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Shahabi S, Bagheri Lankarani K, Hoseeinabadi M, Heydari ST. Methodological and reporting quality of qualitative evidence in the field of lower limb orthoses: a systematic review. Assist Technol 2023; 35:532-550. [PMID: 37058228 DOI: 10.1080/10400435.2023.2199056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2023] [Indexed: 04/15/2023] Open
Abstract
This study aimed to assess the methodological and reporting quality of qualitative studies conducted in the field of lower limb orthoses (LLOs). The following electronic databases were searched from inception to 2022: PubMed, Scopus, ProQuest, WoS, Embase, the Cochrane Central Register of Controlled Trials, and RehabData. Two authors independently screened and selected the potential studies. The methodological quality of included studies was assessed using the Critical Appraisal Skills Programs qualitative checklist. In addition, the reporting quality of included studies was assessed using the Standards for Reporting Qualitative Research (SRQR) tool. The mean methodological quality score of included studies was 8 (from min = 2 to max = 9.5), and most of the studies had a score of more than 7.5. However, SRQR findings revealed that the overall reporting quality of included studies was not desirable in that the mean score was about 15.44 (from min = 6 to max = 19.5) out of 21. In total, the methodological quality of qualitative studies published in the field of LLOs was moderate. Further, the adherence of these studies to available reporting guidelines was unsatisfactory. As a result, when designing, performing, and reporting qualitative investigations, authors should pay more attention to these criteria.
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Affiliation(s)
- Saeed Shahabi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mostafa Hoseeinabadi
- Rehabilitation Research Center, Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Taghi Heydari
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Donnan L, Horn A, Baker E. A cross-sectional analysis of podiatrist-initiated review processes after issuing prescribed foot orthoses. PLoS One 2022; 17:e0276716. [PMID: 36315556 PMCID: PMC9621403 DOI: 10.1371/journal.pone.0276716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/11/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Foot orthoses are widely used in clinical practice to treat foot, lower limb and back pathology. As published information guiding the clinical use of foot orthoses is scarce, the aim of this study is to profile the review processes used by practicing podiatrists after issuing an orthotic device. METHODS A cross-sectional observational study design formed the basis for a self-administered online questionnaire. The questionnaire was distributed through podiatry networks based in Australia. RESULTS Two-hundred and thirty-eight practicing podiatrists participated in this study. Ninety-seven percent of respondents indicated that they would recommend a review appointment after the initial fitting of an orthotic device. Forty percent (n = 84) of respondents scheduled the first review appointment four weeks after the initial fitting, while 33% (n = 69) preferred a two-week review period. A second review consultation was standard practice for 32% (n = 68) or respondents, and were typically scheduled either two (23%, n = 12) or four (38%, n = 20) weeks after the initial review consultation. Annual review of orthotic devices was recommended by 64% (n = 123) of participants in the study, while 19% (n = 37) would suggest that yearly reviews were scheduled only if required. CONCLUSIONS Variation was identified in the orthotic review processes used by practicing podiatrists, although most respondents recommend a routine short-term review appointment for foot orthoses. It is not clear why practitioners adopt such varied approaches. In the absence of any clear evidence on this topic, it may be that the differing approaches to patient review reflect different philosophical perspectives regarding patient management.
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Affiliation(s)
- Luke Donnan
- School of Allied Health, Exercise and Sports Sciences, Faculty of Science and Health, Charles Sturt University, Albury, New South Wales, Australia
- * E-mail:
| | - Anna Horn
- School of Allied Health, Exercise and Sports Sciences, Faculty of Science and Health, Charles Sturt University, Albury, New South Wales, Australia
| | - Emma Baker
- School of Allied Health, Exercise and Sports Sciences, Faculty of Science and Health, Charles Sturt University, Albury, New South Wales, Australia
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Understanding the role of foot biomechanics on regional foot orthosis deformation in flatfoot individuals during walking. Gait Posture 2022; 91:117-125. [PMID: 34673447 DOI: 10.1016/j.gaitpost.2021.10.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 10/04/2021] [Accepted: 10/07/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Foot orthoses (FOs) are one of the most common interventions to restore normal foot mechanics in flatfoot individuals. New technologies have made it possible to deliver customized FOs with complex designs for potentially better functionalities. However, translating the individuals' biomechanical needs into the design of customized FOs is not yet fully understood. RESEARCH QUESTION Our objective was to identify whether the deformation of customized FOs is related to foot kinematics and plantar pressure during walking. METHODS The kinematics of multi-segment foot and FOs contour were recorded together with plantar pressure in 17 flatfoot individuals while walking with customized FOs. The deformation of FOs surface was predicted from its contour kinematics using an artificial neural network. Plantar pressure map and deformation were divided into five anatomically based regions defined by the corresponding foot segments. Forward stepwise linear mixed models were built for each of the four gait phases to determine the feet-FOs interaction. RESULTS It was observed that some associations existed between foot kinematics and pressure with regional FOs deformation. From heel-strike to foot-flat, longitudinal arch angle was associated with FOs deformation in forefoot. From foot-flat to midstance, rearfoot eversion accounted for variation in the deformation of medial FOs regions, and forefoot abduction for the lateral regions. From midstance to heel-off, rearfoot eversion, longitudinal arch angle, and plantar pressure played significant role in deformation. Finally, from heel-off to toe-off, forefoot adduction affected the deformation of forefoot and midfoot. SIGNIFICANCE This study provides guidelines for designing customized FOs. Flatfoot individuals with excessive rearfoot eversion or very flexible medial arches require more support on medial FOs regions, while the ones with excessive forefoot abduction need the support on lateral regions. However, a compromise should be made between the level of support and the level of increase in plantar pressure to avoid stress on foot structures.
