Orthotics for Treatment of Symptomatic Flat Feet in Children

The shape of children's feet change as they grow, with most developing an arch in their feet. However, when the arch does not fully form or it is flat against the ground, this is called pes planus, or flat feet. Pes planus can result in pain in the feet, ankles, legs, or back (called symptomatic flat feet), with it being one of the most common conditions seen in paediatric practice. Currently, it is not clear what the most effective management for symptomatic pes planus is, with it being debated as to whether there should be intervention provided or whether symptoms will resolve without intervention. Common management options for pes planus are orthoses (insoles), which can be custom-made or pre-fabricated, and exercise and advice about shoes.

The OSTRICH study is investigating the effectiveness of custom-made and prefabricated foot orthoses in addition to exercise and advice compared with exercise and advice alone on the physical functioning of children with symptomatic pes planus. We aim to recruit 1085 children/young people aged six to 16 years of age. The primary outcome for this study is the physical domain of the Oxford Ankle Foot Questionnaire for Children over the 12 month follow-up period.

The study is being coordinated by researchers at the York Trials Unit at the University of York, in collaboration with researchers at the University of Salford, University of Oxford, University of Brighton, University of Leeds and Leeds Teaching Hospitals NHS Trust, in addition to input from our patient representatives. The research is funded by the National Institute for Health Research Health Technology Assessment Programme, with Professor David Torgerson as the Chief Investigator.