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