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A Review of the Theoretical Unified Approach to Podiatric Biomechanics in Relation to Foot Orthoses Therapy

Paul Harradine The Podiatry and Chiropody Centre, Portsmouth, Hants, United Kingdom.

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Lawrence Bevan Gloucestershire Podiatry Department, St. Paul’s Medical Centre, Cheltenham, United Kingdom.

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Background: Diverse theories of orthoses application have evolved with the continual development of podiatric biomechanics and orthotic management. This theoretical disparity can lead to confusion in clinical, educational, and research situations. However, although approaches are varied, the common consensus is that foot orthoses outcomes are generally positive.

Methods: Three main podiatric theories exist: the foot morphology theory, the sagittal plane facilitation theory, and tissue stress theory. By researching the available literature, the perspectives of all three theories are summarized, emphasizing areas of conflict and agreement.

Results: Through a unified theory, we introduce a premise by which the similar orthotic outcomes obtained from the three main podiatric theories may be explained.

Conclusions: It remains up to the individual podiatric physician to decide which method to use to prescribe a foot orthosis. It may be of benefit to encompass all approaches rather than be dogmatic or exclusive. (J Am Podiatr Med Assoc 99(4): 317–325, 2009)

Corresponding author: Paul Harradine, MSc, The Podiatry and Chiropody Centre, 77 Chatsworth Ave, Portsmouth, Hants, PO6 2UH United Kingdom. (E-mail: podiathing@yahoo.co.uk)