Foot orthoses vs Manual Therapy for Plantar Fasciitis

NewsBot · May 31, 2019

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Effectiveness of Manual Therapy, Customised Foot Orthoses and Combined Therapy in the Management of Plantar Fasciitis-a RCT.
Grim C et al
Sports (Basel). 2019 May 28;7(6)

BACKGROUND:
Plantar fasciitis (PF) is one of the most common causes of plantar heel pain.

OBJECTIVE:
To evaluate the effectiveness of three different treatment approaches in the management of PF.

METHODS:
Sixty-three patients (44 female, 19 men; 48.4 ± 9.8 years) were randomly assigned into a manual therapy (MT), customised foot orthosis (FO) and a combined therapy (combined) group. The primary outcomes of pain and function were evaluated using the American Orthopaedic Foot and Ankle Society-Ankle Hindfoot Scale (AOFAS-AHS) and the patient reported outcome measure (PROM) Foot Pain and Function Scale (FPFS). Data were evaluated at baseline (T0) and at follow-up sessions after 1 month, 2 months and 3 months (T1-T3).

RESULTS:
All three treatments showed statistically significant (p < 0.01) improvements in both scales from T0 to T1. However, the MT group showed greater improvements than both other groups (p < 0.01).

CONCLUSION:
Manual therapy, customised foot orthoses and combined treatments of PF all reduced pain and function, with the greatest benefits shown by isolated manual therapy.
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Craig Payne · May 31, 2019

Exact same number in all 3 groups (hard to do that is proper randomization)
Characteristic of foot orthotic group very different to the other two groups = randomization failed or not really randomized..
Next.

NewsBot · Apr 26, 2020

Comparing the Role of Different Treatment Modalities for Plantar Fasciitis: A Double Blind Randomized Controlled Trial.
Gupta R et al
Indian J Orthop. 2020 Jan 20;54(1):31-37

INTRODUCTION:
Although many treatment modalities including rest, stretching, strengthening, change of shoes, arch supports, orthotics, night splints and anti-inflammatory agents have been advocated for plantar fasciitis, there is no report in the literature which compares the independent effectiveness of each treatment modality without the concomitant use of any other one.

METHODS:
A double blind, randomized controlled study was undertaken where 140 patients of plantar fasciitis were divided into four groups with 35 patients each. Patients in four groups received analgesics, hot water fomentation and silicon heel pads, plantar fascia stretching and calf stretching exercises, respectively. Heel pain was evaluated using Foot Function Index (FFI) and disability using Foot and Ankle Disability Index (FADI). Clinical evaluation was done weekly up to a period of 4 months and then at 6 months, 8 months, 10 months and 12 months.

RESULTS:
Mean age of patients was 43.4 ± 10.6 years with average duration of symptoms being 27.26 weeks (range 4-200 weeks). Both FFI and FADI showed statistically significant improvement at 12 months in all the four groups (p value < 0.0001 for all groups). However, groups 2, 3 and 4 were observed to show statistically better results in terms of heel pain reduction (FFI) as compared to group 1 (ANOVA, p value < 0.0001 for group 1 vs. 2, group 1 vs. 3 and group 1 vs. 4). In terms of disability (FADI), best results were observed in group 3.

CONCLUSION:
Plantar fascia stretching exercises resulted in most significant improvement in both the scores (FFI and FADI), followed by treatment with heat and silicone heel pad and calf stretching exercises.
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NewsBot · Feb 13, 2022

Comparison of subtalar mobilisation with conventional physiotherapy treatment for the management of plantar fasciitis
Muhammad Kashif et al
J Pak Med Assoc. 2021 Dec;71(12):2705-2709

Objectives: To compare the effectiveness of subtalar mobilisation technique on pain and functional disability compared to conventional physiotherapy in patients with plantar fasciitis.

Methods: The randomised controlled trial was conducted at the Prime Care Hospital, Faisalabad, Pakistan, from January to August 2017, and comprised patients of either gender aged 30-60 years presenting with complaints of heel and foot pain, a limited range of motion at the ankle joint due to heel pain, and pain in the morning when taking the first steps or after prolonged rest. The participants were randomly assigned to intervention group A, that received subtalar mobilisation, and control group B treated with therapeutic ultrasound. The groups received two treatment sessions per week over 3 weeks. Patients in both the groups received stretching and rigid tapping as standard treatment. Visual analogue scale and the foot and ankle disability inventory were used to measure pain and functional disability. Data was analysed using SPSS 20.

