ask about the insoles I purchased recently for a patient who presented with an 'elevated' first metatarsal at neutral stance and complained of tib ant + patellofemoral pain
Quote:
Several months ago you ordered a pair of proprioceptive insoles for one of your patients (or possibly yourself)? What were your observations? Did they have a huge buildup on the inside of the orthoses? Did they destroy the function of the 1st MPJ or result in a hallux rigidus or limitus? Your comments would be very appreciated.
. In addition to your insoles I also compared the results with a Vasyli slimfit orthoses with a 4 degree forefoot varus wedge; a frelon insole with a 4 degree forefoot wedge; and a simple poron insole with a high arch fill and forefoot varus wedge.
The least effective were the 'proprioceptive' insoles which appeared to exacerbate her tib anterior pain, even when worn for an hour/day. She returned them after two weeks. The felon and Vasyli insoles gave good results insomuch as they reduced the tib ant discomfort within six days, however her knee pain persisted. The poron insoles maintained the improvement in her tib anterior and when combined with a 4mm cork heel raise (and two sessions of manipulation of her knee) alleviated her patellofemoral pain considerably.
I have hesitated in submitting this response out of some concern for my colleague Alex Catto who is marketing these insoles in the UK, and I also acknowledge that this is only one patient out of many who might have had a different experience. However, I have to say I am not particularly excited with these insoles and your lack of explanation and general evasiveness in respect of some of your claims - improving infertility and diabetic angiopathy to name but two - does little to allay my fears that you are simply manipulating your position in pursuit of commercial exploitation with little or no clinical benefit to the patient.
Best wishes
Mark Russell
__________________
"citing an indisposition due to special circumstances"
Regarding the use of the technology and insoles I invented:
(1) As to any new technology, you need to be trained in how to use it correctly.
(2) A few people are giving introductory seminars on how to use my technology, on an entry level basis.
(3) If you wish to use this technology on any but the most simple of cases, you must learn the technology in full. This can not be done in a seminar. It requires taking an advanced course. Being the inventor, I am the only qualified person to give this course.
I have a reasonably basic understanding of lower limb function and there are other members of this forum who far greater knowledge. I don't think at any time have you demonstrated - even at a basic level - how your "technology" works, aside from submitting some obscure, irrelevent references in support of bland statements. I re-read the stream on Infertility again last night and was appalled at your obsfuscation. I have fairly strong views on the ethics of prescribing foot orthoses and some of the more obscure claims by clinicians in this field, but your claim that diabetic foot ulcers can be healed and vascular insufficiency improved by using proprioceptive insoles almost elicits a Sponer Response from me. If you cannot explain by written word how your "technology" works I sincerely doubt you can manage at a seminar.
Regards
Mark Russell
__________________
"citing an indisposition due to special circumstances"
Brian
I have fairly strong views on the ethics of prescribing foot orthoses and some of the more obscure claims by clinicians in this field, but your claim that diabetic foot ulcers can be healed and vascular insufficiency improved by using proprioceptive insoles almost elicits a Sponer Response from me.
I presume you mean a Spooner response. I promise you you will feel healed afterwards. This therapy is also useful for piles, premature ejaculation, fat-bloke syndrome and "trapped wind and bloating"- whatever that be. However, the Spooner response can only be achieved after full training, as the inventor, I am the only one who can teach you- please send cheques to "cash". Mark, I'll give you a special introductory offer- take a deep breath, sigh at the ignorance, think to yourself this bloke is a real 2@ then stop with the big words and just tell him to **** off.
Sorry Dieter.
__________________ Science is the antidote to the poison of enthusiasm and superstition
Point of fact, I find your conclusions, regarding proprioceptive insoles, based on one case very enlightening!
Have you taken any seminars in the use of this technology? Also, did this person have the PMs foot type? (have you purchased the biovector kit to make this determination, without it, you cannot make a differential diagnosis). How did you determine what strength of stimulation to use? If the improper strength is used, not only will the patient not respond favorably, they may get worse.
Using the PCIs on a non PMs patient, or using inappropriate stimulation, is totaly counterindicated!
I am sending these comments and queries directly to you and not posting it on the Forum, to avoid any potential misunderstandings regarding your clinical experience or expertise in using this technology.
with regards,
Brian R
I've no problem with my ignorance in respect of your technology being displayed publicly - personally I regard it as a badge of honour. Maybe you would be so kind as to explain the statement "strength of stimulation" and how your simple insoles procure this reaction?
Quote:
Originally Posted by Simon Spooner
I presume you mean a Spooner response.
Yo Spooner. Sorry for the sh!tty spelling! Cheque 's in the post.
