Effects of Custom-Made Rigid Foot Orthosis on Pes Planus in Children Over 6 Years Old

Abstract

ObjectiveTo identify the effects of a custom-made rigid foot orthosis (RFO) in children over six years old with pes planus.MethodsThe 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.ResultsWith 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 baseline measurements.ConclusionThis 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.

Pediatric Pes Planus: A State-of-the-Art Review

“…After 2-year follow-up, multiple radiographic measurements had improved, suggesting development of the medial longitudinal arch. 39 However, this study lacked both a control group and clinical assessments to evaluate any improved function of the feet. It still remains to be proven whether orthotic use can change the natural course of flatfoot in any pediatric age group.…”

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)"

“…However, this review was based on only three randomised control trials (Powell et al 2005;Wenger et al 1989;Whitford & Esterman 2007), with only one of the studies using a symptomatic population. Indeed, much of the research on the use of FOs for flexible pes planus in children, to date, has been focussed on non-symptomatic populations Manuscript to be reviewed (Aboutorabi et al 2014;Bleck & Berzins 1977;Bok et al 2014;Bordelon & Lusskin 1980;Capasso 1993;Riccio et al 2009;Valmassy & Terrafranca 1986). The findings of this research demonstrate that it is the presenting symptoms of a child with flexible pes planus that guide the podiatrists' decision to intervene along with clinical signs of the condition (observations and measurements).…”

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.…”