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Post by podiathing on Mar 26, 2008 9:59:05 GMT
Its a good point, but i think we have to be honest here and say the MOSI is not claiming the kind of 'detailed accuracy' of the old 'balance the cast and allow 4 degrees of motion' way (whether this accuracy was valid of course is a different discussion....). We ideally need to have a clinically applicable way of seeing a STA that is functioning medially, and then for this type of foot take the post more in line to it. This, of course, is tricky. We could use video and assume the talar head is 'visable' on slow-mo and see where it ends up. But then you get into all the skin-movement vrs bone-marker issues etc.
I've done this job for a while now, and i'm starting to see the value of reliable simple measurements leading to sensible clinical choices. What i'm thinking is maybe three different angles of mosi (more oblique to less so) with extrinsic posting or without. Meaning there is a large, moderate or small MOSI (maxi, midi and mini for lawrence......) which can be extrinsically posted or not. The way of choosing which one would need to be based on a clinically valid and relaible examination of the foot (only one part of the complete assessment though). I think looking for the angle of projection from the talar head in relaxed bipedal stance should be a great starting point for this, but would need to be backed up with some kind of research.
what you think? Has anyone tried making one / prescribing one yet?
regards
Paul
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Post by robertisaacs on Mar 26, 2008 15:07:17 GMT
I had a play with a few casts. However i was working on an axial position based on an STJ somewhere between neutral and max pronated so the angle of the skive was not all that dissimilar to that one sees in a kirby skive. Have'nt tried it on any patients yet.
It strikes me that the really innovative thing here is less the concept of aligning a skive to an axis as the position of the STJ when the axis is determined. It seems to me that the MOSI is an outgrowth of this concept so, for me, the first thing to be considered in terms of research, is a consideration / literature review of where the axis lies during the most relevant part of the orthotic's function and a discourse on why it is this positipon which should be considered significant.
This obviously has significant implications for overall assessment as well as this specific modification.
Are you at all familier with simon spooners axial locator? I'm certain we could receate that or something much like it for the purposes of investigation.
Regards
Robert
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Post by podiathing on Mar 26, 2008 15:36:28 GMT
Yes, i saw him present it at a Summer School a while ago and thought it was very cool. Static measurement using such a tool would be very useful, but we could use a range of measurements to equate to the 'size' / angle of MOSI, rather than exact angle 'posting' (such as 4 degree forefoot varus so post 4 degrees etc etc). I might contact Dr Spooner and see if he ever did anything furher with his axis locator.
I've also been playing with some casts over lunch and think i've got a uniform way of making angles to represent different sizes of MOSI (maxi, midi, mini etc). It's a slightly different way to i was doing them before. I'm going to trial them out a bit and then up-load some pictures for your opinion if that's ok?
Great discussion
Paul Harradine
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Post by podiathing on Mar 26, 2008 16:44:09 GMT
why when we write dr 's p o o n e r' does is come out as dr 'Sthingyer'? Any other words being replaced we should know about?  |
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Post by lawrencebevan on Mar 26, 2008 17:04:30 GMT
spooner!
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Post by lawrencebevan on Mar 26, 2008 17:04:45 GMT
weird!
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Post by twirly on Mar 26, 2008 17:17:15 GMT
LOL
Google the word P O O N . (warning though it's rude!)
funny old world innit. I'm learning new words every day.
Regards muchly,
twirls x
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Post by blinda on Mar 26, 2008 20:55:21 GMT
This is great stuff....any chance of a demo by those who are familiar with locating the axis in July? We could then debate where we think the angle of projection of the talar head is?
...the blue corner?
Cheers,
Bel
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Post by ianl on Mar 26, 2008 22:05:39 GMT
"Simple" is something I can very occasionally understand and do so, if it is possible to make it less difficult than "simple", great. Especially if we are trying to locate the axis in "July". Now try as hard as I might I have not managed to find an "A" or "X" or "I" or "S" in the word "July?".
Yea, I know, crap attempt at humour.
Ian
Ian
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Post by blinda on Mar 26, 2008 22:22:51 GMT
Oh Ian, Ian,
Alright, I would love you to demonstrate how to locate the STJ axis, at the next meeting in July? Nicely volunteered my dear.
Bel x
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Post by ianl on Mar 27, 2008 8:38:39 GMT
Sorry to disappoint you Bel but it is not something I do  I know, I know, even whatever karma I might have had is now being ripped from me. Lawrence and Paul and Robert will now create a poll as to my credibility going even lower than it is and what is worse, much worse, is Twirly is probably removing me from her list of identified fond things  I am enjoying the MOSI thread though. Cheers Ian |
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Post by twirly on Mar 27, 2008 10:15:18 GMT
Dearest Ian,  Lawrence and Paul and Robert will now create a poll as to my credibility going even lower than it is and what is worse, much worse, is Twirly is probably removing me from her list of identified fond things Ian Never ever, ever, ever. Pwomise |
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Post by robertisaacs on Mar 27, 2008 10:18:56 GMT
David David We found a witch, may we burn him?  ;D The angry mob (i read the papers every day) |
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Post by robertisaacs on Mar 27, 2008 10:23:43 GMT
Hmmm. Good point. There is also no I in the word "team". Although there is "ME" if you jumble the letters.
I told my wife that their was no I in team when she asked why I never do the washing.
She told me that that may be so, but that there are sometimes three F's in the word "off".
Regards
Robert
PS, finding the axis is something which would be in "complex biomechanics made simple". But i can do it as an aside if we don't do the rest of the assessment stuff.
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Post by blinda on Mar 27, 2008 14:32:20 GMT
please please please please please?
I would like to thank Paul and Lawrence for their very interesting posts too.
Cheers,
Bel
Don`t worry Ian, we will spank you well, and after we are done with you........
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Beautiful people are inside out.
