An exploration of the factors predicting clinical responses to customized foot orthoses in individuals with plantar heel pain.

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.