Thursday, July 31, 2008

Chi Running

Chi running is a "movement" within the running community based a particular running technique based mostly on being more efficient, relaxed and having a midfoot strike. I initially dismissed it as just another one of those fads until I noticed that one of the key Chi running websites had an alliance with New Balance running shoes and they have a shoe that is specific for Chi Running. I wonder where this will go? Will the Pose Running converts get a shoe as well? Chi running is not without controversy, mostly due to the lack of evidence for the claims made by its supporters. I have also written before about Chi Running.

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Wednesday, July 16, 2008

Research on one foot, two feet, or one person

I have recently reviewed several manuscripts that I recommended that editors not publish due to a fundamental flaw in the methodology. It concerned me enough to post a thread here about it (and will freely admit that I have been guilty of this in the past, but times change as we learn more).

One potentially appealing thing about doing foot or podiatry research is that each subject has two feet, meaning that if you use both feet in the data, you have either doubled your sample size or halved the number of subjects used.

HOWEVER, a key assumption of almost all statistical tests is that the subjects in the sample are independent of each other ..... this means that you can not use two feet from the same person in the sample as they are related (not independent of each other; they are paired) - they have the same body weight; the same blood supply; etc etc ...

The use of the two feet of one subject is no longer acceptable in research due to this lack of independence. This is a common issue in the opthalmologic literature (two eyes or one eye?); the orthopaedic literature (two limbs or one?); the rheumatological literature (eg one knee or two):
"SUTTON et al. Two knees or one person: data analysis strategies for paired joints or organs Ann Rheum Dis.1997; 56: 401-402"

Hylton Menz brought this to our attention in the podiatric literature:
"H . Menz: Two feet, or one person? Problems associated with statistical analysis of paired data in foot and ankle medicine . The Foot , Volume 14 , Issue 1 , Pages 2 - 5, 2004"

Why are researchers still using both feet; still submitting the data for publication using both feet in the analysis; and why are journal editors still permitting them to be published (esp in podiatric journals)?

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Monday, July 14, 2008

Hubscher manoeuvre

There has been some good discussion at Podiatry Arena on the Hubscher maneuver (terminology primarily used in the USA) or Jacks Test (used by the rest of the world!). A poll in that thread showed that 82% of those that responded to the poll used it as a clinical test.

A lot of the discussion focused on it value as a static clinical test used to predict dynamic function and, more important, as a tool that may or may not predict the clinical response to foot orthoses. IMHO, the Hubscher maneuver or Jacks test does have clinical use. When you do this test on different people they respond differently .... that has got to mean something for the way the function! At the end of the day, the disagreements are about what we think it means.

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