Sytematic review of use of foot orthotics in plantar fasciitis

NewsBot · Feb 9, 2016

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Orthotics Compared to Conventional Therapy and Other Non-Surgical Treatments for Plantar Fasciitis.
Lewis RD, Wright P, McCarthy LH
J Okla State Med Assoc. 2015 Dec;108(12):596-598.

CLINICAL QUESTION:
In adults with acute plantar fasciitis whose symptoms have not been relieved with the conventional regimen of NSAIDS, stretching and lifestyle modification, do the addition of orthotics (prefabricated or custom fitted) reduce pain and improve function compared with other non-surgical treatments (manipulative chiropractic, physical therapy and/or heel steroid injections)?
ANSWER:
Yes. Studies have shown that orthotics, both prefabricated and custom fitted, reduce pain and improve function in adults with acute plantar fasciitis with few risks or side effects. Used alone or in addition to conventional therapy (NSAIDs, stretching, lifestyle modification), orthotics are effective and well tolerated by patients for short-term pain relief and improved function. Prefabricated orthotics are less costly and provide similar relief to more expensive custom orthotics.
LEVEL OF EVIDENCE OF THE ANSWER:
A.
SEARCH TERMS:
Plantar fasciitis, heel pain, treatment, orthotics.
LIMITS:
Adult, human, English, Review, Randomized-Control Trials, Systematic Reviews, adults age 18 or more, publication dates 2004 to present.
DATE SEARCH WAS CONDUCTED:
January 16, 2014; updated January 20, 2015.
INCLUSION CRITERIA:
Recent published systematic reviews, randomized controlled, meta-analyses; adults with confirmed acute or recent diagnosis of plantar fasciitis.
EXCLUSION CRITERIA:
Studies older than 10 years, children, adolescents less than 18 years of age, chronic or recalcitrant plantar fasciitis.
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Admin2 · Feb 9, 2016

Re: Sytematic review of use of foot orthotic in plantar fasciitis

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NewsBot · Feb 17, 2016

The Use of the Power Step Shoe Insert to Manage Plantar Fasciitis Pain in Industrial Workers: A Seven-Year Pilot
Durak E
J Ergonomics 6: 150. doi:10.4172/2165-7556.1000150 (2016) (full text pdf)

We tested the effects of the Power Step shoe insert in a group of Facilities Management employees (n=23 staff,
seventeen men, six woman, average 15 years of university service), 80% of whom have been clinically diagnosed
with Plantar Fasciitis. Inserts were handed out to staff that qualified based on diagnosis beginning in 2008, and
regular staff surveys were solicited every six months thereafter. New inserts were given to staff each year as they
qualified. Over the course of seven years, eight staff personnel retired or left the program, and 10 were added to the
program. Wear and tear of the insert, and pain levels based on McGill 1-10 rating scale were used each year. In the
seven years of the program- the average length of use was 4.5 years, and pain levels were reduced from 4.83 (year
one average) to 1.60, which includes new personnel who were added after 2010. Changes were also seen over time
with individual workers who used the Power Steps for more than two years, seeing a decrease and levelling off of
pain levels from the first year of use. The results of this program show that over time the chronic pain levels
associated with work efforts in staff with Plantar Fasciitis are reduced by a statistically significant amount and
clinically based on the addition of long- term Power Step inserts added to work boots and shoes in Facilities
Management staff. This trend is continual even for newer users, and comparisons with non-power step usage shows
significant variations in pain levels
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NewsBot · Sep 21, 2017

Foot orthoses for plantar heel pain: a systematic review and meta-analysis
Glen A Whittaker et al
Br J Sports Med Published Online First: 21 September 2017. doi: 10.1136/bjsports-2016-097355

Objective To investigate the effectiveness of foot orthoses for pain and function in adults with plantar heel pain.

Design Systematic review and meta-analysis. The primary outcome was pain or function categorised by duration of follow-up as short (0 to 6 weeks), medium (7 to 12 weeks) or longer term (13 to 52 weeks).

Data sources Medline, CINAHL, SPORTDiscus, Embase and the Cochrane Library from inception to June 2017.

Eligibility criteria for selecting studies Studies must have used a randomised parallel-group design and evaluated foot orthoses for plantar heel pain. At least one outcome measure for pain or function must have been reported.

Results A total of 19 trials (1660 participants) were included. In the short term, there was very low-quality evidence that foot orthoses do not reduce pain or improve function. In the medium term, there was moderate-quality evidence that foot orthoses were more effective than sham foot orthoses at reducing pain (standardised mean difference −0.27 (−0.48 to −0.06)). There was no improvement in function in the medium term. In the longer term, there was very low-quality evidence that foot orthoses do not reduce pain or improve function. A comparison of customised and prefabricated foot orthoses showed no difference at any time point.

Conclusion There is moderate-quality evidence that foot orthoses are effective at reducing pain in the medium term, however it is uncertain whether this is a clinically important change.
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NewsBot · Jan 28, 2018

Comparison of the Effect of Prefabricated Foot Orthoses on Pain and Quality of Life in Women With Plantar Fasciiti
Maryam Sharifian et al
jrehab. 2018; 19 (1)

Objective The purpose of the present study was to investigate the effect of soft and semi-rigid prefabricated insoles on the improvement of pain and quality of life in women with plantar fasciitis.
Materials & Methods This study was a randomized clinical trial. A society with 30 women diagnosed with plantar fasciitis by physical and rehabilitation physicians, orthopedic practitioners, and other rehabilitation colleagues and referred to an orthopedic clinic of Isfahan University of Medical Sciences . Absolute recognition of plantar fasciitis was performed by the researcher using Windlass mechanism test. In this study, prefabricated soft insoles made from ethyl vinyl acetate with low-density and semi-hardened insoles of ethyl vinyl acetate with high-density were used. The insoles were full-length with an internal longitudinal arch proportional to the size of the feet of each patient. The intervention was randomly divided into two treatment groups. The patients (n=30) were divided into two groups of 15, which consisted of the test and measurement steps. The first group was without intervention, soft insoles and the semi-hardened insoles. The second group was with the stage without intervention, the soft insoles and semi-hardened insoles. Before intervention, the Foot and Ankle score and quality of life questionnaire (SF-36) was completed and then orthoses intervention was performed in two stages. One questionnaire completed after two weeks using orthosis and another six weeks after using orthosis. Normal distribution of data was calculated using Shapiro Wilk test, and for the final analysis, tests of repeated measures ANOVA were used. Statistical calculations were performed using SPSS 20 software and P<0.05 was considered significant.
Results The results demonstrated that the difference between the mean quality of life of patients in two stages of without insoles and with soft insoles was significantly higher in comparison to the without insoles stage (P<0.05). This result is same as when without insole stage is compared with semi-rigid insole and mean difference showed that this figure was significantly higher in comparison with the without insoles stage (P<0.05). The mean quality of life is higher in the semi-hard insoles in comparison to soft insole stage and the difference between these two stages is not significant (P˃0.05). The mean of foot and ankle pain in was significantly more inpatient without insole condition in comparison to patient with a soft insole (P<0.05). The mean foot and ankle pain in without insole condition is significantly more than the time when the patient has a semi-rigid insole (P<0.05). While the comparison of the pain score with soft insoles and semi-rigid insoles indicates that the pain level of the foot and ankle is significantly higher with the semi-rigid insoles.
Conclusion Based on the present findings, it can be concluded that orthosis intervention, regardless of its gender, has no significant improvement in the quality of life in patients with plantar fasciitis. Furthermore, soft insole reduces the pain of the ankle and foot in these patients.
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