Medial Arch Orthosis for Paediatric Flatfoot

Abstract

purpose. To evaluate any correlation between various foot angles and their respective American Orthopaedic Foot and Ankle Society (AOFAS) scores for pain, and the effectiveness of a medial arch orthosis. Methods. 81 children with bilateral symptomatic flatfoot were randomised into orthosis (n=55) and control (n=26) groups. The orthosis group consisted of 33 male and 22 female patients aged 36 to 204 (mean, 99) months and they were given a medial arch support. The control group consisted of 15 male and 11 female patients aged 36 to 192 (mean, 100) months and they were managed with analgesics. Foot angles including anteroposterior (AP) and lateral talocalcaneal (TC) angles, AP and lateral talofirst metatarsal (TFM) angles, calcaneal pitch angle (in lateral plane), and talonavicular (TN) angle were measured, as were AOFAS scores for pain for the forefoot, midfoot, and hindfoot. improved significantly. In the controls, all AOFAS scores (except for the midfoot score) and only the AP-TFM angle improved significantly. In the orthosis group, the AOFAS hindfoot score correlated positively with the lateral TC angle of the left foot (r=0.345, p=0.010) and negatively with the calcaneal pitch angle of the right foot (r=-0.33, p=0.015). In the control group, the lateral TFM angle of the left foot correlated negatively with the AOFAS forefoot (r=-0.566, p=0.003) and midfoot scores (r=-0.497, p=0.001), whereas the calcaneal pitch angle of the left foot correlated positively with the AOFAS forefoot score (r=0.497, p=0.010). conclusion. Medial arch support orthosis significantly improved AOFAS scores and foot angles. Calcaneal pitch angle and lateral TC angle correlated well with AOFAS hindfoot scores.

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

“…As per NHMRC levels of evidence, three studies were rated as Level II (RCTs) [ 28 – 30 ], two studies as level III-2 (Case-controls) [ 31 , 32 ] and six studies were rated level IV (five case-series [ 33 – 37 ] and one single case study [ 38 ]). The main methodological concerns amongst the included studies were: lack of justification of the sample size (only one study did the power calculation [ 36 ]); lack of clear diagnostic criteria on how pes planus was diagnosed (only five studies cited their criteria for diagnosis [ 30 , 32 , 35 – 37 ]); lack of psychometrically robust outcome measures [OMs] (validity and reliability recorded in one study [ 35 ] and four studies reporting validity only [ 29 , 31 , 33 , 38 ]); lack of detailed descriptions regarding intervention (only six studies provided adequate description of the FOs used [ 33 – 38 ]); and lack of reporting of clinical significance (only two studies included the effect sizes [ 36 , 37 ]). Furthermore, the method of randomisation was not mentioned within the three RCTs and two studies failed to adequately detail the ethics approval and participants’ consent [ 9 , 13 ].…”

“…A range of research designs, with participants from various countries were identified for this systematic review. The studies were conducted in Korea [ 29 , 33 – 35 ], India [ 28 , 30 ], Iran [ 32 , 36 , 37 ], China [ 38 ] and Poland [ 31 ], published between January 2011 and July 2017.…”

“…Three studies used more than one type of FOs [ 30 , 35 , 38 ], two of those comparing the same orthoses with different levels of customisation [ 35 , 38 ]. Only six studies identified the arch height of the orthoses making it easier to be replicated in clinical practice [ 33 – 38 ], with one study outlining the arch height to be dependent on participant’s age and foot size but no criteria were given to be followed [ 29 ]. The arch heights used across studies ranged from 25mm to 33mm.…”

Eficacia del tratamiento conservador ortésico en el pie plano flexible infantil

“…o Boks y cols. [48][49][50] . Esta reducción fue significativamente mayor en las OE y OR que en la OP, probablemente debido a los conservadores 5-6°de inversión de la OP.…”

Effect of A Navicular Support Foot Orthosis on Resting Calcaneal Standing Position Angle and Navicular Height in Flat Foot Children

“…Most of the studies were on the medial arch support rather than on the Blake internal foot assist. As part of a research project to develop foot orthoses to relieve symptoms, Sinha et al [8] measured pain in the forefoot, midfoot, and hindfoot of 81 children with bilateral pes planus after wearing a medial longitudinal arch support, and Robert et al [9] examined 22 subjects (6 to 57 years old) with pes planus who were wearing custom foot orthoses. They noted the changes in the lateral talocalcaneal angle during their X-ray imaging assessment of the effect of a medial longitudinal arch support on flexible pes planus.…”