SLR - June 2009 - Alfandari, Shiao, Thompson
Reference:
Baldassin, V., Gomes, C., Beraldo, P. (2009). Effectiveness of prefabricated and customized foot orthoses made from lowcost foam for non-complicated plantar fasciitis: A randomized controlled trial. Arcj Phys Med Rehabil 90, 701-706
Scientific Literature Review
Reviewed by: Ronny Alfandari DPM; Terry Shiao DPM; Jonathan Thompson, DPM
Residency Program: VA- West Los Angeles /Olive View Medical Center
Podiatric Relevance:
This study reviews the effectiveness of treating noncomplicated plantar fasciitis with the use of a prefabricated versus customized orthotic insert made from ethylene vinyl acetate (EVA).
Methods:
One hundred and forty two adults (75% women), were evaluated and randomly assigned to receive either a pre-fabricated or customized foot orthotic in this double-blinded trial. All subjects were diagnosed clinically with complaint of first-step pain with maximal tenderness over medial calcaneal tuberosity, without having any anatomic deformities. These subjects were then evaluated after using the orthotic at both 4 and 8 weeks using the modified Foot Function Index (FFI), a visual analog scale that covers activity limitation, disability, and pain, as well as tenderness on palpation of the medial calcaneal tubercle using visual analog scale.
Results:
On-hundred twenty-five participants returned to at least 1 of the follow-up evaluations (63 participants with prefabricated orthotics and 62 with custom orthotics). Both groups showed significant improvement using a modified Foot Function Index (P<.05), however no differences were noted between the two groups both at four and eight weeks follow-up after the start of orthotic use.
Conclusions:
This study shows that pre-fabricated orthotics appear to be at least as effective in reducing heel pain as a custom orthotic device in the treatment in noncomplicated plantar fasciitis. However, as the length of this study was limited to only 8 weeks of treatment, it did not address if prefabricated orthotics would be as effective in the long term treatment of plantar fasciitis, nor if low-dye strapping would be as effective as pre-fabricated orthotics in this acute setting.