Keywords:plantar foot pressure, custom-molded medial arch support, custom-molded heel cushion, silicone
Objective: To compare plantar hindfoot pressure before and during application of the silicone medial arch supports and the silicone heel cushions in standing.
Study design: Cross-over design
Setting: Department of Rehabilitation Medicine, Siriraj Hospital
Subjects: Thirty volunteers were recruited into the study.
Methods: The medial arch supports and the heel cushions were custom-made by foot impression technique, and were fabricated from silicone (hardness 23o shore A). The plantar hindfoot pressures was measured by digital foot scan machine (FSA Insole®), and compared before and during application of each of the orthoses in standing. The volunteers were divided into 2 groups of 15 by randomization. The first group used the medial arch supports, while the second group wore the heel cushions. After 2 weeks of use, each group was switched to the other type of orthoses for another 2 weeks. After using both orthoses, the researcher evaluated durability of each orthoses and looked for complications of use. The volunteers graded their satisfaction and selected the most preferred one.
Results: When compared with not using any orthoses, both orthoses significantly decreased plantar hindfoot pressure (p ≤ 0.001). When comparing between the medial arch supports and the heel cushions, the medial arch design significantly decreased plantar hindfoot pressure better than with the heel cushion design (p ≤ 0.001). Regarding durability, both orthoses were in good condition after being use for 2 weeks. The level of satisfaction was graded as high in most subjects and there was no complication of using both orthoses.
Conclusion: Applications of both custom silicone medial arch supports and heel cushions can decrease plantar hindfoot pressure in standing. In comparison, the medial arch support design can decrease the pressure better than with the heel cushion design.
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