Pain and functional outcomes of orthotic insoles plus rehabilitation in adolescent flatfoot: A 6-month retrospective cohort study

BACKGROUND: Developmental flatfoot in children and adolescents often causes pain and reduced function. The real-world effectiveness of combining orthotic insoles with rehabilitation remains unclear. METHODS: We retrospectively analyzed 100 patients (aged 6-18) with developmental flatfoot treated between March and December 2024. Fifty received orthotic insoles plus rehabilitation; 50 received rehabilitation alone. Outcomes Visual Analog Scale (VAS) pain scores, Foot and Ankle Ability Measure function scores, plantar pressure (measured in kPa), and navicular drop (ND, mm) assessed at 12 and 24 weeks. Statistical analyses were conducted using SPSS version 26.0. Mann-Whitney U tests and chi-square tests were applied for between-group comparisons, whereas Friedman tests were used to assess changes over time. A p-value <0.05 was considered statistically significant. RESULTS: At 12 weeks, 84% in the intervention group had ≥2-point VAS reduction vs. 58% in controls (p = 0.006). Foot and Ankle Ability Measure scores improved more (+12.0 vs. +7.0; p = 0.009), with greater plantar pressure and navicular drop improvements. Benefits persisted at 24 weeks and were more pronounced in children aged 6-12. No serious adverse events occurred. CONCLUSION: Orthotic insoles combined with rehabilitation improve pain, function, and alignment in adolescent flatfoot, especially in younger patients.