Journal of Physical Therapy and Health Promotion
Journal of Physical Therapy and Health Promotion(PTHP)
Frequency: Annually
Comparison of Customised Foot Orthosis and Prefabricated Foot Orthosis in the Management of Plantar Fasciitis: A Systematic Review
Background: Plantar fasciitis (PF) is one of the most common foot conditions. It has a negative impact on foot function and limits daily activities. Among all conservative interventions, foot orthosis is widely used for the management of PF. The aim of this study was to evaluate and compare the effectiveness of customised foot orthosis (CFO) and prefabricated foot orthosis (PFO) on pain and function in people with PF. Research Strategy: Medline, Embase, CINAHL Plus, AMED and SPORTDiscus databases were searched from 2008 (the date of the latest relevant systematic review) to July 2016. Study Selection: Original research trials that met these criteria were included: (1) published randomised controlled trials, (2) participants diagnosed with PF, (3) evaluation of the effectiveness of both CFO and PFO, (4) and pain and/or function as outcome measures. Data Extraction: PRISMA guidelines were employed to extract relevant data from trials that matched the inclusion criteria and two independent reviewers assessed the quality of studies. Results: A total of 631 studies were screened, and in the final process of selection, only two studies met the inclusion criteria. Both studies demonstrated that the use of foot orthosis in people with PF was associated with a greater improvement about pain and function. Also, both studies found that CFO produced similar effects compared to PFO, based on self-reported questionnaires results, such as visual analogue scale (VAS), foot function index (FFI) and 36-Item short form health survey (SF-36). One of the studies used an objective measurement tool to monitor participants’ activities by using a body-worn sensor and found that CFO was over PFO regarding episodes of walking and sit-to-stand duration. However, Meta-analysis of FFI scores showed that CFO was not statistically greater than PFO on pain (SMD −0.09, 95% CI −0.41 to 0.24; P=0.60) and function (SMD −0.18, 95% CI −0.50 to 0.15; P=0.29). Conclusion: There is moderate evidence to show that CFO was as effective as PFO for treating PF in the short term, while the weak evidence showed that CFO was more effective than PFO. However, the long-term effect of both interventions remains unclear. Further well-structured studies with extended follow-up periods and the use of objective measurements are therefore recommended.
Keywords:Plantar Fasciitis; Heel Pain; Foot Orthosis; Customised Foot Orthosis; Prefabricated Foot Orthosis
Author: Mansour Abdullah Alshehri,Wong Wai Man,Omar Farouk Helal


  1. A. C. League, “Current concepts review: plantar fasciitis,” Foot Ankle Int., vol. 29(3), pp. 358-366, 2008.
  2. J. D. Goff and R. Crawford, “Diagnosis and treatment of plantar fasciitis,” Am Fam Physician., vol. 84(6), pp. 676-682, 2011.
  3. D. B. Irving, J. L. Cook, M. A. Young, and H. B. Menz, “Impact of chronic plantar heel pain on health-related quality of life,” J Am Podiatr Med Assoc., vol. 98(4), pp. 283-289, 2008.
  4. K. B. Landorf and H. B. Menz, “Plantar heel pain and fasciitis,” Clin Evid., vol. 2(1111), pp. 1-16, 2008.
  5. S. Cutts, N. Obi, C. Pasapula, and W. Chan, “Plantar fasciitis,” Ann R Coll Surg Engl., vol. 94(8), pp. 539-542, 2012.
  6. D. L. Riddle and S. M. Schappert, “Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis: a national study of medical doctors,” Foot Ankle Int., vol. 25(5), pp. 303-310, 2004.
  7. C. L. Hill, T. K. Gill, H. B. Menz, and A. W. Taylor, “Prevalence and correlates of foot pain in a population-based study: the North West Adelaide health study,” J Foot Ankle Res., vol. 1(1), p. 1, 2008.
