Effects of customized insoles with medial wedges on lower extremity kinematics and ultrasonographic findings in plantar fasciitis persons

Abstract

Abstract Background: The customized insole is widely recommended as an effective intervention for pain reduction and foot function improvement. However, it is unclear whether the symptom improvement is due to anatomical and biomechanical changes after receiving the insole. The objectives of this study were to compare customized insoles with and without medial wedges on lower extremity kinematics during gait and to determine the short-term effects of the insole on pain intensity, foot function, and ultrasonographic findings in individuals with plantar fasciitis. Methods: A within-subject, randomized, crossover design within motion analysis research laboratory was conducted among 35 persons with plantar fasciitis. Main outcome measures included joint motions of the lower extremity and multi-segment foot, pain intensity, foot function, and ultrasonographic findings. Results: The customized insole with medial wedges produced less knee motion in the transverse plane and hallux motion in all planes during the propulsive phase than that without medial wedges (all p < 0.05). After the 3-month follow-up, the insole decreased pain intensity and increased foot function. There was a significant reduction in the number of participants in the apparent group from the ultrasonographic findings, which included those with plantar fascia thickness greater than 3.8 mm and hypo-echogenicity of the plantar fascia. Conclusions: Customized insoles with medial wedges seem superior to those without medial wedges to reduce pathological biomechanics. Positive outcomes from this study supported the use of customized insoles with medial wedges as an effective conservative treatment in patients with plantar fasciitis. Trial registration: TCTR20210928006 (28/09/2021).