History-Evolution-of-Foot-and-Lower-Extremity-Biomechanics-and-Foot-Orthoses_Kevin-Kirby

Recommendations

Info

3/26/2015 New Research on STJ Axis Location Emphasized STJ Kinetics In 1987, concept that STJ axis location may be determined clinically and that GRF medial to STJ axis causes supination moments and GRF lateral to axis causes STJ pronation moments was first introduced Kirby KA: Methods for determination of positional variations in the subtalar joint axis. JAPMA, 77: 228- 234, 1987. In 1989, concept of rotational equilibrium used to explain how balance of STJ moments may explain abnormal internal forces within foot and different types of foot pathology Kirby KA: Rotational equilibrium across the subtalar joint axis. JAPMA, 79: 1-14, 1989. In 1992, medial heel skive technique, was first described as method to increase varus shape of heel cup in functional foot orthosis Designed to increase STJ supination moment from orthosis and more effectively treat symptoms caused by excessive pronation moments such as PTTD and children’s flatfoot deformity Kirby KA: The medial heel skive technique: improving pronation control in foot orthoses. JAPMA, 82: 177-188, 1992. In 2001, new theory of foot function, Subtalar Joint Axis Location and Rotational Equilibrium (SALRE) Theory was first introduced Described how concepts of STJ axis spatial location and rotational equilibrium may be combined to explain many observations relating to biomechanical function Also offered explanation for biomechanical effect of certain foot surgeries Kirby KA: Subtalar joint axis location and rotational equilibrium theory of foot function. JAPMA, 91:465-488, 2001. SALRE Theory Explains How Orthoses Alter STJ Moments If orthosis is designed to “control pronation”, ORF will be shifted medially so STJ supination moment is increased If orthosis is designed to “control STJ supination”, then ORF will be shifted laterally so STJ pronation moment is increased Kirby KA: Subtalar joint axis location and rotational equilibrium theory of foot function. JAPMA, 91:465-488, 2001. ORF ORF ORF ORF Supination Area of Foot Orthosis Normal STJ Axis Location As STJ axis becomes medially deviated, orthosis has decreased area medial to STJ axis to cause STJ supination moments Medial deviation of STJ decreases orthosis ability to supinate STJ Supination Area of Foot Orthosis Child with Flatfoot Deformity 12
3/26/2015 Tissue Stress Model Tissue stress model first proposed as a model for mechanical foot therapy in 1995 by McPoil and Hunt McPoil TG, Hunt GC: Evaluation and management of foot and ankle disorders: Present problems and future directions. JOSPT, 21:381-388, 1995. Tissue stress model is not a novel idea since it is based on same ideas are already in current use in treatment of parts of body other than foot and lower extremity Tissue stress model doesn’t rely on “unreliable measurement techniques” Thomas G. McPoil Gary C. Hunt Tissue Stress Model Tissue stress model and its clinical applications have been discussed by other authors as a clinical method by which to more effectively prescribe custom foot orthoses 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. Kirby KA: Tissue stress approach to mechanical foot therapy. Precision Intricast Newsletter, February 2002. Kirby KA: The biomechanics of tissue stress. Precision Intricast Newsletter, Payson, Arizona, March 2002. Kirby KA: Using the tissue stress approach in clinical practice. Precision Intricast Newsletter, April 2002. Tissue Stress Allows Efficient Determination of Orthosis Goals Orthosis goals are best achieved by specifically designing CFO to : – reduce stress on injured structural components within foot and lower extremity – optimize function of foot and lower extremity for specific weightbearing activities – prevent other injuries or pathologies from occurring due to foot orthosis therapy Steps to Using Tissue Stress 1. Specifically identify anatomical structures which are source of patient’s complaints 2. Determine structural and/or functional variables which may be source of pathological forces on injured structures 3. Design orthosis/shoe treatment plan which will most effectively reduce pathological forces on injured structural components, will optimize gait function and will not cause other pathology or symptoms Paul Robert Scherer Paul Scherer, DPM, is former professor of biomechanics at CCPM and current professor of biomechanics at CSPM Scientific chair for first ten PFOLA Conferences which were world-class international events that presented latest knowledge in biomechanics and foot orthosis therapy His book “Recent Advances in Orthotic Therapy” is premier educational resource detailing scientific research evidence for orthosis therapy Benno Nigg’s Preferred Movement Pathway Model In 2001, Benno Nigg proposed “preferred movement pathway model” of orthosis function Nigg proposes that orthoses do not function by realigning skeleton but rather alter input signals into plantar foot that change “muscle tuning Nigg proposed that if foot orthosis counteracts preferred movement path, then muscle activity will increase and that optimal shoe or foot orthosis design will reduce or minimize muscle activity Nigg BM: The role of impact forces and foot pronation: a new paradigm. Clin J Sport Med, 11:2-9, 2001. 13
Page 1 and 2: 3/26/2015 History and Evolution of
Page 3 and 4: 3/26/2015 Hugh Owen Thomas Newton M
Page 5 and 6: 3/26/2015 Roberts-Whitman Brace Dud
Page 7 and 8: 3/26/2015 Oblique axis John H. Hick
Page 9 and 10: 3/26/2015 Henderson & Campbell: UCB
Page 11: 3/26/2015 Thoughts from Van Langela
Page 15: 3/26/2015 Biomechanics and Historic

History-Evolution-of-Foot-and-Lower-Extremity-Biomechanics-and-Foot-Orthoses_Kevin-Kirby

Create successful ePaper yourself

Delete template?

Save as template?