Results: Of the 60 patients enrolled, 8(13.3%) were lost to follow-up, while 52(86.6%) completed the study. Of the 52 subjects, there were 25(48%) in group A with a mean age of 32.40±8.02 years, while in group B there were 27(52%) subjects with a mean age of 32.59±7.00 years. Group A had 11(44%) males and 14(56%) females, while group B had 16(59.3%) males and 11(40.7%) females. Mean body mass index for group A was 25.35±3.8 compared to 25.67±3.25 for group B. There were significant differences in terms of pain between the two groups (p<0.05). Group A showed more reduction in functional disability than group B (p<0.05).

Conclusions: Subtalar mobilisation with movement was found to be effective in reducing pain and functional disability than conventional treatment in patients with plantar fasciitis.
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NewsBot · Mar 8, 2022

Intensive physiotherapy versus home-based exercise and custom-made orthotic insoles in patients with plantar fasciitis: Pilot study
Sulenur Yildiz et al
Foot (Edinb). 2022 Jan 7

Background: This prospective pilot study assessed the feasibility of comparing intensive physiotherapy group (IPG), home-based exercise (HBEG) group, and insole group (IG) to find the most effective treatment program for plantar fasciitis.

Methods: Thirty-nine individuals with plantar fasciitis were selected to participate in this pilot study. The patients were randomly divided into 3 groups, as IPG (manual interventions, exercise, insoles), HBEG (exercise, insoles), and IG (insoles). The feasibility details including percentage of the enrollment and adherence to the groups were recorded. Pain was measured with a visual analog scale, and dorsiflexion range of motion (DROM), foot function, and health-related quality of life were evaluated at the baseline and week 6. One-way ANOVA analysis and Kruskal Wallis test were used to determine the differences of the percentage change of the parameters.

Results: Pain and functional evaluation results showed improvements clinically in all of groups and quality of life results were similar for all groups. There was no difference between the groups after 6 weeks of treatment (P > 0.05).

Conclusions: The 3 treatment programs were found clinically applicable with high patient adherence. According to the data all intervention types were found moderately effective for pain and function. Insoles could be an option applied alone or with other treatments, and manual techniques gave better results in patients with limited ankle dorsiflexion. Although the results should be interpreted with caution because of the small sample size, these results were found promising and feasible to conduct a future RCT.
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NewsBot · Aug 17, 2022

Effectiveness of mechanical treatment with customized insole and minimalist flexible footwear for women with calcaneal spur: randomized controlled trial
Ana Paula Ribeiro et al
BMC Musculoskelet Disord. 2022 Aug 13;23(1):773

Backround: Calcaneal spurs are described as bony outgrowths arising on medial calcaneal, where inappropriate footwear can promote disease progression.

Objective: Investigate the effectiveness of mechanical treatment with customized insole and minimalist flexible footwear during gait training program in women with calcaneal spur.

Methods: Design: A single-blinded, randomized and controlled trial.

Setting: Biomechanics laboratory.

Participants: Forty-three women, 29 with calcaneal spur and 14 control.

Intervention: Gait training program with use of the minimalist flexible footwear (MFG n = 15, age: 48.9 ± 9.4, height: 1.61 ± 0.1, BMI: 32.1 ± 7.0) and customized insole on footwear (COIG n = 14, age: 50.3 ± 5.8, height: 1.62 ± 0.1, BMI: 32.2 ± 4.3) and control (CG n = 14, age: 47.8 ± 8.6, height: 1.63 ± 0.1, BMI: 27.5 ± 4.5), followed of the evaluations: baseline (T0) and after three (T3) and six (T6) months. Duration of the intervention was of the six months consecutive for at least 42 h per week (six hours a day, seven days a week). Outcome primary were calcaneus pain (visual analogue scale), Foot Function Index (FFI), Foot Health Status Questionnaire (FHSQ-Br) and 6-min walk test (6MWT). Secondary was plantar pressure distribution by a pressure platform system during gait and static index foot posture (FPI).