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Deschamps K, Nester C, Newton V, Gijon-Nogueron G, Simsek E, Brabants A. The biopsychosocial-digital continuum of foot orthosis practice and research: the VALUATOR model. J Foot Ankle Res 2021; 14:25. [PMID: 33789716 PMCID: PMC8011079 DOI: 10.1186/s13047-021-00468-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 03/22/2021] [Indexed: 02/05/2023] Open
Abstract
Foot orthoses have been used for decades despite uncertainty surrunding their therapeutic efficacy. Orthoses have been used exclusively to affect neuro-biomechanical input and outcome variables, however, there is emerging evidence that therapeutic efficacy may be affected by a psychological stimulus. Critical appraisal of the literature highlights that there is no holistic model upon which foot orthosis practice is taught, practised nor investigated. This paper introduces a conceptual model of foot orthosis practice (Value Based Foot Orthosis Practice (VALUATOR) model) that embraces a broader range of factors that are pertinent to orthosis practice, incorporating contemporary health service behaviours and values into orthosis practice for the first time.Within the VALUATOR model, foot orthosis design and clinical value is considered along a bio-psycho-social-digital continuum that reflects the reality of foot orthosis practice. The model contextualises the variable outcomes that are observed in research and practice within 6 key areas: 1) value, 2) person-centered approach, 3) zone of optimal bio-psycho-social stress, 4) bio-psycho-social assessment, 5) monitoring, 6) primary and secondary clinical strategies.The VALUATOR model is targeted at students, lecturers, scientists and practitioners and includes carefully chosen terminology to support a robust basis for educational and scientific discussion. It is believed that it provides a contemporary viewpoint and a structured conceptual metaphor that builds on existing evidence from a wide range of sources, invites constructive intellectual debate, and is anchored in the experiences of practitioners too. Stress testing the VALUATOR model will help determine its model and support further developments and evolution of orthotic practice in a evidence based way.
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Affiliation(s)
- Kevin Deschamps
- Department of Podiatry, Artevelde University of Applied Sciences, Ghent, Belgium
- KULeuven- Department of Rehabilitation Sciences- Musculoskeletal Rehabilitation, Research Group, Campus Brugge, Spoorwegstraat 12, 8200 Brugge, Belgium
- Haute Ecole Leonard De Vinci, Institut D’Enseignement Supérieur Parnasse Deux-Alice, Division of Podiatry, Bruxelles, Belgium
| | - Chris Nester
- School of Health & Society, Brian Blatchford Building, Frederick Road Campus, University of Salford, Salford, M6 6PU UK
| | - Veronica Newton
- School of Health & Society, Brian Blatchford Building, Frederick Road Campus, University of Salford, Salford, M6 6PU UK
| | | | - Engin Simsek
- School of Physical Therapy and Rehabilitation Sciences, Dokuz Eylul University, İzmir, Turkey
| | - Antoine Brabants
- Haute Ecole Leonard De Vinci, Institut D’Enseignement Supérieur Parnasse Deux-Alice, Division of Podiatry, Bruxelles, Belgium
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5
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Deschamps K, Brabants A, Nester C, Gijon-Nogueron G, Simşek E, Newton V. A conceptual framework for contemporary professional foot care practice: ''The value based digital foot care framework''. J Foot Ankle Res 2021; 14:22. [PMID: 33766061 PMCID: PMC7992509 DOI: 10.1186/s13047-021-00465-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 03/16/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND A small minority of countries around the globe have podiatry as a recognized profession, hence, there are considerable differences among these countries when it comes to the curricula, the duration of training and legislation regulating the profession. The growth in research led evidence based practice, and the emerging digital landscape of health care practice, occur alongside trends in disease and health behaviours that strongly impact on foot health. As such, the changing complex role of the podiatrist requires critical reflection on current frameworks of practice and whether they are fit for purpose. This commentary presents a conceptual framework which sets the scene for further development of concepts in a podiatry context, reflecting contemporary health care beliefs and the changing expectations of health care and society. The proposed conceptual framework for podiatry practice utilizes the metaphor of an electronic circuit to reflect the vast and complex interconnections between factors that affect practice and professional behaviours. The framework helps in portraying and defining drivers of practice, actual practice as well potential barriers for current and future practice. The circuit emphasis the interconnectedness/interaction of three clusters: 1) internal factors, 2) interaction factors, 3) external factors. CONCLUSION Whatever promise this new framework holds, it will only be realised through conscious development of community consensus, respectful dialogue, constructive critical appraisal, and maintaining passion and focus on improving the health of people with foot related problems.
