The MOSI

[blinda]

Any thoughts on using Harridines` MOSI modification in place of the Kirby skive, for pts demonstrating a medially deviated STJ?

The article in Pod Now 11(3) March 2008 pp16-22, looks good and I kinda get the theory about having the skive running parallel to the STJA to further improve resupination, or a supination moment, in comparison to a skive (moment) which runs at an angle to the STJA.

The case studies are interesting, but are there any other trials out there, or peoples experience, indicating significant increased improvement?

Cheers,
Bel

[Admin]

blinda said:

The case studies are interesting, but are there any other trials out there, or peoples experience, indicating significant increased improvement?

Hi Bel,

That's what I would be interested in. Case studies are good for illustrative purposes, but lets see some science too!

Cheers,

[ianl]

Hi Bel

Will be reading the article this weekend. Like the picture but again love the way that the STJ axis is "estimated".

[robertisaacs]

Is it on the internetweb yet? my copies of pod now seem to be going astray at the mo. Paranoids suspect foul play...

My thoughts based on your description. Reluctantly i'm going to shuffle to the KISS side of the room and stand at the back muttering darkly and kicking my feet.

I like the K skive. Use it a lot. And i see the point of trying to shoot for the axis with a MOSI. But considering the difficulty in measureing the position of the axis accuratly and the relativly small amounts of variation in axial position at the rearfoot (as opposed to the forefoot) i struggle to beleive there would be much to choose between the two!

I'm now of to have a long shower and try to read Dave Smith's MSc again. Its got potentiometers and vector equations in it. So there.

_{Mutter mutter buggrit mutter}

Robert

[dtt]

I'm now of to have a long shower and try to read Dave Smith's MSc again. Its got potentiometers and vector equations in it. So there.

Err wont it make the paper wet and hard to read ??

But if you can do it , that is "flamboyance" in the extreme ?? = (D S dig ;D ;D ;D )
Enjoy the excellent work
Cheers
D

[Admin]

robertisaacs said:

My thoughts based on your description. Reluctantly i'm going to shuffle to the KISS side of the room and stand at the back muttering darkly and kicking my feet.

[glow=red,2,300]Ha![/glow]

[robertisaacs]

Err wont it make the paper wet and hard to read ??

Silly. Its a pdf!

I meant bath. But i never have time for them any more!

robert

[podiathing]

Hi all

As yet we've got no trials using the MOSI except one reliability study. This had 3 'medially deviated runners' with Rootian type prescription orthoses, Kirby skive type orthoses and then a MOSI type orthoses. We performed this as a reliability study before (hopefully soon) getting a larger sample. Our results showed a significant decrease in pronation angles between the Rootian and the Kirby, and again between the Kirby and the MOSI. Obviously small sample etc, but thought it was interesting and worth a mention.

We've found it incredibly useful for the patient with the 'medial axis'. I know all the "estimating the axis" problems with this modification (and hopefully we will continue to work on prescription methods) but if you follow the physics, it makes a lot of sense to even try to get a bit closer to the axis. We've been doing this for a while now (it took well over a year and a half to get the paper published) and we've probably prescribed well over 500 in my lab.

Very interested to read what you think

Kind regards

Paul Harradine

[robertisaacs]

Hey Paul

I'd be very interested in even a preliminary study on this. Like i say the Mosi is an elegant concept and I'd like it to work, its whether the difference between the Kskive line and the Mosi line is significant enough to make a difference which i question.

Mind you if there is one think that playing with thought experiments has shown it is that a few degrees can make a huge difference!

Any chance you could link us to any literature which DOES exist? I'd be particularly interested in the study you carried out but any kind of modeling you've done would be of great interest.


Regards
Robert

[podiathing]

Hi Robert

I think it all comes down to clinical application. For some people / feet a small increase in the applied moment makes the world of difference, in others it doesn't (as there is enough already from a kirby, or much, much more was required...). As you can see from the physics in the paper, theoretically the MOSI should work better. Our preliminary study suggested it did, but we need a much larger study.

But, if your aim is to supply as much supinatory moments as possible to a 'medial axis, give the MOSI a try. We've been very impressed with it (we've tried many other things that have not worked! It's great having a lab attached to the practice!). Please let me know what you think when you've tried it too. If you want any help on the manufacturing methodology etc, just give me a ring or reply here.

We are hoping to 'follow' Craig Paynes recent paper on the effect of orthoses on rearfoot motion in JAPMA. As you know from this paper, there is a massive lack of available research in the area!


Kind regards

Paul Harradine

[ianl]

Hi Paul

Thanks for coming on and putting us straight ( or pushing us along the right axis - even I'm ashamed of that pun). Like Robeer and others I hope it works well for you and will be interested in seeing more info.

Query from me lies in the area of the affect of the MOSI more distal to the STJ.

In many of the medially deviated STJ axis (that I have dealt with) the conundrum is providing enough control (supinatory moment for the technical purists) so as to lessen the midfoot collapse at the MTJ - especially when the foot moves into heel lift and beyond.

Is it your experience (if possible to glean enough info yet) that the MOSI provides an efficient enough supin' moment:

1. to give a more distal affect
2. maybe reduce the need to include navicular buttressing as in the Muller TPD from allied
OSI

Genuine questions as I'm interested and not clever enough to argue engineering with the likes of you and Robeer.

Cheers
Ian

[blinda]

Thanks for that Paul,

I will try to incorporate a MOSI, but being new to the whole biomech game, I`m sure i will be taking you up on your offer for help on the manufacturing methodology etc.

Cheers,
Bel

[podiathing]

Hi Ian

Yes, we've found great results with the MOSI in this type of foot. But, the shell is dropped away at the distal medial aspect of the MOSI so as not to carry it on into a huge medal arch and blister every foot its fitted to! This can be done by the normal medial cast mod, but we now locally reheat the shell and manually work it away from the plantar navicular area until it seems 'comfy'. I guess you would combine the MOSI with what you were doing before to the mid section of the orthoses for this sort of foot type no problems.

It's also a very low bulk modification, literally curving up into the medial side of the shoe. This means I've got the MOSI into football boots and less-than-ideal shoes easily. More often than not combined with a low-bulk hemi-post and the plantar shell ground almost through.

Sorry, not a very technical answer!

Paul

[robertisaacs]

Paul

Sorry, not a very technical answer!

Tell you what, why not upload a couple of photos of some casts / insoles.

A picture is, i'm told, worth a thousand words.

Robert

[podiathing]

No problem, give me a couple of days. I'll bring my camera to work tomorrow.

regards

Paul