Table 3

Prescription criteria for off-the-shelf stability therapeutic footwear

ConditionIndications for treatmentSole or adjunct treatment
Cerebral palsyWhere mediolateral stability is required for standing and walking.Sole aid
May be used to assist both foot and ankle walking stability in children with GMFCS 1 and no significant tonal issues.
Adjunct
Used simultaneously with other assistive aids* to assist walking and standing in ambulant children GMFCS 1–3 with tonal issues.
Used simultaneously with other assistive aids* to assist standing in non-ambulant children GMFCS 4.
Down’s syndromeSole aid
In prewalking and learning to walk stages with associated hypotonia and delayed motor milestones.
Adjunct
Used simultaneously with:

  1. Foot orthoses to assist walking in individuals with ankle instability.

  2. AFOs to assist walking in individuals with knee instability.

Duchenne muscular
dystrophy		Adjunct
Used simultaneously with:

  1. Foot orthoses to assist foot and ankle stability in early ambulatory stages.

  2. AFOs and walking frames to assist walking in late ambulatory stages.

  3. AFOs and standing frames to assist standing and transfer in early non-ambulatory stages.

Spina bifidaAdjunct
Used simultaneously with:

  1. Foot orthoses to assist foot and ankle stability in sacral level 1 (meningocele).

  2. AFOs and walking frames to assist walking and standing in lumbar level 4–5 (meningocele and myelomeningocele).

  3. HKAFO or KAFO and walking frames to assist walking and standing in lumbar level 1–3 (meningocele and myelomeningocele).

Symptomatic mobile pes planusSecondary line intervention to improve mediolateral stability in walking where foot orthoses have not resolved associated symptoms.Adjunct
Used simultaneously with foot orthoses in:

  1. Children with significant foot and ankle instability associated with tripping and falling.

  2. Children with insufficiency of posterior tibialis function.

  3. Children with conditions associated with motor delay.

  • *Other assistive devices to include AFOs, crutches, foot orthoses, standing frames and walking frames.

  • †Adjunct AFO with stability footwear intervention requires a review of prescription of the sole to address any potential exacerbation of knee hyperextension in midstance.

  • AFO, ankle foot orthoses; GMFCS, Gross Motor Functioning Classification Score; HKAFO, hip knee ankle foot orthoses; KAFO, knee ankle foot orthoses.