After studying how podiatrists in Australia prescribed custom foot orthoses to treat adult symptomatic flexible pes planus, researchers were able to develop consensus-based practice recommendations. The researchers found consensus or agreement for several prescription variables and used the findings to develop the foot orthotics prescription recommendations for symptomatic flexible pes planus in adults (FootPROP) pro forma to guide prescription of custom foot orthotics for this population. The study was published online November 25 in the
Journal of Foot and Ankle Research.
Twenty-four podiatrists participated in a four-round survey to establish current use and the rationale for prescription variables of custom foot orthotics for symptomatic flexible pes planus in adults. Round one determined prescription use (consensus) and rounds two, three, and four determined the rationale for use (agreement) of prescription variables across the rearfoot, midfoot, forefoot, and accommodation and materials used. For consensus and agreement to be accepted, the researchers required that at least 70 percent of the respondents must have used or agreed upon the rationale for use of individual prescription variables. Data not reaching 50 percent agreement were excluded; data that received 50-69 percent agreement were reviewed in subsequent rounds.
Consensus was reached in round one for choice of shell material (polyolefin), and when to prescribe a forefoot post balanced to perpendicular. In rounds two, three, and four agreement was reached for 52 statements related to the rationale for use of individual prescription variables. Agreements included when to prescribe an inverted cast pour (heel in an inverted position), an inverted rearfoot post, a medial heel (Kirby) skive, minimum/maximum arch fill, a medial flange, a forefoot post, and other common orthotic accommodations.