Statistical analysis: analysis of variance for repeated measure and between groups were used to detect treatment-time interactions (α = 5%). Effect size with D Cohen's also was used between T0 and after six (T6) months of intervention.

Results: The MFG and COIG were effective at reducing pain after six months (MFG: 2.5-4.5 CI, p = 0.001; COIG: 1.5-3.5 CI, p = 0.011). The FFI and FHSQ-Br showed improvements with MFG and COIG after T6 (MFG: 13.7-15.4 CI, p = 0.010; COIG: 11.3-15.0 CI, p = 0.001). The 6MWT increased with MFG (589.3-622.7 CI) and COIG (401.3-644.7 CI) and foot pronation was decreased after T3 and T6 MFG (FPI Right: 4.2-5.4 CI; Left: 3.6-5.4 CI) COIG (FPI Right: 3.4-6.8 CI; Left: 3.3-5.7 CI). The contact area reduced on forefoot and rearfoot with MFG and GOIG and midfoot and rearfoot with MFG. Maximum force was reduced on foot with MFG after T3 and T6. The peak pressure was reduced on the forefoot with MFG and COIG and on midfoot and rearfoot with MFG.

Conclusions: The mechanical treatment with customized insole and minimalist flexible footwear during gait training program during six months in women with calcaneal spur reduced the calcaneus pain, increased function and health feet and reduced plantar load on the rearfoot, midfoot and forefoot. However, the footwear alone was more effective than when combined customized insole, given the greater efficacy on clinical and biomechanical aspects.
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NewsBot · Aug 30, 2022

The effects of a custom foot orthosis on dynamic plantar pressure in patients with chronic plantar fasciitis: A randomized controlled trial
Masoomeh Nakhaee et al
Prosthet Orthot Int. 2022 Aug 26

Background: Plantar fasciitis is one of the most common causes of heel pain. The plantar fascia supports the longitudinal arch and absorbs ground reaction forces during the static and dynamic phase(s) of weight-bearing. The purpose of this randomized controlled trial study was to determine the effects of CAD/CAM foot orthoses that were designed based on the dynamic plantar pressure in patients with plantar fasciitis.

Methods: This study was performed on 34 patients with plantar fasciitis. Outcomes were compared based on plantar fascia thickness; peak pressure, mean pressure, and maximum force; and pain, activity of daily living, quality of life, and sports activity that were evaluated by ultrasound, plantar pressure platform, and the Foot and Ankle Outcome Score, respectively. The patients were randomly assigned into two groups: the experimental group (CAD/CAM orthoses and night splint) and the control group (night splint only). All data were recorded again after 4 weeks.

Results: Pain (P = 0.002) and plantar fascia thickness (P = 0.001) decreased significantly after 1 month of intervention. Activity of daily living (P = 0.044) and quality of life (P = 0.001) showed a significant increase. There was a trend in increasing peak pressure in all masking regions in both groups. The maximum force remarkably reduced in the experimental group in all regions.

Conclusions: The results demonstrated that CAD/CAM foot orthoses designed based on dynamic plantar pressure with night splint can reduce the plantar fascia thickness and pain associated with plantar fasciitis and increase the activity of daily living, quality of life, and sports activity.
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NewsBot · Nov 1, 2022

The Effect of Short and Long-Term Therapeutic Treatment with Insoles and Shoes on Pain, Function, and Plantar Load Parameters of Women with Plantar Fasciitis: A Randomized Controlled Trial
Ana Paula Ribeiro et al
Medicina 2022, 58(11), 1546

