Investigation of the impact of foot type on efficacy of anti-pronatory strapping and orthotic devices

This study will investigate the potential link between a patients foot type and the impact of anti-pronatory interventions. The patients foot type will be defined as the level of pronation (how much the foot rolls in) based on the Foot Posture Index (FPI-6). Participants will be those aged over the age of 18 attending the Charles Sturt University podiatry service for treatment or foot pain or pathology, who are provided with an anti-pronatory intervention. The study will be conducted as a component of the patients normal podiatry consultation, and the interventions and assessment used will be consistent with those already being used within the podiatry service, meaning no additional commitment will be required by the patient. Standard biomechanical assessments will be performed (such as neutral and resting calcaneal stance positons, Jack’s test, ankle and 1st metatarsophalangeal joint range of motion, etc), although the assessment information to be retained for this study will be the Foot Posture Index, supination resistance test and lunge test results. The anti-pronatory interventions (measures used to stop the foot rolling in) will include a standard strapping technique using rigid sports tape and orthotic devices (inserts for shoes). These will be recommended and initiated at the discretion of the podiatry student and the Clinical Educator, and will be conducted independent of the researchers. The strapping technique used will be a low-dye strapping (as described by Landorf et al. (2005), JAPMA 95(6): 525-530.), and is very commonly used as a preliminary treatment method for conditions such as plantar fasciitis and tibialis posterior dysfunction. Orthotic devices will be prescribed at the discretion of the podiatry student and the supervising Clinical Educator, and will be conducted independent of the researchers. This prescription used will be based on the assessments performed by the podiatry student and the Clinical Educator, and will be intended to address the specific functional needs of the patient/participant. The initial three dimensional assessment will be completed on the same day the intervention is initiated, and will involve the participant being assessed both with and without the antipronatory intervention (ie. with and without orthoitcs in shoes, or with and without low-dye strapping applied). Three dimensional assessment will be conducted while the patient stands on their dominant foot for 30 seconds, their non-dominant foot for 30 seconds, both feet for 30 seconds; and during the completion of five walking trials 15 meters in length. Should the participant receive a low-dye strapping intervention, it is assumed the patient will wear the strapping for 2-3 days and then remove the strapping. The patient may or may not be asked to replace the strapping in their own time. Should the participant receive orthotic devices, it is typical to advise gradual increase in use over the space of a week (ie. increase by 1hr every day), and wear the devices all the time from the second week onwards. Depending on the requirements of the podiatry student and the clinical educator, the participant will most likely return for review in somewhere between 2 and 4 weeks. Three dimensional assessment will be conducted at the first day of treatment, and at all subsequent review consultations. The duration of engagement with the study will vary depending on the participants clinical progress, by is expected to involve 2-3 consultations over the space of 4-8 weeks. The wash-out period between testing sessions are expected to be a minimum of two weeks. Patient compliance will not be logged by any formal means, however, the podiatry student and the Clinicial Educator will typically make notes regarding patient compliance at all review consultations.