A foot orthosis is an assistive device used in occupational and physical therapy. It is designed to support a person's foot in a way that makes it more functional following disease or injury.
Persons with foot and ankle disorders, such as arthritis, ulcers, diabetes, bunions, various forms of tendinitis, and other deformities, can benefit from foot orthoses. Typically, foot orthoses are inlays placed in a client's shoe. The orthosis supports, cushions, and/or pads the foot.
Types of foot orthoses
Most clients with foot problems benefit from mass-produced, prefabricated orthoses. They are relatively common and may absorb shock in the foot or provide added arch under the foot, for example.
Occasionally a prefabricated orthosis is modified in some way to better accommodate a client, and this is referred to as a customized orthosis. These may be molded to better fit a client's foot or have additional padding.
However, some clients with severe foot deformities or disorders may not be able to use a prefabricated orthosis or even a customized orthosis. These clients require custom-molded orthoses that are made from the mold of the client's foot for a perfect, tight fit.
In order for a client to use a foot orthosis appropriately, he/she must go through a thorough assessment that evaluates the position and range of motion (ROM) of foot and ankle joints in all parts of the foot. Clients should be tested while walking and bearing weight as well as while standing. Clients must be tested for rigidity and flexibility in addition to assessing any foot or ankle pain.
Clients who are prescribed footwear need to maintain their orthoses with proper cleaning and repairs when necessary. As the condition of the foot may change or worsen, a previously prescribed orthosis may become ineffective or unnecessary, just as a prescription drug might. Periodic follow-up with a physician, occupational therapist, or appropriate health care professional is necessary to ensure that the foot orthosis remains as functional as possible.
Health care team roles
A variety of health care professionals can help a client determine the most appropriate foot orthosis. Occupational or physical therapy practitioners can provide assessments and evaluations of the effectiveness of foot orthoses. Orthotists and prosthetists, although typically consulted by patients who have lost limbs, also can help in choosing an appropriate orthosis. Pedorthists can evaluate a client in need of an orthosis, provide and fit the shoe, and follow-up the client. However, a prescription for a foot orthosis is necessary.
Myerson, Mark S., ed. Foot and Ankle Disorders. Philadelphia: W.B. Saunders Company, 2000.
Chen, Chiung-Ling, et al. "Anterior Ankle-Foot Orthosis Effects on Postural Stability in Hemiplegic Patients." Archives of Physical Medicine and Rehabilitation 80 (December 1999): 1587–1592.
American Occupational Therapy Association. 4720 Montgomery Lane, Bethesda, MD 20824-1220. (301) 652-2682. <http://www.aota.org>.
American Physical Therapy Association. 1111 North Fairfax Street, Alexandria, VA 22314-1488. (703) 684-2782. <http://www.apta.org>.
Meghan M. Gourley