Background and Objectives: Plantar fasciitis (PF) is a prevalent musculoskeletal disease, with inflammation at the origin of the plantar fascia, that affects sedentary people, particularly middle-aged women. Foot pain and functional limitations lead patients to seek treatment. Investigate the therapeutic effect of conservative treatment combining a custom insole with minimalist flexible shoes and the shoes alone in a gait-training protocol, in the short and long term, in women with PF. Materials and Methods: Design: A randomized, controlled, and single-blind trial. Setting: Biomechanics laboratory. Participants: 36 women, 26 with acute PF and 10 controls. Intervention: Gait-training protocol wearing the minimalist shoes alone (SG, n = 12, age: 46.4 ± 9.6, height: 1.60 ± 0.2, BMI: 28.8 ± 4.2), with a custom insole in the shoes (CIG, n = 14, age: 48.9 ± 9.8, height: 1.60 ± 0.1, BMI: 26.7 ± 5.6), and control (CG, n = 10, age: 46.1 ± 10.7, height: 1.61 ± 0.2, BMI: 26.4 ± 4.8). Evaluations were performed at baseline (T0) and after three (T3) and six (T6) months. The intervention had a duration of six months (six hours a day, seven days a week). Primary outcomes were rearfoot pain (visual analogue scale), the Foot Function Index (FFI), Foot Health Status Questionnaire (FHSQ-Br), and 6 min walk test (6MWT). The secondary outcomes were plantar pressure distribution during gait, measured by the pressure platform, and foot posture. Results: The CIG was effective for reducing pain and improving the FPI after T6 compared to CG. The FPI, FHSQ-Br and 6MWT demonstrated improvements after T6 in both the CIG and SG, compared to the CG. After T6, contact area (rearfoot) and maximum force (forefoot) reduced with CIG. Maximum force (midfoot and rearfoot) reduced with CIG and SG, as did peak pressure (forefoot and midfoot) in relation to CG. Conclusions: A customized insole associated with minimalist flexible shoes during a gait-training protocol can be recommended as a more effective treatment than minimalist flexible shoes alone over the short and long term, for reduction in calcaneus pain, increased function and foot health, and improved walking through reduced plantar load in women with PF.
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NewsBot · Nov 14, 2022

The Effect of Short and Long-Term Therapeutic Treatment with Insoles and Shoes on Pain, Function, and Plantar Load Parameters of Women with Plantar Fasciitis: A Randomized Controlled Trial
Ana Paula Ribeiro et al
Medicina (Kaunas). 2022 Oct 28;58(11):1546

Background and Objectives: Plantar fasciitis (PF) is a prevalent musculoskeletal disease, with inflammation at the origin of the plantar fascia, that affects sedentary people, particularly middle-aged women. Foot pain and functional limitations lead patients to seek treatment. Investigate the therapeutic effect of conservative treatment combining a custom insole with minimalist flexible shoes and the shoes alone in a gait-training protocol, in the short and long term, in women with PF. Materials and Methods: Design: A randomized, controlled, and single-blind trial.

Setting: Biomechanics laboratory.

Participants: 36 women, 26 with acute PF and 10 controls.

Intervention: Gait-training protocol wearing the minimalist shoes alone (SG, n = 12, age: 46.4 ± 9.6, height: 1.60 ± 0.2, BMI: 28.8 ± 4.2), with a custom insole in the shoes (CIG, n = 14, age: 48.9 ± 9.8, height: 1.60 ± 0.1, BMI: 26.7 ± 5.6), and control (CG, n = 10, age: 46.1 ± 10.7, height: 1.61 ± 0.2, BMI: 26.4 ± 4.8). Evaluations were performed at baseline (T0) and after three (T3) and six (T6) months. The intervention had a duration of six months (six hours a day, seven days a week). Primary outcomes were rearfoot pain (visual analogue scale), the Foot Function Index (FFI), Foot Health Status Questionnaire (FHSQ-Br), and 6 min walk test (6MWT). The secondary outcomes were plantar pressure distribution during gait, measured by the pressure platform, and foot posture. Results: The CIG was effective for reducing pain and improving the FPI after T6 compared to CG. The FPI, FHSQ-Br and 6MWT demonstrated improvements after T6 in both the CIG and SG, compared to the CG. After T6, contact area (rearfoot) and maximum force (forefoot) reduced with CIG. Maximum force (midfoot and rearfoot) reduced with CIG and SG, as did peak pressure (forefoot and midfoot) in relation to CG. Conclusions: A customized insole associated with minimalist flexible shoes during a gait-training protocol can be recommended as a more effective treatment than minimalist flexible shoes alone over the short and long term, for reduction in calcaneus pain, increased function and foot health, and improved walking through reduced plantar load in women with PF.
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NewsBot · Apr 3, 2023

