Kevin,
Many thanks for the thoughts but we are being asked for objective
measurements / guidelines on at what point we would recommend treatment (
with research based evidence).
At present it still appears we have no objective guidelines as to what
is normal at a given age.
Regards
John Bickerstaffe
-----Original Message-----
From: Kevin Kirby [mailto:[log in to unmask]]
Sent: 20 April 2004 21:54
To: [log in to unmask]
Subject: Re: Prescribing Orthoses to Children who aren't in any Pain
John:
You asked:
<<How would you define at what point a foot (pronated foot) is moderatly or
severely flat.
It seems to me that until we have defined what we are treating we cannot
move on.>>
If the STJ is maximally pronated throughout the midstance phase of gait,
does not resupinate until late propulsion, has a STJ is maximally pronated
and the STJ axis is exiting medial to the midpoint of the medial aspect of
the first metatarsal shaft during relaxed bipedal stance, the supination
resistance test requires much more force than normal, and the longitudinal
arch is significantly flattened then I consider these to indicate a
moderately to severely pronated foot. All or a combination of these factors
may be present.
If you are asking for something more quantitative, then you will probably
need to wait another lifetime, I am afraid.
Cheers,
Kevin
****************************************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
Private Practice:
107 Scripps Drive, Suite 200
Sacramento, CA 95825 USA
Voice: (916) 925-8111 Fax: (916) 925-8136
****************************************************************************
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