  8. S. J. Bartold, “The plantar fascia as a source of pain - biomechanics, presentation and treatment,” J Bodyw Mov Ther., vol. 8(3), pp. 214-226, 2004.
  9. B. L. Warren, “Plantar fasciitis in runners,” Sports Med., vol. 10(5), pp. 338-345, 1990.
  10. J. E. Taunton, M. B. Ryan, D. B. Clement, D. C. McKenzie, D. R. Lloyd-Smith, and B. D. Zumbo, “A retrospective case-control analysis of 2002 running injuries,” Br J Sports Med., vol. 36(2), pp. 95-101, 2002.
  11. P. F. Davis, E. Severud, and D. E. Baxter, “Painful heel syndrome: results of nonoperative treatment,” Foot Ankle Int., vol. 15(10), pp. 531-535, 1994.
  12. D. L. Riddle, M. Pulisic, and K. Sparrow, “Impact of demographic and impairment-related variables on disability associated with plantar fasciitis,” Foot Ankle Int., vol. 25(5), pp. 311-317, 2004.
  13. F. Badlissi, J. E. Dunn, C. L. Link, J. J. Keysor, J. B. McKinlay, and D. T. Felson, “Foot musculoskeletal disorders, pain, and foot-related functional limitation in older persons,” J Am Geriatr Soc., vol. 53(6), pp. 1029-1033, 2005.
  14. J. E. Dunn, C. L. Link, D. T. Felson, M. G. Crincoli, J. J. Keysor, and J. B. McKinlay, “Prevalence of foot and ankle conditions in a multiethnic community sample of older adults,” Am J Epidemiol., vol. 159(5), pp. 491-498, 2004.
  15. S. Prichasuk and T. Subhadrabandhu, “The relationship of pes planus and calcaneal spur to plantar heel pain,” Clin Orthop Relat Res., vol. 306, pp. 192-196, 1994.
  16. N. Sahin, A. Ozturk, and T. Atıcı, “Foot mobility and plantar fascia elasticity in patients with plantar fasciitis,” Acta Orthop Traumatol Turc., vol. 44(5), pp. 385-391, 2010.
  17. A. Cetin, A. Sivri, F. Dincer, P. Kiratli, and E. Ceylan, “Evaluation of chronic plantar fasciitis by scintigraphy and relation to clinical parameters,” J Musculoskelet Pain., vol. 9(4), pp. 55-61, 2001.
  18. E. Kuyucu, F. Koçyigit, and M. Erdil, “The association of calcaneal spur length and clinical and functional parameters in plantar fasciitis,” Int J Surg., vol. 21, pp. 28-31, 2015.
  19. A. Turgut, E. Gokturk, N. Kose, S. Seber, B. Hazer, and Î. Günal, “The relationship of heel pad elasticity and plantar heel pain,” Clin Orthop Relat Res., vol. 360, pp. 191-196, 1999.
  20. D. B. Irving, J. L. Cook, M. A. Young, and H. B. Menz, “Obesity and pronated foot type may increase the risk of chronic plantar heel pain: a matched case-control study,” BMC Musculoskelet Disord., vol. 8(1), pp. 1-8, ‏2007.
  21. R. H. Allen and M. T. Gross, “Toe flexors strength and passive extension range of motion of the first metatarsophalangeal joint in individuals with plantar fasciitis,” J Orthop Sports Phys Ther., vol. 33(8), pp. 468-478, 2003.
  22. W. B. Kibler, C. Goldberg, and T. J. Chandler, “Functional biomechanical deficits in running athletes with plantar fasciitis,” Am J Sports Med., vol. 19(1), pp. 66-71, 1991.
  23. R. A. Werner, N. Gell, A. Hartigan, N. Wiggerman, and W. M. Keyserling, “Risk factors for plantar fasciitis among assembly plant workers,” PM&R, vol. 2(2), pp. 110-116, 2010.
  24. B. Rajput and R. J. Abboud, “Common ignorance, major problem: the role of footwear in plantar fasciitis,” The Foot., vol. 14(4), pp. 214-218, 2004.
