title: Adults with flexible pes planus and the approach to the prescription of customised foot orthoses in clinical practice: A clinical records audit.
abstract: A clinical records audit of the University of South Australia's podiatry clinic clients attending in 2010 was undertaken to determine prevalence of symptomatic flexible pes planus, presenting reasons and treatment options most frequently used. Analysis of rearfoot measures (resting calcaneal stance position, subtalar joint range of motion) between those prescribed a vertical (heel) or inverted (heel) cast pour and a medial heel (Kirby) skive was undertaken. Of 223 clinical records audited, 50% (111/223) of clients were assessed with flexible pes planus, 77% (86/111) of clients with pes planus presented with back or lower limb pain and 58% (64/111) were prescribed customised foot orthoses. Of 42 prescriptions for customised foot orthoses audited; 64% (27/42) were prescribed a vertical (heel) cast pour, 36% (15/42) an inverted (heel) cast pour and 19% (8/42) received a medial heel (Kirby) skive. Those prescribed a medial heel (Kirby) skive had a more everted resting calcaneal stance position than those that were not (mean -8.6±2.8° vs. -5.5±3.4°, p=0.02). Those prescribed an inverted (heel) cast pour had a greater range of subtalar joint motion than those prescribed a vertical (heel) cast pour (median 36.0±10.0° vs. 29.0±5.0°, p=0.01).
authors.affiliation: School of Health Sciences, University of South Australia, Adelaide, South Australia 5001, Australia. Electronic address: helen.banwell@mymail.unisa.edu.au.
authors.forename: Helen A
authors.initials: HA
authors.lastname: Banwell
authors.affiliation: School of Health Sciences, University of South Australia, Adelaide, South Australia 5001, Australia; Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia 5001, Australia.
authors.forename: Dominic
authors.initials: D
authors.lastname: Thewlis
authors.affiliation: School of Health Sciences, University of South Australia, Adelaide, South Australia 5001, Australia; Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia 5001, Australia.
authors.forename: Shylie
authors.initials: S
authors.lastname: Mackintosh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D054869:Clinical Audit; D004867:Equipment Design; D005260:Female; D005413:Flatfoot / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D061826:Foot Orthoses; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D055815:Young Adult
keywords: Clinical audit; Foot orthoses; Pes planus; Podiatry; Prescription variables