Regards
Mark Russell
__________________
"citing an indisposition due to special circumstances"
I have a reasonably basic understanding of lower limb function and there are other members of this forum who far greater knowledge. I don't think at any time have you demonstrated - even at a basic level - how your "technology" works, aside from submitting some obscure, irrelevent references in support of bland statements. I re-read the stream on Infertility again last night and was appalled at your obsfuscation. I have fairly strong views on the ethics of prescribing foot orthoses and some of the more obscure claims by clinicians in this field, but your claim that diabetic foot ulcers can be healed and vascular insufficiency improved by using proprioceptive insoles almost elicits a Sponer Response from me. If you cannot explain by written word how your "technology" works I sincerely doubt you can manage at a seminar.
Regards
Mark Russell
Mark:
Now, with these comments to Dr. Rothbart, you have impressed me even more than you did with your comments regarding the poultry question. Mark, you never cease to amaze me....in a very positive fashion....I must add.
However, I don't know if you want to tempt fate and make the giant leap to Sponer Responses........sorry, I mean Spooner Responses. Like Simon says, you will likely need to be giving up on a long-term habit of cigarettes to reach that level of commentary. :p
__________________
Sincerely,
Kevin
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
Simon - no need to apologize, Kevin explained to me that your occasional Tourets-like affliction is essentially an expression of humour, and that I should learn to live with it. So I will.
Playing devils' advocate: I have also experimented with the PCI... on myself. I am ignoring in this, just for a moment, the outlandish claims and lack of scientific evidence. Until proven differently this has to be accepted. I note Prof R's indignant response when challenged about his 'research' claims. The criticisms from this community has to be justified until there is some activity at a level that satisfies some basic criteria to give sufficient weight to the evidence, which it lacks, as of right now. Seems to me Prof R. is after all keen to have peer acceptance which is presumably why he appears on this blog. The kind of evidence required to satisfy some of the critics cannot be that difficult to obtain especially with the resources available to him at the Italian Institute? ( If he needs a Research Assistant I could make myself available i.e. I could also use a free holiday)
Here is my story: I use orthoses because I get heel pain - the common garden variety. I have always assumed it is because my STJ slips into pronation with a tad more enthusiams than I care for, courtesy of mild genu varum. I use orthoses routinely and have done so for some years. I have made orthoses myself since I was a student, but I have also experimented with professionally made devices incorporating a range of design variables with an OK result, and later, as quality improved also off-the-shelf devices e.g InterPod etc.
Without exception all of these have failed to place my heel or STJ (or rather talo-navicular congruency) in any meaningful position other than a position found when device-free on full weight bearing. This now appears to be an acceptable conclusion. We do not treat pronation. Or whatever it is that happens when a foot is standing on a wedged device.
From time to time my heel pain would become more noticeable... and quite bothersome, and most recently so, in spite of orthoses.
Following the PCI thread I acquired a free sample courtesy of Alex C. I have tried the insole specifically for inferior heel pain brought after increasing my daily walking ration quite substantially due to the acquisition of a new puppy.
Now, it does puzzle me rather but the damn things worked for me... within days the heel pain improved markedly so, and in spite of increasing the walking burden in duration and cadence. If I follow R's assessment methodology, I would have to say there is MD present but I do not have a short 1st metatarsal segment or decreased 1st metatarsal stiffness. Clearly PCI in situ there is no net change in the static foot posture but I can also tip toe well and I am not aware of any 1st MTP joint restriction. A settling in period was required with some aching from the 1st MCJ for two weeks.
What does this prove? Not much. Evidence it certainly is not. But I am sure glad my heel pain is gone. And I doubt I am susceptible to the charms of the 'snake oil' vendor I can after all resist Dr. Sponners natural charm quite easily.
I am bracing myself for a public slaying but it is possible that Dr. Spooner is out for lunch or has gone fishing?
Reading your comments, one thing keeps coming to mind. I am only hearing from the same people, over and over again. Hopefully, other people will join in on this thread.
However, until that happens, I suggest you visit the following webpage where you will find many other comments on proprioceptive insoles from every type of healthcare provider. The following site is: http://www.rothbartsfoot.info/
A peculiar professor named Brian
Proposed a theory that was intellectually aspiring
Prescribe my insoles he claimed
And you’ll receive international fame
For they'll prevent all your patients from dying
Whatever condition presents
Infertility or cranial complaints
Can be alleviated for sure
For proprioception is the cure
Fifty bucks is money well spent
Never mind that the theory is all crap
For biomechanics is just a dumb-rap
With a micro-wedge here
Podiatrists need not fear
Falling foul of the ethical trap
So visit his website today
And soon you’ll be well on your way
Selling snake-oil and goods
Of questionable repute
Whilst practising on a wing and a prayer
(apologies to McGonagle)
......now where's that friggin' chicken.....?