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Affiliation(s)
- Kevin Deschamps
- Department of Podiatry, Artevelde University of Applied Sciences, Ghent, Belgium. .,KULeuven-Department of Rehabilitation Sciences- Musculoskeletal Rehabilitation Research Group, Campus Brugge, Spoorwegstraat 12, 8200, Brugge, Belgium. .,Division of Podiatry, Haute Ecole Leonard De Vinci, Bruxelles, Belgium.
| | - Antoine Brabants
- Division of Podiatry, Haute Ecole Leonard De Vinci, Bruxelles, Belgium
| | - Chris Nester
- School of Health & Society,Brian Blatchford Building, Frederick Road Campus, University of Salford, M6 6PU, Salford, UK
| | | | - Engin Simşek
- School of Physical Therapy and Rehabilitation Sciences, Dokuz Eylul University, İzmir, Turkey
| | - Veronica Newton
- School of Health & Society,Brian Blatchford Building, Frederick Road Campus, University of Salford, M6 6PU, Salford, UK
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Design of a Modular Plantar Orthosis System through the Application of TRIZ Methodology Tools. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11052051] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Innovations within the medical device sector are constantly and rapidly emerging due to increasing demand, especially for orthosis systems, which usually constitute built rigids with low comfort, due mainly to the standardized production process. This article reports the design process of a plantar orthosis system from the application of Theory of Inventive Problem Solving (TRIZ) tools, known as generic parameters, matrix of contradictions, and inventive principles. The final orthosis is integrated by four modules or components (1 central and 3 movables) and customers can buy only the required ones, reducing cost in unnecessary parts. The plantar orthosis was defined based on three engineering parameters that delimited the design work by developing a customizable system that is capable of performing simultaneous functions and whose manufacture could be standardized. We identified the existence of a technical contradiction between the engineering parameters, customization, and standardization, which was solved by the inventive principles of segmentation, inversion, transition to a new dimension, and porous materials. A modular design with four components was accomplished, molds are built for each component in a machining center and injected using granulated ethylene vinyl acetate copolymer. The positions of the movable components are configured through a bolt-hole assembly mechanism to the central component, which is a flat perforated plantar base. The novelty in the design here presented is elated to supports that constitute the orthosis, which are interchangeable and adjustable to the pathological and morphological needs of each patient.
