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Published in: Journal of Foot and Ankle Research 1/2017

Open Access 01-12-2017 | Research

National profile of foot orthotic provision in the United Kingdom, part 1: practitioners and scope of practice

Authors: CJ Nester, A Graham, A Martinez-Santos, AE Williams, J McAdam, V Newton

Published in: Journal of Foot and Ankle Research | Issue 1/2017

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Abstract

Background

Foot orthoses have been advocated in the management of a wide range of clinical foot and lower limb problems and are within the scope of podiatry, orthotic and physiotherapy practice. Previous reports into the provision of orthoses have consistently identified significant issues with services and devices, but data were never specific to foot orthoses. The aim of this first of a series of papers was to report the first ever national multi professional profile of foot orthosis provision in the United Kingdom.

Methods

Quantitative and qualitative data were collected from podiatrists, orthotists and physiotherapists via an online questionnaire. The topics, questions and answers were developed through a series of pilot phases. The professions were targeted through electronic and printed materials. Data were captured over a 10 month period in 2016.

Results

A total of 499 responses were included in analysis, including 357 podiatrists, 93 orthotists and 49 physiotherapists. The results reveal wide ranging practices across podiatrists, orthotists and physiotherapists, provision of orthoses through different health care departments (uni and multidisciplinary), for different health conditions (acute and chronic), and involving different types of orthoses (prefabricated and customised).