The Effectiveness of Foot-insoles Orthosis on the Recovery Process of
Plantar Fasciitis Symptoms and Quality of Life among Health Care Providers
Takroni et al
Source

Introduction: Plantar fasciitis (PF) accounts for about 80% of cases of heel pain. Foot orthoses (shoe insole/arch support), are
one of the conservative management for plantar fasciitis. To our knowledge, we could not find any study that assesses the authentic benefits of using foot insoles with their different types on reducing PF pain among healthcare providers in the kingdom
of Saudi Arabia (KSA). The aim of this was to evaluate the short and long-term effectiveness of foot orthosis in the recovery of
plantar fasciitis and assess its influence on pain and quality of life among healthcare providers.
Methods: 93 subjects agreed to participate in the study male (n=30) 32.3%, and Female (n=63) 6.78%. All participants were
asked to sign a consent form before participating in filling out the survey questions.
Study Design: Experienced Musculoskeletal researchers/Clinicians developed the study online questionnaire.
Results: 93 participants (n=30) 32.3% were male and (n=63) 64.5 % were Female. The results showed that 42 (45.2%) of the
participants used the foot-orthosis and 51(45.8) did not use it. Out of the 42 participants who used the foot orthosis 33 (35.5%)
benefited from the foot orthosis. A significant decrease in pain level score was reported after using the foot orthosis (3.00)
compared to before using the orthosis (6.79), p= 0.000.
Conclusion: The study confirms that Planter Fasciitis is one of the common problems among healthcare providers in the KSA,
and foot orthosis is one of the best conservative management for decreasing PF symptoms. the study did not find a direct effect
of Age, gender, BMI, and the received PT treatments on the benefits of using foot orthosis
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NewsBot · Apr 11, 2023

IS MULLIGAN CONCEPT EFFECTIVE TREATMENT FOR CHRONIC PLANTAR FASCIITIS? A RANDOMIZED CONTROLLED TRIAL
E.T. Çil, F. Subaşı, U. Şaylı
The International Combined Orthopaedic Research Societies (ICORS), World Congress of Orthopaedic Research, Edinburgh, Scotland, 7–9 September 2022. Part 1 of 3.

Plantar fasciitis (PF) is one of the widespread conditions causing hindfoot pain. The most common presenting symptoms are functional limitation and pain (first step and activity) on plantar surface of the foot. The non-operative treatments provide complete resolution of pain in 90% of patients, but functional limitation still remains as a risk factor for recurrency of PF. Although the number of non-operative treatment options showing efficacy on pain and functional limitation are excessive, the evidences are limited for functional limitation. Additionally, Mulligan mobilization with movement (MMWM) in Chronic Plantar Fasciitis has been poorly studied in the literature. According to these findings, the study was aimed to determine effectiveness of Mulligan mobilization with movement on Chronic Plantar Fasciitis.

A total of 25 patients (40 feet) with chronic PF were included in the study. The patients were randomly divided into Mulligan concept rehabilitation group (PF-M, n=20 feet) and Home Rehabilitation group (PF-H, n=20 feet). (MMWM), Foot and ankle exercises program were applied to PF-M, twice a week totally 8 week (16 sessions) and foot- ankle exercises as a home program were given for PF-H, 8 weeks. The range of motion (ROM) for dorsiflexion and plantar flexion was measured by using a manual goniometer. Pain, disability and activity restriction were assessed by Foot Function Index (FFI) . The first step morning pain was evaluated by Visual Analogue Scale (VAS) and Kinesiophobia was also reported by using Tampa Scale (TSK). Patients were evaluated at baseline and 8 weeks.

FFI, VAS, TSK, ROM values improved in all groups (intragroup variability) at 8th week (P < .05). The other result indicated that ROM values for DF and PF and TSK scores in PF-M had more significant improvement than PF-H (p<.05).

To the best of our knowledge this is the first randomised controlled trial for investigating Mulligan Concept efficiancy on chronic PF. Both Mulligan mobilization with movement (MMWM) and exercise protocols are effective for chronic PF. Furthermore, The Mulligan concept seems more effective treatment option in reducing kinesiophobia and improving functional capacity.
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Craig Payne · Apr 11, 2023

"The other result indicated that ROM values for DF and PF and TSK scores in PF-M had more significant improvement than PF-H (p<.05)."