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Chapman LS, Redmond AC, Landorf KB, Rome K, Keenan AM, Waxman R, Alcacer-Pitarch B, Siddle HJ, Backhouse MR. Foot orthoses for people with rheumatoid arthritis: a survey of prescription habits among podiatrists. J Foot Ankle Res 2019; 12:7. [PMID: 30700994 PMCID: PMC6347791 DOI: 10.1186/s13047-019-0314-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 01/14/2019] [Indexed: 11/29/2022] Open
Abstract
Background Guidelines recommend foot orthoses for people with both early (< 2 years) and established rheumatoid arthritis (RA). While prefabricated foot orthoses are cheaper and can exhibit comparable effects to customised devices, the available evidence for their effectiveness is inconsistent. Little is known about what types of foot orthoses clinicians prescribe. This study describes the foot orthoses prescription habits of podiatrists for people with rheumatoid arthritis. Methods One hundred and eighty-three podiatrists from the United Kingdom (UK) (n = 88), Australia (n = 68) and New Zealand (n = 27) completed a self-administered, online survey regarding the types of foot orthoses prescribed in clinical practice for people with RA. This study forms part of a wider international survey exploring foot orthosis prescription habits. Results UK respondents were more likely to prescribe prefabricated orthoses for early RA (n = 47, 53%) and customised orthoses for established RA (n = 47, 53%). Respondents in Australia were more likely to prescribe customised orthoses for both early (n = 32, 47%) and established (n = 46, 68%) RA, whilst respondents in New Zealand were more likely to prescribe prefabricated orthoses for both early (n = 16, 59%) and established (n = 10, 37%) disease. Irrespective of disease stage, the use of foam impression boxes was more prevalent in the UK and New Zealand when capturing a model of the feet prior to manufacturing customised orthoses. In contrast, electronic scanning and plaster of Paris were more common in Australia. Computer aided manufacture was utilised more frequently among respondents in Australia than in the UK and New Zealand. Respondents in all three countries specified more flexible shell materials for established RA, compared to early disease. Cushioning top covers (e.g. PORON® or polyurethane) were most frequently specified in all countries for both disease stages. Conclusions Considerable variation was seen in the self-reported foot orthoses prescription habits of respondents for people with RA. Variation between countries and disease stage was seen in type of orthoses, specific brands, manufacturing methods, and materials prescribed. The results allow podiatrists and broader health service providers to compare their practice against reported national and international patterns. Electronic supplementary material The online version of this article (10.1186/s13047-019-0314-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lara S Chapman
- 1Department of Podiatry, Harrogate and District NHS Foundation Trust, Harrogate District Hospital, Lancaster Park Road, Harrogate, UK.,2Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Anthony C Redmond
- 2Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,3NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Karl B Landorf
- 4Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Australia.,5La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Australia
| | - Keith Rome
- 6Health and Rehabilitation Research Institute and School of Podiatry, Auckland University of Technology, Auckland, New Zealand
| | - Anne-Maree Keenan
- 3NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK.,7School of Healthcare, University of Leeds, Leeds, UK
| | - Robin Waxman
- 2Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,3NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Begonya Alcacer-Pitarch
- 2Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,3NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Heidi J Siddle
- 2Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,3NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Michael R Backhouse
- 8York Trials Unit, Department of Health Sciences, University of York, York, UK
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If It Doesn't Work, Why Do We Still Do It? The Continuing Use of Subtalar Joint Neutral Theory in the Face of Overpowering Critical Research. J Orthop Sports Phys Ther 2018; 48:130-132. [PMID: 29490602 DOI: 10.2519/jospt.2018.0604] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The use of subtalar joint neutral (STJN) in the assessment and treatment of foot-related musculoskeletal symptomology is common in daily practice and still widely taught. The main pioneer of this theory was Dr Merton L. Root, and it has been labeled with a variety of names: "the foot morphology theory," "the subtalar joint neutral theory," or simply "Rootian theory" or "Root model." The theory's core concepts still underpin a common approach to musculoskeletal assessment of the foot, as well as the consequent design of foot orthoses. The available literature continues to point to Dr Root's theory as the most prevalently utilized. Concurrently, the worth of this theory has been challenged due to its poor reliability and limited external validity. This Viewpoint reviews the main clinical areas of the STJN theory, and concludes with a possible explanation and concerns for its ongoing use. To support our view, we will discuss (1) historical inaccuracies, (2) challenges with reliability, and (3) concerns with validity. J Orthop Sports Phys Ther 2018;48(3):130-132. doi:10.2519/jospt.2018.0604.
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Swinnen E, Deliens T, Dewulf E, Van Overstraeten S, Lefeber N, Van Nieuwenhoven J, Ilsbroukx S, Kerckhofs E. What is the opinion of patients with multiple sclerosis and their healthcare professionals about lower limb orthoses? A qualitative study using focus group discussions. NeuroRehabilitation 2018; 42:81-92. [PMID: 29400679 DOI: 10.3233/nre-172222] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this study was to collect patients' and healthcare professionals' opinions about lower limb orthoses (LL-orthoses): 1) the positive and negative aspects; 2) the differences in wearing them according to location; and 3) their recommendations for future modifications. METHODS Four focus group discussions were performed, with in total twenty patients with MS with a prescribed LL-orthosis and seven healthcare professionals. Audiotaped discussions were transcribed and qualitatively processed (NVivo11). RESULTS Healthcare professionals and patients state that a LL-orthosis improves gait and reduces the risk of falling. Some negative aspects were indicated like stigmatization, difficulties to put on and off the LL-orthosis and the aesthetic aspects. Several patients mentioned that they did not get enough or no correct information about the adaptability and use of the orthoses. Opinions regarding differences in wearing according to location (e.g. in and outside the rehabilitation center) were diverse. Recommendations for future changes were e.g. more refined and firmer orthoses. CONCLUSIONS The opinions collected are interesting for taking into account in the process of construction and delivering of LL-orthoses. Future research should focus on the opinions concerning different types of LL-orthosis in relation with the severity of the limitations of the patients.
