The Effect of Different Types of Foot Orthoses on Foot Plantar Pressure in Subjects with Plantar Fasciitis: A Literature Review

Plantar fasciitis is a plantar fascia inflammation and one of the most common causes of heel pain, causing pain in the inner side of the heel bone. The purpose of this investigation was to analyze the effect of different foot orthoses on the distribution of foot pressure in patients with plantar fasciitis.

The systematic search of PubMed, Science Direct and Web of Knowledge databases was conducted using keywords such as plantar pressure, plantar fasciitis, heel pain, foot orthoses, and orthotic insoles to identify published articles in this field. The statistical population was all studies that examined heel and foot pressure in patients with plantar fasciitis. In addition, studies on different perspectives were identified in plantar fasciitis. From 1999 to 2018, thirteen articles were evaluated in Persian and English, nine of which directly evaluated the effect of foot orthoses on heel and foot pressure, and were selected based on entry criteria for the final examination.

Nine articles were selected for inclusion in the study. These articles examined types of foot orthoses include, custom insole, prefabricated insole, foam insole, silicone heel cup, foam heel pad, viscoelastic heel pad, and tape and then measured heel and foot pressure using various devices. The results show that the insoles can be effective in reducing the maximum pressure and also reducing the average pressure. In one study, the maximum total pressure before using the insoles was 12 and decreased using custom insoles and prefabricated insoles respectively 7/7 and 8/7. Some studies have found little difference between these two insoles in reducing the heel and foot pressure. In one study, both insoles reduced the maximum pressure at the inside of heel to a value of 13%. Compared to the prefabricated insole with foam heel pad and silicone heel cup and heel lift, decrease pressure in prefabricated insoles was higher than other groups (P<0.001). Silicone insoles also reduce the pressure of the heel, but this is insignificant (P=1). Also, according to studies cups and pads also contribute to decreasing foot pressure (P<0.05).

Although all types of foot orthotics are effective in reducing the heel and foot pressure, the effect of custom-made and prefabricated insoles in reducing foot pressure was greater than heel orthoses. Also, in most studies, custom-made insoles were more effective than different prefabricated insoles, however, the slight difference in reducing the amount of pressure by the prefabricated and custom-made insoles makes it impossible to come to a definite conclusion regarding the superiority of the insoles.