Comparative trial of the foot pressure patterns between corrective orthotics,formthotics, bone spur pads and flat insoles in patients with chronic plantar fasciitis.
BACKGROUND
The objective of the study is to compare the efficacy of fl at insoles, bone spur pads, pre-fabricated orthotics and customised orthotics in reducing plantar contact pressure of subjects with plantar fasciitis.


METHODS
This is a controlled non-blinded comparative study conducted in a tertiary medical institute. Thirty subjects with unilateral plantar fasciitis between the ages of 20 and 65 years were recruited at the sports medicine clinic. The contact pressures and pressure distribution patterns in both feet for each subject were measured with sensor pressure mats while standing. Repeat measurements were made with the subjects wearing shoes, fl at insoles, bone spur heel pads, pre-fabricated insoles and customised orthotics on both feet. The asymptomatic side was used as the control. Contact pressure measurements of the symptomatic and asymptomatic feet and power ratio of the pressure distribution pattern of the rearfoot were then compared.


RESULTS
Contact pressure was higher on the asymptomatic side due to unequal distribution of weight. Bone spur heel pads were ineffective in reducing rearfoot pressure while formthotics and customised orthotics reduced peak rearfoot pressures significantly. The power ratio of the rearfoot region decreased with the use of formthotics and customised orthotics.


CONCLUSIONS
Pre-fabricated orthotics and customised orthotics reduced rearfoot peak forces on both sides while bone spurs heel pad increase rearfoot peak pressures. Pre-fabricated and customised orthotics are useful in distributing pressure uniformly over the rearfoot region.
Chia
Kok Kiong Jason
KK
Department of Sports Medicine, Changi General Hospital, Singapore. jason_chia@cgh.com.sg
Suresh
Sanjay
S
Kuah
Angeline
A
Ong
Jean L J
JL
Phua
Jessie M T
JM
Seah
Ai Ling
AL
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001696:Biomechanical Phenomena; D015992:Body Mass Index; D002908:Chronic Disease; D036981:Fasciitis, Plantar / Q000628:therapy*; D005260:Female; D005528:Foot / Q000502:physiology*; D006365:Heel; D036982:Heel Spur / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D010146:Pain / Q000517:prevention & control; D010147:Pain Measurement; D011312:Pressure; D055815:Young Adult