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Purpose: This study aimed to examine the evidence for flatfoot intervention in children with gross motor delay of neurological origin, and to understand how physical therapists use foot orthoses (FOs) to treat this population.
Methods: Thirty-four physical therapists employed in Canadian publicly funded pediatric centers were surveyed to explore current practices and beliefs related to FOs.
Results: Responses are discussed in the context of the research literature. Objective physical examination and differentiation between developmental and pathological flatfeet can help clinicians to identify suitable FO candidates, monitor foot posture over time, and evaluate treatment effectiveness.
Conclusions: An evidence-informed approach to assessment and intervention has the potential to improve clinical outcomes for clients with pediatric flatfoot.
Effects of Custom-Made Rigid Foot Orthosis on
Pes Planus in Children Over 6 Years Old
Soo-Kyung Bok, MD, Bong-Ok Kim, MD, Jun-Ho Lim, MD, So-Young Ahn, MD Ann Rehabil Med 2014;38(3):369-375
Objective To identify the effects of a custom-made rigid foot orthosis (RFO) in children over six years old with pes
Methods The medical records of 39 children (mean age, 10.3±4.09 years) diagnosed with pes planus, fitted with
RFOs, and had who more than two consecutive radiological studies were reviewed. The resting calcaneal stance
position (RCSP), anteroposterior talocalcaneal angle (APTCA), lateral talocalcaneal angle (LTTCA), the lateral
talometatarsal angle (LTTMA), and calcaneal pitch (CP) of both feet were measured to evaluate foot alignment.
After diagnosis, children were fitted with a pair of RFOs and recommended to walk with heel strike and reciprocal
arm swing to normalize the gait pattern. A follow-up clinical evaluation with radiological measurements was
performed after 12–18 months and after 24 months of RFO application. Post-hoc analysis was used to test for
significant differences between the radiological indicators and RCSP.
Results With RFOs, all radiological indicators changed in the corrective direction except LTTCA. RCSP and
CP in the third measurement showed significant improvement in comparison with the second and baseline
measurements. Additionally, APTCA and LTTMA revealed improvements at the third measurement versus the
Conclusion This study revealed that radiological indicators improved significantly after 24 months of RFO
application. A prospective long-term controlled study with radiographical evaluation is necessary to confirm the
therapeutic effects of RFOs and to determine the optimal duration of wear in children with pes planus.