clinical case february 2006

Child 7 years old, male.
DIAGNOSIS: anatomic flat feet of 3^rd degree, bilateral valgus backfoot. The child was already treated since he was three years old by means of classical orthotics made of multiform. When he came to the Ks Studies and researches centre on the 17-11-04 his foot print on the podogram showed a flat foot of 3^rd degree, a bilateral valgus backfoot and a great flattening of the medial plantar arch of both soles of the feet. Furthermore he had the left knee slightly blended; he also had an atypical swallowing, open bite and oral breathing.
	x-ray performed on the 17-7-03

Among the symptoms referred during the anamnesis, he told us he suffered from pains affecting the muscles of the legs, above all during walking, frequent musculo-tensive headaches, and he felt sometimes a sensation of confusion and difficulty to keep on reading for more than 10/15 minutes.
A radiograph of the whole spine in orthostatics showed an horizontalization of the sacrum, a light hyperkyphosis and a light sideward deviation of the low back segment caused by a pelvis tilt.

The 3D VRS Formetric examination performed barefoot on the17-11-04, showed an asymmetry of the pelvis measuring 2,4 mm; a leftwards lateral deviation of the vertical axis of the spine of a forwards inclination of the low back segment in lateral projection.

The same day, we repeated as usual, the Formetric examination performed whit orthotics under the feet, in order to verify what kind of correction they exerted.

The examination highlighted an asymmerty of the pelvis of 8,2 mm; a leftwards lateral deviation of the vertical axis of the spine 5,2 mm; a light decreasing of the forwards inclination of the law back segment of the spine in lateral projection. The instrumental picture of the postural arrangement of the child worsened when he carried his orthotics used to correct the flat foot.


Examination 17 November 04 `barefoot`	Examination 17 November 04 orthotics made of multiform

We replaced the orthotics made of multiform with the Ks Medical orthotics acting a neuro-muscular stimulation activated to treat the flat foot of 3^rd degree.
We explained to the child and his parents that the effects of the neuro-muscular stimulation exerted by this kind of orthotics are produced above all while walking so we suggested him to always use the orthotics, also when he wore his slippers.
At he first control examination, performed on the 4 January 2005, we noticed a light decrease of the flat foot and of the valgus backfoot, as you can see in the hereby attached pictures, and we also noticed a decrease of the flexion of the left knee. We did not notice any important modification of the occlusion.
Concerning the symptoms, the child told us he had experienced a great decrease of the headaches and his parents told he was now able to walk for a longer time.
At the second examination performed on the 9-5-05 we noticed a clear improvement of the occlusion and of the arrangement of the knees.
The deviation of the backfoot decreased, as proved both by the picture and by the foot print.
Headaches disappeared completely.


Picture of the Ks Medical orthotic activated	Occlusion photographed on the 4 January 2005

Picture and foot print of the backfoot and picture of the knees taken on the 4 January 05



3D Formetric examination of the 4 January 05	3D Formetric examination of the 9 May 05

Pictures of the occlusion taken on the 9 May 05

Picture of legs and picture and foot print of the backfoot taken on the 9 May 05

Finally at the one year later follow-up performed on the16-11-05 we noticed a normalization of all assessed parameters: NORMAL BITE, NORMAL KNEES AND BACKFOOT ARRANGEMENT AND NORMAL FOOT PRINT.

Pictures of bite taken on the 16 November 05
Pictures of the legs and podogram taken on the 16 November 05

DISCUSSION
The above explained clinical case is one of the many children suffering from flattening foot and valgus backfoot we normally examine. The peculiarity of this clinical case is that the child was already using since four years orthotics made of multiform to correct the flat foot without solving his problem and at the same time he also presented an open bite, oral breathing, atypical swallowing, and very frequent headaches. Furthermore the low resistance to efforts described by his parents is very important. In fact for a long time parents had noticed that the child was getting more and more lazy, and even at school he preferred to stay alone, even when he was incited to take part to class games or physical training, he refused to participate. As the child had a flat foot of 3^rd degree and a valgus backfoot, he had been treated since he was three years old with passive orthotics made of multiform, the orthotics had been replaced several times according to the growth of the feet, without achieving any results.
In fact the foot print did not change during the previous four years, the symptoms (headaches) the child lamented about did not disappeare, so that the parents had been suggested to try a surgical operation consisting in the Giannini's prosthesis.
The open bite and the oral breathing had always been neglected and the atypical swallowing had never been diagnosed.
The use of the Ks Medical orthotics acting a neuro-muscular stimulation on the sole of the feet allows the recovery of the tone of the intrinsic muscles of the sole of the feet and at the same time it triggers a normalization of the peripheral sensitive afferences that in their turn activate the postural tone of the whole organism, in this way we were able to achieve a quick disappearing of the headaches already in the first months of treatment; even the morphological and morphometrical parameters changed and gradually normalized within one year. The social life of our young patient improved, he participated to all school and family activities.
Obviously this child will be wearing the stimulating orthotics in his shoes for some years more and this will grant an harmonic growth of the whole organism..

THERAPEUTIC RESULTS BY THE NEURO-BIO-MECHANIC ACTING ORTHOTICS "ATTIVO KS MEDICAL"