title: Where should a school shoe provide flexibility and support for the asymptomatic 6- to 10-year-olds and on what information is this based? A Delphi yielded consensus.
abstract: BACKGROUND
  There is a paucity of evidence regarding the design of children's footwear in relation to musculoskeletal structure.
  
  
  OBJECTIVE
  The aim was to gain consensus regarding where flexibility and support should be given on a school shoe for the 6- to 10-year-olds.
  
  
  METHODS
  Delphi Questionnaire.
  
  
  METHODS
  Recruitment of 10 Allied Health Professionals yielded a consensus group. Those recruited had dedicated experience in paediatrics and foot health. Rounds of questions were delivered to investigate the basis of the opinions made by the group on the location of support and flexibility in a school shoe for the age range identified.
  
  
  RESULTS
  Six themes were generated. Four themes gained 100% consensus regarding footwear allowing normal foot movement, footwear allowing normal forefoot function, footwear providing a stable base and the foot being secure in the shoe. Fleiss' kappa calculations revealed 'poor agreement' for the remaining two themes regarding clinical intervention and the purpose of footwear design in the midfoot in both the upper and sole of the shoe.
  
  
  CONCLUSIONS
  The qualitative data generated through discussion have highlighted areas where more understanding and research are required, particularly in understanding how, in the long term, shoe design can affect the developing foot.
  
  
  CONCLUSIONS
  Children's footwear advice is often delivered from experience and personal belief. This article questions current understanding and opinion from clinical experts in the field of paediatric footwear and highlights that there is a lack of knowledge and confidence into the effects of children's footwear. There is a strong requirement for further empirical research to be completed on children's footwear to allow clinicians to formulate relevant and appropriate footwear advice.
authors.affiliation: Leeds Community Healthcare NHS Trust, Leeds, UK.
authors.forename: Nina
authors.initials: N
authors.lastname: Davies
authors.affiliation: Staffordshire University, Stoke-on-Trent, UK H.R.Branthwaite@staffs.ac.uk.
authors.forename: Helen
authors.initials: H
authors.lastname: Branthwaite
authors.affiliation: Staffordshire University, Stoke-on-Trent, UK.
authors.forename: Nachiappan
authors.initials: N
authors.lastname: Chockalingam
mesh_terms: D001696:Biomechanical Phenomena / Q000502:physiology; D002648:Child; D003697:Delphi Technique; D005260:Female; D005531:Foot Deformities, Acquired / Q000517:prevention & control; D033023:Foot Joints / Q000502:physiology*; D061826:Foot Orthoses; D006282:Health Personnel; D006801:Humans; D008297:Male; D010146:Pain / Q000517:prevention & control; D011361:Professional Competence; D016059:Range of Motion, Articular / Q000502:physiology*; D012574:Schools; D012775:Shoes / Q000592:standards*; D011795:Surveys and Questionnaires
keywords: Delphi; Footwear; children; consensus