Abstract

Background
Customized foot orthoses (CFOs) are commonly used to manage plantar heel pain (PHP); however, individual responses vary. This study aimed to evaluate the effects of CFOs on pain and foot function and identify predictors of treatment response.

Methods
A total of 120 individuals with PHP underwent baseline assessments, including demographics, pain, foot function, and physical examination. Participants wore CFOs for at least 6 hours daily over six months and were reassessed for pain and foot function. Treatment response was assessed using a 15–point Global Rating of Change (GRC) scale, with responders defined as those reporting GRC ≥ +4. Baseline variables were analyzed to identify predictors of treatment response.

Results
Of the 120 participants, 107 (89.2%) were classified as responders. Significant improvements in pain and function were observed at six months (p < 0.05), with large effect sizes. Logistic regression identified four significant predictors of a positive response: higher pain during barefoot walking (OR = 1.84, 95% CI, p = 0.018), lower low back disability (OR = 0.69, 95% CI, p = 0.007), greater calcaneal eversion on the asymptomatic side (OR = 4.17, 95% CI, p = 0.014), and absence of neural tension on the symptomatic side (OR = 0.05, 95% CI, p = 0.022). The model explained 51.1% of the variance and correctly classified 90.4% of cases.

Conclusion
Most participants who received CFOs demonstrated significant improvements in pain and function at six months. Both local and remote physical factors predicted response, highlighting the value of a comprehensive physical assessment in guiding orthotic treatment.