An investigation of the factors affecting flatfoot in children with delayed motor development

Chen, Kun Chung; Tung, Li Chen; Tung, Chien Hung; Yeh, Chih Jung; Yang, Jeng-Feng; Wang, Chun Hou

doi:10.1016/j.ridd.2013.12.012

Cited by 39 publications

(33 citation statements)

References 29 publications

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“…While paediatric flexible pes planus is common, affecting around 48% to 77.9% children [ 6 – 8 ] there is ambiguity in terms of its definition, diagnosis and management strategies. The prevalence estimates of flat feet within the literature, whilst inconsistent, suggests that it is more frequently seen in younger children, males and those who are overweight or obese [ 7 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Some studies have highlighted that treatment may be unnecessary, suggesting asymptomatic flatfeet do not decrease motor ability, sports performance or cause disability [ 3 , 10 , 13 ]. Conversely, other researchers suggest that paediatric flexible pes planus can cause pain, abnormal gait, poor balance, motor dysfunction and activity withdrawal thus justifying intervention [ 1 , 7 , 14 ]. Furthermore, as symptoms may continue into adulthood, podiatric management may be required [ 1 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

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The effectiveness of non-surgical intervention (Foot Orthoses) for paediatric flexible pes planus: A systematic review: Update

et al. 2018

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BackgroundFlexible pes planus (flat feet) in children is a common presenting condition in clinical practice due to concerns amongst parents and caregivers. While Foot Orthoses (FOs) are a popular intervention, their effectiveness remains unclear. Thus, the aim of this systematic review was to update the current evidence base for the effectiveness of FOs for paediatric flexible pes planus.MethodsA systematic search of electronic databases (Cochrane, Medline, AMED, EMBASE, CINHAL, SportDiscus, Scopus and PEDro) was conducted from January 2011 to July 2017. Studies of children (0–18 years) diagnosed with flexible pes planus and intervention to be any type of Foot Orthoses (FOs) were included. This review was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. McMaster critical review form for quantitative studies, was used to assess the methodological quality of the included studies. Given the heterogeneity of the included studies, a descriptive synthesis of the included studies was undertaken.ResultsOut of 606 articles identified, 11 studies (three RCTs; two case-controls; five case-series and one single case study) met the inclusion criteria. A diverse range of pre-fabricated and customised FOs were utilised and effectiveness measured through a plethora of outcomes. Summarised findings from the heterogeneous evidence base indicated that FOs may have a positive impact across a range of outcomes including pain, foot posture, gait, function and structural and kinetic measures. Despite these consistent positive outcomes reported in several studies, the current evidence base lacks clarity and uniformity in terms of diagnostic criteria, interventions delivered and outcomes measured for paediatric flexible pes planus.ConclusionThere continues to remain uncertainty on the effectiveness of FOs for paediatric flexible pes planus. Despite a number of methodological limitations, FOs show potential as a treatment method for children with flexible pes planus.PROSPERO registration numberCRD42017057310.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effectiveness of non-surgical intervention (Foot Orthoses) for paediatric flexible pes planus: A systematic review: Update

et al. 2018

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“…It is distinct from rigid pes planus, a congenital, rigid or spastic deformity of the foot, affecting less than 1% of the population and often requiring surgical management ( Harris et al, 2004 ; Rome, Ashford & Evans, 2010 ; WHO, 2016 ). Prevalence of paediatric pes planus ranges from 48.5% to 77.9% in children aged 2–16 years ( Chen et al, 2014 ; Evans & Rome, 2011 ; Halabchi et al, 2013 ), reducing to only 2–23% in the adult population ( Dunn et al, 2004 ; Golightly et al, 2012 ; Kosashvili et al, 2008 ). The larger prevalence observed in children can be explained by many factors, including age appropriate ligament laxity, and advancing maturation of neuromuscular control ( Lin et al, 2001 ; Pfeiffer et al, 2006 ; Stavlas et al, 2005 ; Uden, Scharfbillig & Causby, 2017 ), with most of the arch ‘flatness’ reducing over the first decade of life ( El et al, 2006 ; Rome, Ashford & Evans, 2010 ; Stavlas et al, 2005 ).…”

Section: Introductionmentioning

confidence: 99%

When, why and how foot orthoses (FOs) should be prescribed for children with flexible pes planus: a Delphi survey of podiatrists