__________________
"citing an indisposition due to special circumstances"
For anyone interested, you can read the history on how the diabetic study evolved at the ISS. You can access this information at http://www.rothbartsfoot.info/Diabetic.html
This webpage also has animated models demonstrating the proposed theory behind this study. Point of interest: this study was motivated by 3 prior clinical studies of diabetics scheduled for partial foot amputation due to non healing plantar ulcers. Using proprioceptive insoles, 2 of the 3 patients did not require surgery. Coincidence, possibly, but this aroused interest in repeating the study on a larger scale, hence the ISS study.
This thread has attracted over 400 hits. Hopefully, some of these readers will decide to participate in this discussion.
Brian,
Since you believe the same few views are repeated, I shall dip my toe in here!!
I am always concerned when authors consistently quote themselves in regard to the "research" used to support their views.
I would be very interested to see any information apart from your own, supporting the correlation of "excessive pronation" ( whatever that is??) in relation to reduced blood flow to the foot.
Looking forward to your reply
Tony
The hypothesis of this study is that 'normalization' of gait biomechanics via proprioceptive stimulation automatically increases blood flow and sensation to the plantar compartment of the foot.
and
Quote:
Correlate abnormal pronation to mechanical entrapment of the posterior tibial artery, nerve and vein against the suscentaculum tali (Rothbart 2002)
(please note another spelling mistake with "sustentaculum" spelt incorrectly )
Brian Rothbart, please correct me if I have got the wrong message here, but according to the blurb on the website it seems to me that this "research" assumes that all (or most cases of) diabetic blood flow and sensory impairment is secondary to mechanical entrapment? Are there any statistics to indicate how this result was obtained? I can't see any links on the website to indicate the success vs failure rate of the insoles with regard to alleviating mechanical entrapment of the posterior tibial artery/nerve/vein... How was it measured? What about the patients who are suffering small vessel damage from other causes, like those with chronic high BGLs/poorly controlled diabetes mellitus? Were these patients included in the study? Did they also improve with these "proprioceptive" insoles?
You sent me the following email in response to my previous posts. In the interests of openness and transparency I think it best to continue this discussion on a public forum rather than supplement it by private email. I hope you don't mind.
Quote:
Again, I am sending you this email privately because I want to eliminate any possible negative impressions that might arise from my comments.
Apparently you fitted a patient with my insoles without first making a differential diagnosis. I make this statement after talking to Alex Catto. Apparently you refused to invest the 30 quid necessary to buy the biovectors (microwedges). I have stressed on many many different occasions that prior to using my technology, you must measure the patient using these devices. Or possibly, you purchased them from another source (if so, who)?
In all deference to your clinical and biomechanical skills, you are NOT an expert in the insole technology that I invented. To use my technology without adequate training, in my way of thinking, is a very arrogant attitude. Would you perform an ingrown nail procedure without first being trained how to do it properly? I think not.
I feel badly that I found it necessary to say these things to you. I have admired many of the astute comments you have made on various topics in the best. However, you recent comments belie what I have previously thought.
Can you keep an open mind regarding my research? Visit the following webpage and read the comments from experts (and patients) from all over the world (most of whom I have never met) regarding proprioceptive insoles. One is from Marie Pierre Gagey, the father of Posturology, internationally known and respected, who wrote the standard textbook on Posturology. The webpage site is www.rothbartsfoot.info
regards,
Brian R
PS My comments on infertility stand. I have conversed with a Gynocologist who uses the ligament suspension technique to reverse a retroverted uterus (for intractable infertility). To me, repositioning the pelvis (and with it, the uterus) with an insole makes more sense.
I would like to address some of the points you make. First, I did not refuse to invest thirty quid for biovectors (whatever they may be). The first I heard of them was yesterday in your previous post. I purchased an insole from Alex as I wanted to see what you were selling and whether it had any clinical veracity. After reading your previous correspondence and all the instructions in the pack (no-where does it say the prescriber must attend a seminar conducted by the inventor by the way) I supplied them to a patient with an elevated first metatarsal. As mentioned previously, this was just one patient and can hardly be described as an authoritative piece of research, but I wonder what your reaction would have been if the patient's symptoms had improved? Perhaps a slot in your websites roll of honour?
I also note that you include comments from a podiatry forum on your website which you referred to yesterday. Not comments from Podiatry Arena - probably the most subscribed and respected podiatry forum available, but comments from the Steve Kite Website which enjoys less than a dozen contributors. Regular subscribers to Arena will remember this character fondly after his threat to pay a hostile visit to Craig Payne some months ago. Will you now also include comments made on Arena in the interests of fairness and balance?
