A pilot study on function and symptom changes with the use of foot orthoses in the flat footed adult.

INTERVENTION: Custom made functional foot orthoses are prescribed customised devices manufactured from impressions of the participant's feet. The impressions are used to form positive moulds, which are modified across the rearfoot, midfoot and forefoot as per individual prescription requirements. The functional foot orthoses will be formed from the modified positive casts and moulded in semi‐rigid polypropylene with 3mm multiform (thin blown rubber) top covers. Participants will be given written instructions to wear the orthoses for increasing increments of one hour per day (day 1 = 1 hour, day 2 = 2 hours etc.) until they are wearing the orthoses full time with comfort. The 'wearing in' of orthoses is individual and it is expected that some participants will 'wear them in' quicker than others. At the follow up session participants will be asked to report the percentage of time the orthoses has been worn over the previous four weeks. CONDITION: Symptomatic flexible pes planus PRIMARY OUTCOME: Primary outcome will be a measured change in energy expenditure and/or increased walking ability. Increased walking ability will be demonstrated by completing a known distance walk test (200 metres) in reduced time or by walking a greater distance during a timed distance test (six minute walk test). Participants will complete both walking tests wearing their allocated orthoses (functional or non‐functional) and in their shoes alone in a randomised order. Energy expenditure will be measured by an armband monitor worn on the upper arm of the participant during the testing procedure (SenseWear(copyright)). SECONDARY OUTCOME: The secondary outcome will be self‐reported changes in foot health levels. Pain and fatigue will be measured using 100 mm visual analogue scales (VAS) and overall foot health changes will be measured using the foot health status questionnaire (FHSQ) which is a validated survey covering short and long term pain, function and general foot health. ; ; INCLUSION CRITERIA: Symptomatic flexible pes planus where the scale of pes planus has been mesured (by a podiatrist independent to the research) to be equal or greater than +7 on the Foot Posture Index ‐ 6 item version (FPI‐6). The FPI‐6 is a validated tool to determine foot posture and falls within the bounds of normal practice within the podiatry clinical setting.