Conclusion

Foot orthoses in the United Kingdom are provided in areas of well recognised health and rehabilitation priorities. A wide range of orthotic devices and practices are employed and different professions provide foot orthoses in different ways.
Appendix
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Literature
1.
go back to reference Chalmers AC, Busby C, Goyert J, Porter B, Schulzer M. Metatarsalgia and rheumatoid arthritis--a randomized, single blind, sequential trial comparing 2 types of foot orthoses and supportive shoes. J Rheumatol. 2000;27:1643–7.PubMed Chalmers AC, Busby C, Goyert J, Porter B, Schulzer M. Metatarsalgia and rheumatoid arthritis--a randomized, single blind, sequential trial comparing 2 types of foot orthoses and supportive shoes. J Rheumatol. 2000;27:1643–7.PubMed
2.
go back to reference Chapman GJ, Halstead J, Redmond AC. Comparability of off the shelf foot orthoses in the redistribution of forces in midfoot osteoarthritis patients. Gait Posture. 2016;49:235–40.CrossRefPubMedPubMedCentral Chapman GJ, Halstead J, Redmond AC. Comparability of off the shelf foot orthoses in the redistribution of forces in midfoot osteoarthritis patients. Gait Posture. 2016;49:235–40.CrossRefPubMedPubMedCentral
3.
go back to reference Maddali Bongi S, Del Rosso A, Mikhaylova S, Landi G, Ferretti B, Cavigli E, et al. A comparison of two podiatric protocols for metatarsalgia in patients with rheumatoid arthritis and osteoarthritis. Clin Exp Rheumatol. 2014;32:855–63.PubMed Maddali Bongi S, Del Rosso A, Mikhaylova S, Landi G, Ferretti B, Cavigli E, et al. A comparison of two podiatric protocols for metatarsalgia in patients with rheumatoid arthritis and osteoarthritis. Clin Exp Rheumatol. 2014;32:855–63.PubMed
4.
go back to reference Menz HB, Auhl M, Tan JM, Levinger P, Roddy E, Munteanu SE. Biomechanical effects of prefabricated foot Orthoses and rocker-sole footwear in individuals with first Metatarsophalangeal joint osteoarthritis. Arthritis Care Res (Hoboken). 2016;68:603–11.CrossRef Menz HB, Auhl M, Tan JM, Levinger P, Roddy E, Munteanu SE. Biomechanical effects of prefabricated foot Orthoses and rocker-sole footwear in individuals with first Metatarsophalangeal joint osteoarthritis. Arthritis Care Res (Hoboken). 2016;68:603–11.CrossRef
5.
go back to reference Munteanu SE, Scott LA, Bonanno DR, Landorf KB, Pizzari T, Cook JL, et al. Effectiveness of customised foot orthoses for Achilles tendinopathy: a randomised controlled trial. Br J Sports Med. 2015;49:989–94.CrossRefPubMed Munteanu SE, Scott LA, Bonanno DR, Landorf KB, Pizzari T, Cook JL, et al. Effectiveness of customised foot orthoses for Achilles tendinopathy: a randomised controlled trial. Br J Sports Med. 2015;49:989–94.CrossRefPubMed
6.
go back to reference Crossley KM, van Middelkoop M, Callaghan MJ, Collins NJ, Rathleff MS, Barton CJ. 2016 Patellofemoral pain consensus statement from the 4th international Patellofemoral pain research retreat, Manchester. Part 2: recommended physical interventions (exercise, taping, bracing, foot orthoses and combined interventions). Br J Sports Med. 2016;50:844–52.CrossRefPubMedPubMedCentral Crossley KM, van Middelkoop M, Callaghan MJ, Collins NJ, Rathleff MS, Barton CJ. 2016 Patellofemoral pain consensus statement from the 4th international Patellofemoral pain research retreat, Manchester. Part 2: recommended physical interventions (exercise, taping, bracing, foot orthoses and combined interventions). Br J Sports Med. 2016;50:844–52.CrossRefPubMedPubMedCentral
7.
go back to reference Chuter V, Spink M, Searle A, Ho A. The effectiveness of shoe insoles for the prevention and treatment of low back pain: a systematic review and meta-analysis of randomised controlled trials. BMC Musculoskelet Disord. 2014;15:140.CrossRefPubMedPubMedCentral Chuter V, Spink M, Searle A, Ho A. The effectiveness of shoe insoles for the prevention and treatment of low back pain: a systematic review and meta-analysis of randomised controlled trials. BMC Musculoskelet Disord. 2014;15:140.CrossRefPubMedPubMedCentral
8.
