title: A comparison of semi-custom and custom foot orthotic devices in high- and low-arched individuals during walking.
abstract: BACKGROUND
  Orthotic devices can be a successful treatment for lower extremity injuries. However, the high cost of custom devices prevents some patients from purchasing them. Some orthotic companies have begun to offer a less expensive, semi-custom alternative. The purpose of this study was to examine whether the semi-custom devices can provide similar rearfoot control and comfort as custom devices in individuals with excessively high- and low-arches.
  
  
  METHODS
  Thirty-seven subjects walked through the motion analysis lab under three conditions: no-orthotic, custom orthotics, and semi-custom orthotics. Rearfoot kinematics and comfort were collected in each device.
  
  
  RESULTS
  Both devices were effective at reducing eversion velocity and excursion. As compared to the no-orthotic condition, the custom device significantly decreased eversion velocity (P=0.03), while the semi-custom device showed a trend toward decreased eversion velocity (P=0.09). Eversion excursion was significantly reduced in both orthotic conditions (P<0.01). In terms of comfort, high-arched individuals tended to be more comfortable in the semi-custom device in the heel and arch regions. However, the differences in comfort between the devices were generally small (<7%).
  
  
  CONCLUSIONS
  Overall, with respect to a comfort and ability to control rearfoot motion, the semi-custom orthotic device is a feasible alternative to the custom orthotic device for high- and low-arched individuals.
authors.affiliation: Leon Root, MD Motion Analysis Laboratory, The Hospital for Special Surgery, New york, NY 10021, USA. zifchockr@hss.edu
authors.forename: Rebecca Avrin
authors.initials: RA
authors.lastname: Zifchock
authors.forename: Irene
authors.initials: I
authors.lastname: Davis