Knowledge platform hosting the new knowledge framework connecting foot health research and science to foot therapeutic insole practice, to underpin undergraduate and postgraduate  clinical skills and knowledge.

A conceptual framework for contemporary professional foot care practice. : The ValuE BaseD DIgiTal FOot CaRe Framework (EDITOR FRAMEWORK)

A small minority of countries around the globe have podiatry as a recognized profession, hence, there are considerable differences among these countries when it comes to the curricula, the duration of training and legislation regulating the profession. The growth in research led evidence based practice, and the emerging digital landscape of health care practice, occur alongside trends in disease and health behaviours that strongly impact on foot health. As such, the changing complex role of the podiatrist requires critical reflection on current frameworks of practice and whether they are fit for purpose. This commentary presents a conceptual framework which sets the scene for further development of concepts in a podiatry context,  reflecting contemporary health care beliefs and the changing expectations of health care and society.

The proposed conceptual framework for podiatry practice utilizes the metaphor of an electronic circuit to reflect the vast and complex interconnections between factors that affect practice and professional behaviours. The framework helps in portraying and defining drivers of practice, actual practice as well potential barriers for current and future practice.

The circuit emphasis the interconnectedness/interaction of three clusters: 1) internal factors, 2) interaction factors, 3) external factors. 

Conclusion: Whatever promise this new framework holds, it will only be realised through conscious development of community consensus, respectful dialogue, constructive critical appraisal, and maintaining passion and focus on improving the health of people with foot related problems.

Figure. Illustration of the conceptual framework.

Back to our ‘Roots’: customization among the biopsychosocial-digital continuum in foot orthotic practice and research

Foot orthotics have been used for decades, however, considerable issues and uncertain therapeutic efficacy persists. Until know, customisation of orthoses has often been used exclusively to affect neuro-biomechanical input and outcome variables, however, there is emerging evidence suggesting that therapeutic efficacy may be (partially) achieved by a psychological stimulus. Critical appraisal of the literature highlights that there is no hollistic model upon which foot orthotic practice is taught, investigated nor practised. This paper introduces a conceptual model of foot orthotic practice (Value Based Foot Orthotic Practice (VALUATOR) model) that embraces a broader range of factors that are pertinent in practice and reflect contemporary health service behaviours and values.

Within the model, the foot orthotic design and clinical value is considered along a bio-psycho-social-digital continuum reflecting the nature of foot orthotic practice. The model contextualises the variable outcomes that are observed in research and practice within 6 key areas: 1) value, 2) person-centered apporach, 3) zone of optimal bio-psycho-social stress, 4) bio-psycho-social assessment, 5) monitoring, 6) primary and secondary clinical strategies.

The VALUATOR model is targeted at students, lecturers, scientists and practitioners as it includes carefully chosen terminology providing a robust basis for educational and scientific discussion. It is believed that it provides a contemporary viewpoint and a well-structured conceptual metaphor which may support the intellectual debate and teaching among the profession of podiatry. Stress testing the current model will help determining the limits of the model and hopefully provide opportunities for further development and innovation.

Figure. Conceptual map representing the six key areas of the VALUATOR model

Review of the different practices used to design and manufacture therapeutic insoles: a survey among the EUROPEAN NETWORK OF PODIATRY IN HIGHER EDUCATION

Innovative technology used in foot orthotic practice: review and critical appraisal of digital clinical insole technologies

. The review will contribute to a summary of evidence for the use of technology and digital tools in the context of foot orthoses practice. The summary of evidence will be embedded within a broader aim of the Future feet project, which relates to a conceptual digital foot orthoses framework. This framework can be used by foot health scientists and researchers to enhance knowledge of technology and digital tools in relation to foot orthotic practice. It will also help educators develop teaching curriculum and working practices in foot health science and education.

Future Feet Toolkit: Patient Reported Outcome Measure Calculator

Application of the EDITOR framework and VALUATOR model