Balsdon Megan E R, Dombroski Colin E
SoleScience Inc, Fowler Kennedy Sports Medicine Clinic, Western University, London, ON, Canada.
Department of Mechanical and Materials Engineering, Western University, London, ON, Canada.
Prosthet Orthot Int. 2025 May 14. doi: 10.1097/PXR.0000000000000450.
Plantar fasciitis (PF) is considered to be the most common cause of plantar heel pain in adults. Various types of foot orthoses (FOs) have been used to treat plantar heel pain, between flat ethylene-vinyl acetate (EVA) devices, to prefabricated orthoses, to completely custom FOs. The objective of this crossover study was to quantify both objective plantar pressures, and subjective foot function and comfort ratings for two custom foot orthoses (CFOs), one with a heel plug (HP) and one without.
Twenty-one patients with diagnosed PF participated in this study and were casted using a semi-weight-bearing foam box cast. Both CFOs were made with the same materials and specifications, but the HP orthosis had a softer blue PORON® plug under the heel for added cushioning. The foot function index (FFI) was given at weeks 0, 4, and 8, as well as a subjective comfort rating at 4 and 8 weeks. Plantar pressures were recorded during treadmill walking for both devices in a running shoe after 8 weeks, after having worn each pair for 4 weeks. Average pressure, peak pressure, and pressure contact area were determined for 3 regions of the foot: hindfoot, midfoot, and forefoot. A paired samples t test determined differences in each region.
Average pressure, peak pressure, and pressure contact area were significantly reduced at the hindfoot in the HP orthosis (P < 0.001), and peak pressure was significantly reduced at the midfoot with the HP orthosis (P < 0.05). Total FFI scores were significantly reduced with both orthosis types compared to baseline (P < 0.01), but there was no difference in FFI scores or comfort scores between CFO conditions.
CFOs with heel plugs are more effective at reducing plantar pressure at the heel in patients with PF compared to CFOs without heel plugs. Both CFOs were effective at reducing FFI scores, showing an improvement in pain, and an increase in function and activity after both 4 and 8 weeks of treatment.
足底筋膜炎（PF）被认为是成人足跟疼痛最常见的原因。各种类型的足部矫形器（FO）已被用于治疗足跟疼痛，从扁平的乙烯-醋酸乙烯酯（EVA）装置到预制矫形器，再到完全定制的FO。这项交叉研究的目的是量化两种定制足部矫形器（CFO）的客观足底压力、主观足部功能和舒适度评分，一种带有足跟垫（HP），另一种没有。
21名被诊断为PF的患者参与了本研究，并使用半负重泡沫箱石膏模型进行取模。两种CFO均采用相同的材料和规格制作，但带HP的矫形器在足跟下方有一个较软的蓝色PORON®垫，以增加缓冲。在第0、4和8周给出足部功能指数（FFI），并在第4和8周给出主观舒适度评分。在分别穿着每双矫形器4周后，于第8周在跑步机上穿着跑鞋行走时记录两种装置的足底压力。确定足部3个区域（后足、中足和前足）的平均压力、峰值压力和压力接触面积。采用配对样本t检验确定每个区域的差异。
带HP的矫形器后足的平均压力、峰值压力和压力接触面积显著降低（P<0.001），带HP的矫形器中足的峰值压力显著降低（P<0.05）。与基线相比，两种矫形器类型的总FFI评分均显著降低（P<0.01），但CFO条件之间的FFI评分或舒适度评分没有差异。
与不带足跟垫的CFO相比，带足跟垫的CFO在降低PF患者足跟的足底压力方面更有效。两种CFO在降低FFI评分方面均有效，在治疗4周和8周后疼痛均有改善，功能和活动能力均有所提高。
