Kevin Kirby, DPM is one of the most
knowledgeable people in the world when it comes
to research related to foot orthotic therapy. It
comes as no surprise to me that he was kind
enough to take the time to post a letter in the
4-30-12 issue of PM News in order to highlight a
study examining the efficacy of foot orthoses in
the treatment of patellofemoral pain syndrome in
an effort help educate his colleagues and
others. The objective of this study outlined by
Dr. Kirby was simply to investigate the short-
term clinical efficacy of three pre-fabricated
orthoses as compared to a “wait-and-see”
approach to treatment.
In the very next issue of PM News, there were
two letters questioning the methodology of the
study. Obviously the study was not designed to
compare custom manufactured, prescription
orthoses to the practitioner/researcher selected
prefabricated devices that were utilized in the
study. Perhaps a follow-up study comparing
different types or brands of pre-fabricated
orthoses to one another and comparing the
difference between some pre-fabricated and some
custom manufactured (Rx) orthoses might yield
valuable information. Clearly that was not the
objective of this study.
Like it or not, we must all accept the
limitations of the research environment. For
example, we can’t conclude that all pre-
fabricated orthoses would be as effective in the
treatment of anterior knee pain as those used in
this study. Nor can we assume that other
individuals with the same condition would
achieve the same level of symptom relief had
they opted for self treatment with pre-
fabricated orthoses or had they chosen to seek
orthotic therapy from other providers of pre-
fabricated foot orthoses. I appreciated Dr.
Kirby bringing this interesting study to the
attention of others and I look forward to
reading his response on this topic.
Mr. Jeff Root, President, Root Lab, Inc.,
jroot@root-lab.com
