Foot Orthoses for Pediatric Flexible Flatfoot

NewsBot · Dec 23, 2024

The effects of foot orthoses on radiological parameters and pain in children with flexible flat feet: a systematic review and meta-analysis
Chao Liu et al
Front. Pediatr., 02 August 2024

Objective: This study aimed to investigate the impact of foot orthoses on foot radiological parameters and pain in children diagnosed with flexible flatfoot.

Methods: A comprehensive search was conducted across several databases, including PubMed, Web of Science, EMBASE, Cochrane Library, and EBSCO, covering publications from the inception of each database up to 8 June 2024. The study focused on randomized controlled trials investigating the use of foot orthoses for treating flexible flat feet in children. Four researchers independently reviewed the identified literature, extracted relevant data, assessed the quality of the studies, and performed statistical analyses using RevMan 5.4 software.

Results: Six studies involving 297 participants were included. The methodological quality of the included literature ranged from moderate to high. Radiological parameters of the foot improved significantly in older children with flexible flat feet following foot orthotic intervention compared to controls, particularly in the lateral talar-first metatarsal angle [mean difference (MD) = −2.76, 95% confidence interval (95% CI) −4.30 to −1.21, p = 0.0005], lateral talo-heel angle (MD = −5.14, 95% CI −7.76 to −2.52, p = 0.0001) and calcaneal pitch angle (MD = 1.79, 95% CI 0.88–2.69, p = 0.0001). These differences were statistically significant. Additionally, foot orthoses significantly improved the ankle internal rotation angle and reduced foot pain in children with symptomatic flexible flatfoot (MD = −2.51, 95% CI −4.94 to −0.07, p = 0.04).

Conclusion: The use of foot orthoses positively impacts the improvement of radiological parameters of the foot and reduces pain in older children with flexible flat feet. However, in younger children with flexible flat feet, the improvement from foot orthoses was not significant, likely due to challenges in radiological measurements caused by the underdevelopment of the ossification centers in the foot. Further studies are needed. Consequently, the results of this meta-analysis support the implementation of an early intervention strategy using foot orthoses for the management of symptomatic flat feet in older children.
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NewsBot · Aug 13, 2025

OrthoticS for TReatment of symptomatic flat feet In CHildren (OSTRICH): a randomised controlled trial
Sarah Cockayne et al
Health Technol Assess. 2025 Aug 6:1-49.

Background: Children and young people with symptomatic pes planus (flat feet) often seek treatment from healthcare professionals. There are various treatment options, but there is a lack of high-quality evidence about which is most effective.

Objectives: To assess the clinical and cost-effectiveness of prefabricated orthoses, plus exercise and advice, compared with exercise and advice alone on physical function, measured using the physical domain of the Oxford Ankle Foot Questionnaire for Children, among children with symptomatic pes planus.

Design and methods: A pragmatic, multicentre, two-armed individually randomised controlled trial with an internal pilot, economic evaluation and qualitative study.

Setting and participants: Children and young people aged 6-14 years with symptomatic flat feet were recruited from hospital or community healthcare facilities in England and Wales. Participants were randomised 1 : 1 using a secure web-based randomisation system and followed up for up to 12 months.

Interventions: We planned to provide all participants with advice and exercises, with the intervention group also receiving a prefabricated orthosis. Due to the nature of the study treatments, blinding of participants or the research team was not possible.

Main outcome measures: The primary outcome was the physical domain subscale of the Oxford Ankle Foot Questionnaire for Children over the 12-month follow-up. Secondary outcomes included the physical domain subscale at 3, 6 and 12 months, and the 'School and Play' and 'Emotional' domains of the Oxford Ankle Foot Questionnaire, pain scores, healthcare resource use, EQ-5D-Y and Child Health Utility 9D at all time points. The qualitative study drew on health literacy and health belief perspectives and examined fidelity and explored the experiences of being in the trial for those receiving and delivering the study treatments.

Results: COVID-19 severely delayed trial set-up and recruitment and the study closed before meeting its recruitment target. Of 549 participants assessed for eligibility, 134 were randomised (intervention n = 70, control n = 64). The mean age of participants was 10.6 years (range 6.3-14.8) and 55.2% were male. No adverse events were reported. The planned statistical and health economic analyses could not be fully conducted due to the limited data. The qualitative study identified pain, posture and gait as the most common concerns by participants with pain relief as the primary motivator for seeking health care. Participants generally reported little understanding of their condition with barriers including misattribution (e.g. growing pains). Misinformation was common emphasising a need for accessible accurate education materials and structured follow-up care. There was a common belief that orthoses were superior to exercises leading to high levels of adherence, satisfaction and outcomes with orthoses compared with poor adherence, and low perceived efficacy with exercises linked to challenges incorporating these into daily routines.

Limitations: We could not deliver the study objectives as planned. Due to the limited data available, we were unable to undertake the planned analysis.

Conclusions: The COVID-19 pandemic significantly impacted trial set-up and recruitment. Extending the study was not feasible due to cost and time constraints.

Future work: The evidence for the clinical and cost-effectiveness of orthotics for the treatment of symptomatic flat feet in children remains inconclusive and an area for further research.
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NewsBot · Dec 2, 2025

Research trends and future directions in foot orthosis for flatfoot: A bibliometric approach to innovation and ergonomic design
Lina Dianati Fathimahhayati et al
Assist Technol. 2025 Dec 2:1-18.

Flatfoot is a common condition characterized by a low foot arch, causing pain and discomfort. Foot orthoses are commonly used to alleviate these symptoms. This study conducts a bibliometric analysis of 465 documents from the Scopus database using VOSviewer and Biblioshiny tools to identify research trends and future directions in foot orthosis for flatfoot treatment. The research is grouped into five main clusters: orthopedic and surgical procedures, patient demographics, biomechanics and physical assessments, advanced technologies in orthosis development, and clinical research. Key keywords include flatfoot, foot orthosis, female, adult, and biomechanics. The United States leads the publication output with 392 articles, followed by China, Italy, Iran, and South Korea. Future research should focus on new materials for orthoses, optimizing designs for better foot biomechanics, and incorporating advanced technologies such as 3D printing and computer simulations to enhance production. The study also calls for more research on patient-specific treatments, considering gender and demographic differences. Furthermore, controlled clinical trials are essential for evaluating long-term effectiveness and patient outcomes. Addressing these research gaps will improve foot orthosis design, manufacturing, and clinical application, enhancing treatment efficacy and patient outcomes.
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Foot Orthoses for Pediatric Flexible Flatfoot

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Foot Orthoses for Pediatric Flexible Flatfoot

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Pediatric flatfeet correction with foot orthoses

Exercise more effective than foot orthoses in pediatric flat foot

Foot orthoses and asymptomatic pediatric flatfoot

Foot orthoses with and without heel plugs

The Misuse of Foot Orthoses

Bridging the gap between custom foot orthoses research and clinical practice

Shoe modifications and foot orthoses in conservative treatment of lesser toe deformities

Share This Page

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