  25. B. R. Wilk, K. L. Fisher, and W. Gutierrez, “Defective running shoes as a contributing factor in plantar fasciitis in a triathlete,” J Orthop Sports Phys Ther., vol. 30(1), pp. 21-31, 2000.
  26. M. Wolgin, C. Cook, C. Graham, and D. Mauldin, “Conservative treatment of plantar heel pain: long-term follow-up,” Foot Ankle Int., vol. 15(3), pp. 97-102, 1994.
  27. E. K. Agyekum and K. Ma, “Heel pain: a systematic review,” Chin J Traumatol., vol. 18(3), pp. 164-169, 2015.
  28. J. A. Rano, L. M. Fallat, and R. T. Savoy-Moore, “Correlation of heel pain with body mass index and other characteristics of heel pain,” J Foot Ankle Surg., vol. 40(6), pp. 351-356, 2001.
  29. E. Roos, M. Engstrom, and B. Soderberg, “Foot orthoses for the treatment of plantar fasciitis,” Foot Ankle Int., vol. 27(8), pp. 606-611, 2006.
  30. G. F. Kogler, S. E. Solomonidis, and J. P. Paul, “Biomechanics of longitudinal arch support mechanisms in foot orthoses and their effect on plantar aponeurosis strain,” Clin Biomech., vol. 11(5), pp. 243-252, 1996.
  31. J. K. Chia, S. Suresh, A. Kuah, J. L. Ong, J. M. Phua, and A. L. Seah, “Comparative trial of the foot pressure patterns between corrective orthotics, formthotics, bone spur pads and flat insoles in patients with chronic plantar fasciitis,” Ann Acad Med Singapore., vol. 38(10), pp. 869-875, 2009.
  32. D. A. Seligman and D. R. Dawson, “Customized heel pads and soft orthotics to treat heel pain and plantar fasciitis,” Arch Phys Med Rehabil., vol. 84(10), pp. 1564-1567, 2003.
  33. M. T. Gross, J. M. Byers, J. L. Krafft, E. J. Lackey, and K. M. Melton, “The impact of custom semirigid foot orthotics on pain and disability for individuals with plantar fasciitis,” J Orthop Sports Phys Ther., vol. 32(4), pp. 149-157, 2002.
  34. M. Walther, B. Kratschmer, J. Verschl, C. Volkering, S. Altenberger, S. Kriegelstein, and M. Hilgers, “Effect of different orthotic concepts as first line treatment of plantar fasciitis,” Foot Ankle Surg., vol. 19(2), pp. 103-107, 2013.
  35. K. Ring and S. Otter, “Clinical efficacy and cost-effectiveness of bespoke and prefabricated foot orthoses for plantar heel pain: a prospective cohort study,” Musculoskeletal Care., vol. 12(1), pp. 1-10, 2014.
  36. A. C. Redmond, K. B. Landorf, and A. M. Keenan, “Contoured, prefabricated foot orthoses demonstrate comparable mechanical properties to contoured, customised foot orthoses: a plantar pressure study,” J Foot Ankle Res., vol. 2(1), pp. 1-10, 2009.
  37. J. Anderson and J. Stanek, “Effect of foot orthoses as treatment for plantar fasciitis or heel pain,” J Sport Rehabil., vol. 22(2), pp. 130-136, 2013.
  38. F. Hawke, J. Burns, J. A. Radford, and V. Du Toit, “Custom-made foot orthoses for the treatment of foot pain,” Cochrane Database Syst Rev., vol. 16, iss. 3, Article No: CD006801, 2008.
  39. S. Y. Lee, P. McKeon, and J. Hertel, “Does the use of orthoses improve self-reported pain and function measures in patients with plantar fasciitis? A meta-analysis,” Phys Ther Sport., vol. 10(1), pp. 12-18, 2009.
