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 patientYou can find Gabriel Moisan and his work here:https://www.researchgate.net/profile/Gabriel-Moisanhttps://www.linkedin.com/in/gabriel-moisan-a382aaa7/Chapters00:00 Introduction to the episode03:14 Gabriel Moisan's Journey in Podiatry05:15 Understanding the Mechanisms of Foot Orthotics10:05 Variability in Patient Responses to Orthotics17:55 The Need for Individualized Orthotic Solutions23:40 Predicting Patient Responses to Foot Orthotics29:56 Clinical Approaches to Orthotic Prescription36:15 Patient-Centered Care in Orthotic Treatment42:26 Understanding Neurodivergence in Patient Management46:52 The Importance of Task-Specific Orthotic Design51:14 Casting Techniques and Their Impact on Orthotic Effectiveness55:35 The Future of 3D Printing in Orthotic Design59:32 Navigating Clinical Experimentation and Patient Communication01:03:16 Ethics in Custom Orthotic Prescriptions01:07:47 The Role of Prefabricated Orthotics in Treatment01:13:38 Long-Term Use of Foot Orthotics: When Is It Necessary?01:18:21 Embracing Uncertainty in Clinical Practice01:23:04 The Need for Continued Research in Foot Orthotics

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