With a statement like that they clearly did not analyse the study in the appropriate way. Next.

NewsBot · May 2, 2023

Different orthotics in management of plantar fasciitis: a
systematic review
Elwan et al
EJPT.2023; ;13(1):42-56.

Purpose: to provide an objective and comprehensive overview about
effectiveness of each type of orthotics used in the management of calcaneal
plantar fasciitis.
Methods: This systematic review aimed to evaluate the efficacy of various
orthotic interventions in the treatment of plantar fasciitis. The review protocol
was registered in PROSPERO, and a specific search strategy was developed
for different databases, including Cochrane Library, PEDro, MEDLINE,
EMBASE, and CINAHL. Eligibility criteria were defined, and two reviewers
independently screened titles and abstracts, followed by full-text screening of
potentially relevant studies. A data extraction form was used to collect key
study characteristics, and the quality of evidence was evaluated using
Cochrane Collaboration's tool. The primary outcome measure was pain and
disability is considered the secondary outcome.
Results: A total of 2699 studies were found, of which 10 studies were
included in the systematic review. The included studies were of randomized
controlled trials (RCTs). The review found that various orthotic interventions
could improve pain, and disability in patients with plantar fasciitis. The
combined effect size was statistically significant in all models, indicating a
significant effect of orthotics on pain and disability. However, significant
heterogeneity was observed among the studies. Subgroup analysis showed
significant heterogeneity. No significant publication bias was detected in any
of the analyses.
Conclusion: The systematic review concludes that orthotics may be a
promising non-invasive treatment for people with plantar fasciitis, as the metaanalysis showed a significant effect on pain and disability. However, the high
heterogeneity among the studies suggests that further research is needed.
While there was no significant publication bias, more high-quality research is
needed to confirm the findings and establish the optimal use of orthotics for
planter fasciitis. Clinicians should consider using orthotics with other
conservative treatments for people with Planter fasciitis.
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NewsBot · May 30, 2023

Effects of customized insoles with medial wedges on lower extremity kinematics and ultrasonographic findings in plantar fasciitis persons
Suthasinee Thong-On, Pavinee Harutaichun
Sci Rep. 2023 May 27;13(1):8642

The customized insole is widely recommended as an effective intervention for pain reduction and foot function improvement in plantar fasciitis persons. However, it is unclear whether the additional correction of medial wedges could change the kinematics from the only insole. The objectives of this study were thus to compare customized insoles with and without medial wedges on lower extremity kinematics during gait and to determine the short-term effects of the customized insole with medial wedges on pain intensity, foot function, and ultrasonographic findings in plantar fasciitis persons. A within-subject, randomized, crossover design within motion analysis research laboratory was conducted among 35 persons with plantar fasciitis. Main outcome measures included joint motions of the lower extremity and multi-segment foot, pain intensity, foot function, and ultrasonographic findings. The customized insole with medial wedges produced less knee motion in the transverse plane and hallux motion in all planes during the propulsive phase than that without medial wedges (all p < 0.05). After the 3-month follow-up, the insoles with medial wedges decreased pain intensity and increased foot function. Abnormal ultrasonographic findings also decreased significantly after the 3-month treatment of insoles with medial wedges. Customized insoles with medial wedges seem superior to those without medial wedges on both multi-segment foot motion and knee motion during propulsion. Positive outcomes from this study supported the use of customized insoles with medial wedges as an effective conservative treatment in patients with plantar fasciitis.
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NewsBot · Aug 12, 2023

The clinical and biomechanical effects of customized foot orthoses in individuals with plantar heel pain: A pre-post intervention study
Pavinee Harutaichun et al
Gait & Posture; Volume 105, September 2023, Pages 163-170

Highlights
•Foot orthoses could reduce pathological biomechanics related to plantar heel pain.
•After follow up, foot orthoses provide positively subjective and objective outcomes.
•This study offers new insights into the action of customized foot orthoses.
•Present results support the foot orthosis as an intervention of plantar heel pain.
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Background
Customized foot orthoses (CFOs) are often recommended for the management of plantar heel pain. However, there is a lack of information regarding lower limb and multi-segment foot motion during gait.