go back to reference Gelis A, Coudeyre E, Hudry C, Pelissier J, Revel M, Rannou F. Is there an evidence-based efficacy for the use of foot orthotics in knee and hip osteoarthritis? Elaboration of French clinical practice guidelines. Joint Bone Spine. 2008;75:714–20.CrossRefPubMed Gelis A, Coudeyre E, Hudry C, Pelissier J, Revel M, Rannou F. Is there an evidence-based efficacy for the use of foot orthotics in knee and hip osteoarthritis? Elaboration of French clinical practice guidelines. Joint Bone Spine. 2008;75:714–20.CrossRefPubMed
9.
go back to reference Gross KD, Niu J, Zhang YQ, Felson DT, McLennan C, Hannan MT, et al. Varus foot alignment and hip conditions in older adults. Arthritis Rheum. 2007;56:2993–8.CrossRefPubMed Gross KD, Niu J, Zhang YQ, Felson DT, McLennan C, Hannan MT, et al. Varus foot alignment and hip conditions in older adults. Arthritis Rheum. 2007;56:2993–8.CrossRefPubMed
10.
go back to reference Papuga MO, Cambron J. Foot orthotics for low back pain: the state of our understanding and recommendations for future research. Foot (Edinb). 2016;26:53–7.CrossRef Papuga MO, Cambron J. Foot orthotics for low back pain: the state of our understanding and recommendations for future research. Foot (Edinb). 2016;26:53–7.CrossRef
13.
go back to reference Williams AE, Davies S, Graham A, Dagg A, Longrigg K, Lyons C, et al. Guidelines for the management of the foot health problems associated with rheumatoid arthritis. Musculoskeletal Care. 2011;9:86–92.CrossRefPubMed Williams AE, Davies S, Graham A, Dagg A, Longrigg K, Lyons C, et al. Guidelines for the management of the foot health problems associated with rheumatoid arthritis. Musculoskeletal Care. 2011;9:86–92.CrossRefPubMed
15.
go back to reference Guldemond NA, Leffers P, Schaper NC, Sanders AP, Nieman FH, Walenkamp GH. Comparison of foot orthoses made by podiatrists, pedorthists and orthotists regarding plantar pressure reduction in The Netherlands. BMC Musculoskelet Disord. 2005;6:61.CrossRefPubMedPubMedCentral Guldemond NA, Leffers P, Schaper NC, Sanders AP, Nieman FH, Walenkamp GH. Comparison of foot orthoses made by podiatrists, pedorthists and orthotists regarding plantar pressure reduction in The Netherlands. BMC Musculoskelet Disord. 2005;6:61.CrossRefPubMedPubMedCentral
16.
go back to reference Kane K. Foot orthoses for pediatric flexible flatfoot: evidence and current practices among Canadian physical therapists. Pediatr Phys Ther. 2015;27:53–9.CrossRefPubMed Kane K. Foot orthoses for pediatric flexible flatfoot: evidence and current practices among Canadian physical therapists. Pediatr Phys Ther. 2015;27:53–9.CrossRefPubMed
17.
go back to reference Disabled Living Foundation. Footwear: A Quality Issue - Provision of Prescribed Footwear Within the National Health Service. 1991. Disabled Living Foundation. Footwear: A Quality Issue - Provision of Prescribed Footwear Within the National Health Service. 1991.
19.
go back to reference Bowker P, Rocca E, Powell E. A study of the organisation of orthotic services in England and Wales. UK: Report to the Department of Health; 1992. Bowker P, Rocca E, Powell E. A study of the organisation of orthotic services in England and Wales. UK: Report to the Department of Health; 1992.
20.
go back to reference Audit Commission. Assisting independence - fully equipped. 2002. Audit Commission. Assisting independence - fully equipped. 2002.
21.
go back to reference Landorf K, Keenan AM, Rushworth RL. Foot orthosis prescription habits of Australian and New Zealand podiatric physicians. J Am Podiatr Med Assoc. 2001;91:174–83.CrossRefPubMed Landorf K, Keenan AM, Rushworth RL. Foot orthosis prescription habits of Australian and New Zealand podiatric physicians. J Am Podiatr Med Assoc. 2001;91:174–83.CrossRefPubMed
22.
go back to reference Reja U, Manfreda K, Hlebec V, Vehovar V. Open-ended versus closed-ended questions in web questionnaries: advances in methodology and satistics. Metodoloski zvezki. 2003;19:159–77. Reja U, Manfreda K, Hlebec V, Vehovar V. Open-ended versus closed-ended questions in web questionnaries: advances in methodology and satistics. Metodoloski zvezki. 2003;19:159–77.
25.
go back to reference Workforce and Facilities Team. NHS Workforce Statistics, February 2016, Provisional Statistics February 2016. Workforce and Facilities Team. NHS Workforce Statistics, February 2016, Provisional Statistics February 2016.
26.
go back to reference Sharman A. NHS England. Personal Communication, January 2017. Sharman A. NHS England. Personal Communication, January 2017.
29.