  40. H. Uden, E. Boesch, and S. Kumar, “Plantar fasciitis - to jab or to support? A systematic review of the current best evidence,” J Multidiscip Healthc., vol. 4, pp. 155-164, 2011.
  41. R. D. Lewis, P. Wright, and L. H. McCarthy, “Orthotics Compared to Conventional Therapy and Other Non-Suraical Treatments for Plantar Fasciitis,” J Okla State Med Assoc., vol. 108(12), pp. 596-598, 2015.
  42. E. R. Waclawski, J. Beach, A. Milne, E. Yacyshyn, and D. M. Dryden, “Systematic review: plantar fasciitis and prolonged weight bearing,” Occup Med., vol. 65(2), pp. 97-106, 2015.
  43. D. B. Irving, J. L. Cook, and H. B. Menz, “Factors associated with chronic plantar heel pain: a systematic review,” J Sci Med Sport., vol. 9(1-2), pp. 11-22, 2006.
  44. J. G. Furey, “Plantar fasciitis. The painful heel syndrome,” J Bone Joint Surg Am., vol. 57(5), pp. 672-673, 1975.
  45. O. Micke, A. Ernst-Stecken, R. Mücke, and M. H. Seegenschmiedt, “Calcaneodynia: plantar and dorsal heel spur/heel spur syndrome. Radiotherapy for Non-Malignant Disorders,” Springer Berlin Heidelberg., pp. 295-315, 2008.
  46. C. Cole, C. Seto, and J. Gazewood, “Plantar fasciitis: evidence-based review of diagnosis and therapy,” Am Fam Physician., vol. 72(11), pp. 2237-2242, 2005.
  47. A. M. Alshami, T. Souvlis, and M. W. Coppieters, “A review of plantar heel pain of neural origin: differential diagnosis and management,” Man Ther., vol. 13(2), pp. 103-111, 2008.
  48. J. L. Thomas, J. C. Christensen, S. R. Kravitz, R. W. Mendicino, J. M. Schuberth, J. V. Vanore, L. S. Weil, H. J. Zlotoff, R. Bouche, and J. Baker, “The diagnosis and treatment of heel pain: a clinical practice guideline-revision 2010,” J Foot Ankle Surg., vol. 49(3), pp. 1-19, 2010.
  49. M. A. Mohseni-Bandpei, M. Nakhaee, M. E. Mousavi, A. Shakourirad, M. R. Safari, and R. V. Kashani, “Application of ultrasound in the assessment of plantar fascia in patients with plantar fasciitis: a systematic review,” Ultrasound Med Biol., vol. 40(8), pp. 1737-1754, 2014.
  50. J. P. Higgins, D. G. Altman, P. C. Gotzsche, P. Jüni, D. Moher, A. D. Oxman, J. Savović, K. F. Schulz, L, Weeks, and J. A. Sterne, “The Cochrane Collaboration’s tool for assessing risk of bias in randomized trials,” BMJ, vol. 343, pp. d5928, 2011.
  51. L. Hartling, M. Ospina, Y. Liang, D. M. Dryden, N. Hooton, J. K. Seida, and T. P. Klassen, “Risk of bias versus quality assessment of randomised controlled trials: cross sectional study,” BMJ, vol. 339(7728), pp. 1017, 2009.
  52. L. Hartling, M. P. Hamm, A. Milne, B. Vandermeer, P. L. Santaguida, M. Ansari, A. Tsertsvadze, S. Hempel, P. Shekelle, and D. M. Dryden, “Testing the risk of bias tool showed low reliability between individual reviewers and across consensus assessments of reviewer pairs,” J Clin Epidemiol., vol. 66(9), pp. 973-981, 2013.
  53. L. Hartling, K. Bond, B. Vandermeer, J. Seida, D. M. Dryden, and B. H. Rowe, “Applying the risk of bias tool in a systematic review of combination long-acting beta-agonists and inhaled corticosteroids for persistent asthma,” PLoS One., vol. 6(2), pp. e17242, 2011.
