Evidence for Custom Foot Orthoses in Clinical Practice with Prof Gabriel Moisan
12/03/24 • 88 min
In this episode of the Foot and Ankle podcast, host Alex Murray talks with Professor Gabriel Moisan to explore the complexities of custom foot orthotics and the underlying research.
They discuss the mechanisms of how orthotics work, the variability in patient responses, and the importance of individualized treatment plans. Gabriel shares insights from his clinical practice, emphasizing the need for a bottom-up approach in research, figuring out the how and why foot orthoses work, before if they work clinically for specific conditions and patient and the potential for predicting patient responses to orthotics.
They also delve into the complexities of foot orthotic design and management, particularly:
- Individualised orthoses prescription based on the condition, patient population and task to inform the design,
- The importance and impact of casting techniques,
- The balance between prefabricated and custom solutions,
- The evolving role of technology such as 3D printing.
- The lack of research to guide the complete orthotic prescription and therefore
- The need to customise the device after prescription to find the optimum prescription for each patient
You can find Gabriel Moisan and his work here:
https://www.researchgate.net/profile/Gabriel-Moisan
https://www.linkedin.com/in/gabriel-moisan-a382aaa7/
Chapters
00:00 Introduction to the episode
03:14 Gabriel Moisan's Journey in Podiatry
05:15 Understanding the Mechanisms of Foot Orthotics
10:05 Variability in Patient Responses to Orthotics
17:55 The Need for Individualized Orthotic Solutions
23:40 Predicting Patient Responses to Foot Orthotics
29:56 Clinical Approaches to Orthotic Prescription
36:15 Patient-Centered Care in Orthotic Treatment
42:26 Understanding Neurodivergence in Patient Management
46:52 The Importance of Task-Specific Orthotic Design
51:14 Casting Techniques and Their Impact on Orthotic Effectiveness
55:35 The Future of 3D Printing in Orthotic Design
59:32 Navigating Clinical Experimentation and Patient Communication
01:03:16 Ethics in Custom Orthotic Prescriptions
01:07:47 The Role of Prefabricated Orthotics in Treatment
01:13:38 Long-Term Use of Foot Orthotics: When Is It Necessary?
01:18:21 Embracing Uncertainty in Clinical Practice
01:23:04 The Need for Continued Research in Foot Orthotics
In this episode of the Foot and Ankle podcast, host Alex Murray talks with Professor Gabriel Moisan to explore the complexities of custom foot orthotics and the underlying research.
They discuss the mechanisms of how orthotics work, the variability in patient responses, and the importance of individualized treatment plans. Gabriel shares insights from his clinical practice, emphasizing the need for a bottom-up approach in research, figuring out the how and why foot orthoses work, before if they work clinically for specific conditions and patient and the potential for predicting patient responses to orthotics.
They also delve into the complexities of foot orthotic design and management, particularly:
- Individualised orthoses prescription based on the condition, patient population and task to inform the design,
- The importance and impact of casting techniques,
- The balance between prefabricated and custom solutions,
- The evolving role of technology such as 3D printing.
- The lack of research to guide the complete orthotic prescription and therefore
- The need to customise the device after prescription to find the optimum prescription for each patient
You can find Gabriel Moisan and his work here:
https://www.researchgate.net/profile/Gabriel-Moisan
https://www.linkedin.com/in/gabriel-moisan-a382aaa7/
Chapters
00:00 Introduction to the episode
03:14 Gabriel Moisan's Journey in Podiatry
05:15 Understanding the Mechanisms of Foot Orthotics
10:05 Variability in Patient Responses to Orthotics
17:55 The Need for Individualized Orthotic Solutions
23:40 Predicting Patient Responses to Foot Orthotics
29:56 Clinical Approaches to Orthotic Prescription
36:15 Patient-Centered Care in Orthotic Treatment
42:26 Understanding Neurodivergence in Patient Management
46:52 The Importance of Task-Specific Orthotic Design
51:14 Casting Techniques and Their Impact on Orthotic Effectiveness
55:35 The Future of 3D Printing in Orthotic Design
59:32 Navigating Clinical Experimentation and Patient Communication
01:03:16 Ethics in Custom Orthotic Prescriptions
01:07:47 The Role of Prefabricated Orthotics in Treatment
01:13:38 Long-Term Use of Foot Orthotics: When Is It Necessary?
01:18:21 Embracing Uncertainty in Clinical Practice
01:23:04 The Need for Continued Research in Foot Orthotics
Previous Episode
Diagnosing and treating the collapsing flatfoot with Dr Doug Richie
Alex is joined by Dr Doug Richie, Podiatrist and Surgeon from Los Angeles and the inventor of the Richie Brace, an ankle foot orthoses.
They talk about everything collapsing flatfoot including:
- The latest clinical name Progressive Collapsing Flatfoot Deformity (replacing adult acquired flatfoot deformity and posterior tibial tendon dysfunction) and what this means for our understanding of the condition.
- The difference between the collapsing flatfoot and posterior tibial tendon pathology
- Diagnosis, clinical tests and communicating the condition to patients
- Treatment, including why we need to aggressively manage people as early as possible
- Discuss Doug's clinical experience as both a physician and surgeon
A perfect accompaniment to our previous episode with Dr Peter Malliaras discussing Posterior Tibial Tendinopathy.
About Douh:
Dr. Richie is a Clinical Associate Professor at the California School of Podiatric Medicine. He has authored many original articles published in peer-reviewed medical journals as well as several chapters in respected textbooks of foot and ankle surgery. Dr. Richie recently published his own textbook titled Pathomechanics of Common Foot Disorders which is available at https://link.springer.com/book/10.1007/978-3-030-54201-6. Dr. Richie is a Fellow and Past President of the American Academy of Podiatric Sports Medicine and is a Fellow of the American College of Foot and Ankle Surgeons. Dr. Richie designed and launched the Richie Brace(R) line of custom ankle-foot orthoses in 1996 which are now distributed in seven countries around the world.
You can follow Alex and the podcast on facebook and instagram
@therehabpodiatrist
If you like this episode you’ll love
Episode Comments
Generate a badge
Get a badge for your website that links back to this episode
<a href="https://goodpods.com/podcasts/the-foot-and-ankle-podcast-406500/evidence-for-custom-foot-orthoses-in-clinical-practice-with-prof-gabri-79308251"> <img src="https://storage.googleapis.com/goodpods-images-bucket/badges/generic-badge-1.svg" alt="listen to evidence for custom foot orthoses in clinical practice with prof gabriel moisan on goodpods" style="width: 225px" /> </a>
Copy