go back to reference van Netten JJ, Price PE, Lavery LA, Monteiro-Soares M, Rasmussen A, Jubiz Y, et al. Prevention of foot ulcers in the at-risk patient with diabetes: a systematic review. Diabetes Metab Res Rev. 2016;32(Suppl 1):84–98.CrossRefPubMed van Netten JJ, Price PE, Lavery LA, Monteiro-Soares M, Rasmussen A, Jubiz Y, et al. Prevention of foot ulcers in the at-risk patient with diabetes: a systematic review. Diabetes Metab Res Rev. 2016;32(Suppl 1):84–98.CrossRefPubMed
30.
go back to reference Bus SA, Waaijman R, Arts M, de Haart M, Busch-Westbroek T, van Baal J, et al. Effect of custom-made footwear on foot ulcer recurrence in diabetes: a multicenter randomized controlled trial. Diabetes Care. 2013;36:4109–16.CrossRefPubMedPubMedCentral Bus SA, Waaijman R, Arts M, de Haart M, Busch-Westbroek T, van Baal J, et al. Effect of custom-made footwear on foot ulcer recurrence in diabetes: a multicenter randomized controlled trial. Diabetes Care. 2013;36:4109–16.CrossRefPubMedPubMedCentral
31.
go back to reference Carroll M, Annabell ME, Rome K. Reliability of capturing foot parameters using digital scanning and the neutral suspension casting technique. J Foot Ankle Res. 2011;4:9.CrossRefPubMedPubMedCentral Carroll M, Annabell ME, Rome K. Reliability of capturing foot parameters using digital scanning and the neutral suspension casting technique. J Foot Ankle Res. 2011;4:9.CrossRefPubMedPubMedCentral
32.
go back to reference Telfer S, Abbott M, Steultjens MP, Woodburn J. Dose-response effects of customised foot orthoses on lower limb kinematics and kinetics in pronated foot type. J Biomech. 2013;46:1489–95.CrossRefPubMed Telfer S, Abbott M, Steultjens MP, Woodburn J. Dose-response effects of customised foot orthoses on lower limb kinematics and kinetics in pronated foot type. J Biomech. 2013;46:1489–95.CrossRefPubMed
33.
go back to reference Bonanno DR, Zhang CY, Farrugia RC, Bull MG, Raspovic AM, Bird AR, et al. The effect of different depths of medial heel skive on plantar pressures. J Foot Ankle Res. 2012;5:20.CrossRefPubMedPubMedCentral Bonanno DR, Zhang CY, Farrugia RC, Bull MG, Raspovic AM, Bird AR, et al. The effect of different depths of medial heel skive on plantar pressures. J Foot Ankle Res. 2012;5:20.CrossRefPubMedPubMedCentral
34.
go back to reference Wen DY, Puffer JC, Schmalzried TP. Lower extremity alignment and risk of overuse injuries in runners. Med Sci Sports Exerc. 1997;29:1291–8.CrossRefPubMed Wen DY, Puffer JC, Schmalzried TP. Lower extremity alignment and risk of overuse injuries in runners. Med Sci Sports Exerc. 1997;29:1291–8.CrossRefPubMed
35.
go back to reference Nielsen RO, Buist I, Parner ET, Nohr EA, Sorensen H, Lind M, et al. Foot pronation is not associated with increased injury risk in novice runners wearing a neutral shoe: a 1-year prospective cohort study. Br J Sports Med. 2014;48:440–7.CrossRefPubMed Nielsen RO, Buist I, Parner ET, Nohr EA, Sorensen H, Lind M, et al. Foot pronation is not associated with increased injury risk in novice runners wearing a neutral shoe: a 1-year prospective cohort study. Br J Sports Med. 2014;48:440–7.CrossRefPubMed
36.
go back to reference Wallden M. Don’t get caught flat footed - how over-pronation may just be a dysfunctional model. J Bodyw Mov Ther. 2015;19:357–61.CrossRefPubMed Wallden M. Don’t get caught flat footed - how over-pronation may just be a dysfunctional model. J Bodyw Mov Ther. 2015;19:357–61.CrossRefPubMed
37.
go back to reference Nester CJ, Jarvis HL, Jones RK, Bowden PD, Liu A. Movement of the human foot in 100 pain free individuals aged 18-45: implications for understanding normal foot function. J Foot Ankle Res. 2014;7:51.PubMedPubMedCentral Nester CJ, Jarvis HL, Jones RK, Bowden PD, Liu A. Movement of the human foot in 100 pain free individuals aged 18-45: implications for understanding normal foot function. J Foot Ankle Res. 2014;7:51.PubMedPubMedCentral
Metadata
Title
National profile of foot orthotic provision in the United Kingdom, part 1: practitioners and scope of practice
Authors
CJ Nester
A Graham
A Martinez-Santos
AE Williams
J McAdam
V Newton
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Journal of Foot and Ankle Research / Issue 1/2017
Electronic ISSN: 1757-1146
DOI
https://doi.org/10.1186/s13047-017-0215-4

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