Ann Rehabil Med.  2014 Jun;38(3):369-375. 10.5535/arm.2014.38.3.369.

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

• Bok SK
• Kim BO
• Lim JH
• Ahn SY

• KMID: 2165755
• DOI: http://doi.org/10.5535/arm.2014.38.3.369

Abstract

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

Keyword

Foot orthoses; Flatfoot

MeSH Terms

Arm
Child*
Diagnosis
Flatfoot*
Follow-Up Studies
Foot
Foot Orthoses*
Gait
Heel
Humans
Medical Records
Strikes, Employee

Figure

• 

  Fig. 1 Anterioposterior view and lateral view of both feet. ①, Anteroposterior talocalcaneal angle; ②, lateral talocalcaneal angle; ③, lateral talometatarsal angle; ④, calcaneal pitch.

• 

  Fig. 2 Serial change in values of anteroposterior talocalcaneal angle (APTCA, A), lateral talocalcaneal angle (LTTCA, B), lateral talometatarsal angle (LTTMA, C), calcaneal pitch (CP, D), and resting calcaneal stance position (RCSP, E).*p<0.05.

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