Background: Physiotherapy offers an active approach to prevent and treat foot dysfunction, but it is currently rarely used. A Spiraldynamik®-inspired 6‒8-h educational program, called "Mainzer Fußschule" (Mainz Foot-school, MFS), was established to offer a framework for effective implementation. Elements of the courses are: knowledge transfer about anatomy and function, perception training, mobilization, as well as strengthening and coordination. In order to evaluate opinions of former

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... nts about the course format and their subjective effects of course participation, we collected patient-reported outcomes (PROs).Methods: In mid-2018, we conducted a retrospective, monocentric, questionnaire-based cohort study. The online-questionnaire comprised 23-items. All MFS attendees in 2015‒2017 who were contactable via e-mail (522; 90.3%) were approached. Finally, 350 completed questionnaires (67%) were returned.Results: The overall framework of the course was evaluated very positively by most participants, with 94.8% expressing a positive opinion about the course format, 97.2 % about the theory vs. practice ratio, and 97.2% about the information content. PROs regarding the offering were equally positive, with 84.3 % stating that their feet are now used and treated differently, and 63,9 % that they still perform exercises learned in the MFS. Furthermore, the majority (67.9 %) believes that the procedure had a positive effect on their existing foot problem. Feedback on the various other examined aspects was similarly positive.Conclusions: The courses were rated positively by the majority of former participants, both in terms of format and subjective effects. Thus the MFS is a promising therapy option that should be included in an extended treatment concept with individual orthopedic examination and therapy options. Our results should be verified in a multicenter, randomized controlled study.Trial registration: The Trial was approved by the ethical review committee of the Rhineland-Palatinate state chamber of physicians (18.04.2018). International Clinical Trials Registry Platform (ICTRP), DRKS00013890. Registered 11 May 2018, http://apps.who.int/trialsearch/Trial2.aspx?TrialID=DRKS00013890.