Dars

Uden

Kumar

et al. 2018

PeerJ

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BackgroundFlexible pes planus (flat feet) in children is a common reason parents and caregivers seek health professionals consult and a frequent reason podiatrists prescribe foot orthoses. Yet no universal agreement exists on the diagnosis of this condition, or when and how foot orthoses should be prescribed. The aim of this study was to garner consensus and agreement among podiatrists on the use of FOs for paediatric flexible pes planus.MethodsA three round Delphi consensus survey was undertaken with 15 podiatry experts from Australia, New Zealand and the United Kingdom. Round One gathered consensus on the diagnosis and intervention into paediatric pes planus with specific questions on types of FOs and prescription variables used. Round Two and Three were based on answers from Round One and gathered agreement (rationale for choices) on a five point Likert scale. 70% of respondents had to agree to a statement for it to be accepted as consensus or agreement.ResultsConsensus and agreement was achieved for 83 statements directing the diagnosis of pes planus (using FPI-6 and/or rearfoot measures), common signs and symptoms (e.g., pain, fatigue, abnormal gait and other functional concerns) that direct when to intervene into paediatric flexible pes planus. Prefabricated orthoses were the preferred intervention where adequate control is gained with their use. When customised orthoses are prescribed, a vertical [heel] cast pour (71.4%) and minimal arch fill (76.9%) are the prescription variables of choice, plus or minus additional variables (i.e., medial heel (Kirby) skive, the use of a University of California Biomechanical Laboratory device or a medial flange) dependent on level of disorder and plane of excessive motion.ConclusionsThis study identified consensus and agreement on a series of diagnosis methods and interventions for the paediatric flexible pes planus. A clinical protocol was developed from the resultant consensus statements which provides clinicians with a series of evidenced-informed statements to better guide them on when, how and why FOs are used specific to this population.

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“…It is distinct from rigid pes planus, a congenital, rigid or spastic deformity of the foot, affecting less than 1% of the population and often requiring surgical management (Harris et al 2004; Rome et al 2010;WHO 2016). Prevalence of paediatric pes planus ranges from 48.5% to 77.9% in children aged 2-16 years (Chen et al 2014;Evans & Rome 2011;Halabchi et al 2013), reducing to only 2-23% in the adult population (Dunn et al 2004;Golightly et al 2012;Kosashvili et al 2008). The larger prevalence observed in children can be explained by many factors, including age appropriate ligament laxity, and advancing maturation of neuromuscular control (Lin et al 2001;Pfeiffer et al 2006;Stavlas et al 2005;Uden et al 2017), with most of the arch 'flatness' reducing over the first decade of life (El et al 2006;Rome et al 2010;Stavlas et al 2005).…”

Section: Introductionmentioning

confidence: 99%

Peer Review #2 of "When, why and how foot orthoses (FOs) should be prescribed for children with flexible pes planus: a Delphi survey of podiatrists (v0.1)"

David¹

2018

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Background: Flexible pes planus (flat feet) in children is a common reason parents and caregivers seek health professionals consult and a frequent reason podiatrists prescribe foot orthoses. Yet no universal agreement exists on the diagnosis of this condition, or when and how foot orthoses should be prescribed. The aim of this study was to garner consensus and agreement among podiatrists on the use of FOs for paediatric flexible pes planus. Methods: A three round Delphi consensus survey was undertaken with 15 podiatry experts from Australia, New Zealand and the United Kingdom. Round one gathered consensus on the diagnosis and intervention into paediatric pes planus with specific questions on types of FOs and prescription variables used. Round two and three were based on answers from Round one and gathered agreement (rationale for choices) on a five point Likert scale. 70% of respondents had to agree to a statement for it to be accepted as consensus or agreement. Results: Consensus and agreement was achieved for 83 statements directing the diagnosis of pes planus (using FPI-6 and/or rearfoot measures), common signs and symptoms (e.g. pain, fatigue, abnormal gait and other functional concerns) that direct when to intervene into paediatric flexible pes planus. Prefabricated orthoses were the preferred intervention where adequate control is gained with their use. When customised orthoses are prescribed, a vertical [heel] cast pour (71.4%) and minimal arch fill (76.9%) are the prescription variables of choice, plus or minus additional variables (i.e. medial heel (Kirby) skive, the use of a University of California Biomechanical Laboratory device or a medial flange) dependent on level of disorder and plane of excessive motion. Conclusions: This study identified consensus and agreement on a series of diagnosis methods and interventions for the paediatric flexible pes planus. A clinical protocol was developed from the resultant consensus statements which provides clinicians with a series of evidenced-informed statements to better guide them on the when, how and why FOs are used specific to this population.

show abstract

An investigation of the factors affecting flatfoot in children with delayed motor development

Cited by 39 publications

References 29 publications

The effectiveness of non-surgical intervention (Foot Orthoses) for paediatric flexible pes planus: A systematic review: Update

The effectiveness of non-surgical intervention (Foot Orthoses) for paediatric flexible pes planus: A systematic review: Update

When, why and how foot orthoses (FOs) should be prescribed for children with flexible pes planus: a Delphi survey of podiatrists

Peer Review #2 of "When, why and how foot orthoses (FOs) should be prescribed for children with flexible pes planus: a Delphi survey of podiatrists (v0.1)"

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