Research question
This study aimed to determine the effects of heat moulded CFOs on foot and lower limb kinematics when compared with prefabricated foot orthoses (PFOs) and wearing no orthoses (shod condition), and to determine the short-term effects of CFOs on pain intensity and foot function.

Methods
The immediate effects of CFOs on the lower limb and multi-segment foot motion were assessed. Participants were then asked to use the CFOs for one month and foot pain, function, and temporal-spatial parameters were assessed at baseline and at one month follow up.

Results
Thirty-five participants (22 females), aged 40.1 (10.5) years, with a mean duration of symptoms of 12.59 months were recruited. The symptomatic limbs showed a higher forefoot varus angle and greater rearfoot and forefoot corrections were required compared to the non-symptomatic limbs. When compared with PFOs and shod conditions, CFOs provided the least forefoot and knee motion in the transverse plane during contact phase (P < 0.05, d=0.844–1.720), least rearfoot motion in the coronal plane during midstance (P < 0.05, d=0.652), and least forefoot motion in the frontal plane, knee motion in the transverse plane, and hallux motion during the propulsive phase (P < 0.05, d=0.921–1.513). Significant improvements were seen for foot pain and function (P < 0.05, d=1.390–2.231) with significant increases in cadence and walking velocity after one month of CFO use (P < 0.05, d=0.315–0.353), and those most likely to respond had greater pain and less ankle eversion (P < 0.05, d=0.855–1.115).

Significance
CFOs appear to improve pathological biomechanics associated with plantar heel pain. After one month follow up, the CFOs decreased pain intensity and increased foot function, and showed significant improvements in temporal and spatial parameters of gait.
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NewsBot · Sep 19, 2023

Use of orthotics with orthotic sandals versus the sole use of orthotics for plantar fasciitis: Randomised controlled trial.
Amoako-Tawiah P, Love H, Chacko Madathilethu J, LaCourse J, Fortune AE, Sims JMG, Ampat G.
World J Orthop 2023; 14(9): 707-719

BACKGROUND
Plantar fasciitis (PF) affects around 10% of the population. Prefabricated orthotics with arch support has been shown to provide symptom relief in PF by decreasing the repetitive stress sustained by the plantar fascia. However, prefabricated orthotics are only effective when shoes are worn, meaning the foot may be left unsupported when it is impractical to wear shoes. Using orthotic sandals in conjunction with prefabricated orthotics may increase PF symptom relief, as they can be worn inside the home, extending the period in which the foot is supported.

AIM
To compare the combined use of prefabricated orthotics and orthotic sandals vs the sole use of prefabricated orthotics in the treatment of PF.

METHODS
98 participants with PF were randomised into two groups. The intervention group received the Aetrex L420 Compete orthotics and the Aetrex L3000 Maui Flips (orthotic sandals), whilst the control group received the Aetrex L420 Compete orthotics only. Foot pain was assessed both by the numerical rating scale (NRS) and the pain sub-scale of the foot health status questionnaire (FHSQ). Foot functionality was measured using the function sub-scale of the FHSQ. Symptom change was measured using the global rating of change scale (GROC).

RESULTS
Foot pain scores measured both by NRS and FHSQ pain sub-scale showed statistically significant reductions in foot pain in both groups (P < 0.05) at six months. Both groups also reported statistically significant improvements (P < 0.05) in function as measured by the FHSQ function subscale and improvement of symptoms as measured by the GROC scale. Between-group analysis showed that the intervention group with the combined use of orthotics and orthotic sandals scored better on all four outcome measures as compared to the control group with the sole use of orthotics. However, the between-group analysis only reached statistical significance on the NRS pain score (P < 0.05).

CONCLUSION
Combined use of prefabricated orthotics and orthotic sandals provides a greater decrease in foot pain and improvement in foot function in PF compared to using prefabricated orthotics alone.
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NewsBot · Oct 3, 2023

Both carbon fiber, polyethylene shoe insoles may improve treatment of plantar fasciitis
Results showed a significant trend of improvement in pain intensity and interference scores for each insole group.
However, carbon fiber insoles and polyethylene insoles were associated with the greatest improvements.

NewsBot · Feb 19, 2024

Is osteopathic manipulative treatment effective for pain relief in plantar fasciitis?

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