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Affiliation(s)
- Eva Swinnen
- Vrije Universiteit Brussel, Faculty of Physical Education and Physiotherapy, Rehabilitation Research - Neurological Rehabilitation (RERE-Neuro), Brussels, Belgium.,Vrije Universiteit Brussel, Center for Neurosciences (C4N), Brussels, Belgium.,Vrije Universiteit Brussel, Brubotics, Brussels, Belgium
| | - Tom Deliens
- Vrije Universiteit Brussel, Faculty of Physical Education and Physiotherapy, Rehabilitation Research - Neurological Rehabilitation (RERE-Neuro), Brussels, Belgium.,Vrije Universteit Brussel, Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Brussels, Belgium
| | - Elke Dewulf
- Vrije Universiteit Brussel, Faculty of Physical Education and Physiotherapy, Rehabilitation Research - Neurological Rehabilitation (RERE-Neuro), Brussels, Belgium
| | - Shauni Van Overstraeten
- Vrije Universiteit Brussel, Faculty of Physical Education and Physiotherapy, Rehabilitation Research - Neurological Rehabilitation (RERE-Neuro), Brussels, Belgium
| | - Nina Lefeber
- Vrije Universiteit Brussel, Faculty of Physical Education and Physiotherapy, Rehabilitation Research - Neurological Rehabilitation (RERE-Neuro), Brussels, Belgium.,Vrije Universiteit Brussel, Center for Neurosciences (C4N), Brussels, Belgium.,Vrije Universiteit Brussel, Brubotics, Brussels, Belgium
| | | | | | - Eric Kerckhofs
- Vrije Universiteit Brussel, Faculty of Physical Education and Physiotherapy, Rehabilitation Research - Neurological Rehabilitation (RERE-Neuro), Brussels, Belgium.,Vrije Universiteit Brussel, Center for Neurosciences (C4N), Brussels, Belgium.,Vrije Universiteit Brussel, Brubotics, Brussels, Belgium
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Menz HB, Allan JJ, Bonanno DR, Landorf KB, Murley GS. Custom-made foot orthoses: an analysis of prescription characteristics from an Australian commercial orthotic laboratory. J Foot Ankle Res 2017; 10:23. [PMID: 28596806 PMCID: PMC5463305 DOI: 10.1186/s13047-017-0204-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 05/30/2017] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Foot orthoses are widely used in the prevention and treatment of foot disorders. The aim of this study was to describe characteristics of custom-made foot orthosis prescriptions from a Australian podiatric orthotic laboratory. METHODS One thousand consecutive foot orthosis prescription forms were obtained from a commercial prescription foot orthosis laboratory located in Melbourne, Victoria, Australia (Footwork Podiatric Laboratory). Each item from the prescription form was documented in relation to orthosis type, cast correction, arch fill technique, cast modifications, shell material, shell modifications and cover material. Cluster analysis and discriminant function analysis were applied to identify patterns in the prescription data. RESULTS Prescriptions were obtained from 178 clinical practices across Australia and Hong Kong, with patients ranging in age from 5 to 92 years. Three broad categories ('clusters') were observed that were indicative of increasing 'control' of rearfoot pronation. A combination of five variables (rearfoot cast correction, cover shape, orthosis type, forefoot cast correction and plantar fascial accommodation) was able to identify these clusters with an accuracy of 70%. Significant differences between clusters were observed in relation to age and sex of the patient and the geographic location of the prescribing clinician. CONCLUSION Foot orthosis prescriptions are complex, but can be broadly classified into three categories. Selection of these prescription subtypes appears to be influenced by both patient factors (age and sex) and clinician factors (clinic location).
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Affiliation(s)
- Hylton B Menz
- Discipline of Podiatry and La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC Australia
| | - Jamie J Allan
- Discipline of Podiatry and La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC Australia
| | - Daniel R Bonanno
- Discipline of Podiatry and La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC Australia
| | - Karl B Landorf
- Discipline of Podiatry and La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC Australia
| | - George S Murley
- Discipline of Podiatry and La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC Australia
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