Abstract

Introduction: Plantar fasciitis (PF) is a common cause of heel pain that significantly impacts daily activities. While 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: This study aimed to investigate the effects of different types of CFOs on pain, static and dynamic balance in individuals with PF.
Design: Randomized controlled trial
Patients: 120 participants with PF (age 44.29 ± 10.06 years; 72.5% female; BMI 26.51 ± 4.93 kg/m²)
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 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<0.01). The CFO group showed significantly better static balance in center of mass sway during ECFS (p<0.01), ECSS (95% CEA; p=0.042), and EOSS (p<0.05) compared to both the W1 and W2 groups.
Conclusion: While 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.