The effect of different designs of custom foot orthoses on pain and balance in individuals with plantar fasciitis: A randomized controlled trial with 6‐month follow‐up

BACKGROUND: Plantar fasciitis (PF) is a common cause of heel pain that significantly affects daily activities. Although custom foot orthoses (CFOs) are widely used to treat this condition, there is limited evidence comparing different orthotic designs and their effects on balance parameters. OBJECTIVE: To investigate the effects of different types of CFOs on pain and static and dynamic balance in individuals with PF. DESIGN: Randomized controlled trial. PATIENTS: ). INTERVENTIONS: All participants were randomly allocated to receive either CFOs without wedge (control group), CFOs with orthotic wedge type 1 (W1), or CFOs with orthotic wedge type 2 (W2), all of which were prescribed for daily weight-bearing activities. MAIN OUTCOME MEASURES: Pain intensity, dynamic balance from the Y Balance Test, and static balance were assessed at baseline, 3-month, and 6-month follow-up. Static balance parameters were measured using a force platform under four conditions: eyes closed on firm surface (ECFS), eyes closed on soft surface (ECSS), eyes open on firm surface (EOFS), and eyes open on soft surface (EOSS). RESULTS: All three interventions significantly reduced pain and improved dynamic balance over the 6-month period (p < .01). The CFO group showed significantly better static balance in center of mass sway during ECFS (p < .01), ECSS (95% confidence ellipse area; p = .042), and EOSS (p < .05) compared to both the W1 and W2 groups. CONCLUSION: Although all three interventions effectively reduced pain and improved dynamic balance. The CFOs without wedge demonstrated greater improvements in static balance parameters under the more challenging conditions (eyes closed and/or soft surface) compared to wedged designs. These findings suggest that basic CFOs may be sufficient for managing pain in PF; however, if balance is a concern, then the selection of specific orthotic designs may be warranted.