  54. A. Liberati, D. G. Altman, J. Tetzlaff, C. Mulrow, P. C. Gøtzsche, J. P. A. Ioannidis, M. Clarke, P. J. Devereaux, J. Kleijnen, and D. Moher, “The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration,” Ann Intern Med., vol. 151(4), pp. 65-94, 2009.
  55. G. H. Guyatt, D. L. Sackett, J. C. Sinclair, R. Hayward, D. J. Cook, R. J. Cook, E. Bass, H. Gerstein, B. Haynes, A. Holbrook, R. Jaeschke, A. Laupacls, V. Moyer, and M. Wilson, “Users’ guides to the medical literature. IX. A method for grading health care recommendations,” JAMA., vol. 274(22), pp. 1800-1804, 1995.
  56. V. Baldassin, C. R. Gomes, and P. S. Beraldo, “Effectiveness of prefabricated and customized foot orthoses made from low-cost foam for noncomplicated plantar fasciitis: a randomized controlled trial,” Arch Phys Med Rehabil., vol. 90(4), pp. 701-706, 2009.
  57. J. S. Wrobel, A. E. Fleischer, R. T. Crews, B. Jarrett, and B. Najafi, “A randomized controlled trial of custom foot orthoses for the treatment of plantar heel pain,” J Am Podiatr Med Assoc., vol. 105(4), pp. 281-294, 2015.
  58. K. Landorf, A. M. Keenan, and R. L. Rushworth, “Foot orthosis prescription habits of Australian and New Zealand podiatric physicians,” JAPMA., vol. 91(4), pp. 174-183, 2001.
  59. H. J. Fox and I. G. Winson, “Foot orthoses: an audit of expenditure and efficacy,” The Foot., vol. 4(2), pp. 79-82, 1994.
  60. J. E. Martin, J. C. Hosch, W. P. Goforth, R. T. Murff, D. M. Lynch, and R. D. Odom, “Mechanical treatment of plantar fasciitis: a prospective study,” J Am Podiatr Med Assoc., vol. 91(2), pp. 55-62, 2001.
  61. K. B. Landorf, A. M. Keenan, and R. D. Herbert, “Effectiveness of foot orthoses to treat plantar fasciitis: a randomized trial,” Arch Intern Med., vol. 166(12), pp. 1305-1310, 2006.
  62. M. Powell, M. Seid, and I. S. Szer, “Efficacy of custom foot orthotics in improving pain and functional status in children with juvenile idiopathic arthritis: a randomised trial,” J Rheumatol., vol. 32(5), pp. 943-950, 2005.
  63. A. C. Chalmers, C. Busby, J. Goyert, B. Porter, and M. Schulzer, “Metatarsalgia and rheumatoid arthritis- a randomised, single blind, sequential trial comparing 2 types of foot orthoses and supportive shoes,” J Rheumatol., vol. 27(7), pp. 1643-1647, 2000.
  64. J. S. Paton, E. A. Stenhouse, G. Bruce, D. Zahra, and R. B. Jones, “A comparison of customised and prefabricated insoles to reduce risk factors for neuropathic diabetic foot ulceration: a participant-blinded randomised controlled trial,” J Foot Ankle Res., vol. 5(1), pp. 1-11, 2012.
  65. M. A. Turlik, T. J. Donatelli, and M. G. Veremis, “A comparison of shoe inserts in relieving mechanical heel pain,” The Foot., vol. 9(2), pp. 84-87, 1999.
  66. G. Pfeffer, P. Bacchetti, J. Deland, A. I. Lewis, R. Anderson, W. Davis, R. Alvarez, J. Brodsky, P. Cooper, C. Frey, R. Herhck, M. Myerson, J. Sammarco, C. Janecki, S. Ross, M. Bowman, and R. Smith, “Comparison of custom and prefabricated orthoses in the initial treatment of proximal plantar fasciitis,” Foot Ankle Int., vol. 20(4), pp. 214-221, 1999.