You also sent me two photographs of a woman in an email headed Cranial Changes after Proprioceptive Stimulation. I am not sure what research protocols are used at the Italian Institute but these photographs prove nothing in themselves - they could easily be headed - Woman's face upon waking and woman's face after first cup of coffee. What are you trying to claim with these?
I'm perfectly happy to keep an open mind about most things, even alien abductions, but please Brian let's keep these insoles and what they achieve firmly anchored on Planet Earth!
Lastly, you keep describing these insoles as "technology". Why? I make simple insoles every working day of my life, very often more complex and intricate than these simple rubber ones. I don't call them "technology" and I don't use strange terms such as micro-wedges or biovectors - just simple insoles tailored to my patient's need. Generally speaking they do the job for which they were made - they improve the patient's condition. I dare say some of these patients who wore my insoles have become pregnant, won the lottery, beaten a chronic illness, achieved multiple orgasms, even fallen in love - maybe all at the same time - but I make no claim to that effect.
Do you think I should?
Best wishes
Mark Russell
__________________
"citing an indisposition due to special circumstances"
Thanks for catching the typo error. With over 100 pages online, typo errors do seem to 'sneak in'.
Regarding the ISS study, I proposed A THEORY, read that, PROPOSED THEORY to approach recalcitrant plantar ulcers. Where did you read that I stated all diabetic ulcers are mechanically induced (which would be a ludicrous assumption)?
Robert, I am sorry, but what does the MASS Model have to do with this thread. And am I catching pejoratives vented towards one of your colleagues (Ed Glaser). This seems to be a common occurrence on this forum.
Mark, Regarding the photos, they are immediately before and immediately after proprioceptive stimulation. The changes are remarkable! But again, what do the photos have to do with this discussion???
And Mark, the email I sent to you in private, stands. Since you decided to make it public, my point is, why is it surprising that you saw less than favorable results using my technology, when apparently you used it on a NON PMs foot type. As Craig Payne has pointed out on numerous occasions, if you raise the first MPJ (in the absence of the PMs foot type, my comment), you can jam the joint. But again, what does all this have to do this thread??
And Mark, another point, what does alien abductions have to do with anything about Podiatry??
Are you getting my drift of thought by now. This discussion has drifted, on many occasions, off the subject. Let's refocus, or call it a day.
Its always nice to hear from Simon and Kevin and all the (un)usual suspects. There is one person who's view on this thread i would LOVE to see.
Where are you Ed Glaser, your community needs you!
Failing that, Brian what is your view on the claims of the MASS Model?
Kind regards
Robert
Robert:
I just had to smile when I saw your posting since these are my sentiments exactly. Mark Russell is really showing us what he is made of here, and I am so proud of him for that, but I see that you, Robert, also have great potential. So.......keep up the good work! However, you may not want to try to go directly to a Spooner Response since I understand, from Simon, that you must learn that directly from the inventor.
__________________
Sincerely,
Kevin
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
However, you may not want to try to go directly to a Spooner Response since I understand, from Simon, that you must learn that directly from the inventor.
Moreover, a cash sum must always change hands, otherwise you may jam-up the response. I'm now selling bio-blasphemy's which you must use in order to achieve differential diagnosis prior to the issue of a Spooner response. If you don't use this and the response back-fires, don't blame me.
Did I or did I not say that this corporate selling on Podiatry Arena would get out of hand?
__________________ Science is the antidote to the poison of enthusiasm and superstition
Did I or did I not say that this corporate selling on Podiatry Arena would get out of hand?
On the contrary, Simon, reading the responses to podiatrists trying to sell something on Podiatry Arena (E.G. and B.R., for example) has given me the most entertainment and enjoyment over the past few months on this website. I believe, instead of complaining about these individuals, that we should be thankful for the amusement they bring us all. In other words, we should encourage all podiatrists who think that their products are superior to all others be allowed to publicly announce on Podiatry Arena how smart that they are, how great their product is and proclaim all the other wonderful things that their products can do for people. There is something curiously enjoyable in irritating these people and exposing them for what they truly are when they think they should "advertise" their products here on Podiatry Arena with no valid research or rational explanation to back up their claims.
By the way, does this character trait of mine where I enjoy irritating certain types of individuals indicate that I have some sort of personality disorder?
__________________
Sincerely,
Kevin
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
Research Study using Proprioceptive Insoles
Or whatever it is that happens when a foot is standing on a wedged device.
Were these patients included in the study? Did they also improve with these "proprioceptive" insoles? 
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