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Treating heel pain in adults: a randomized controlled trial of hard versus modified soft custom orthotics and heel pads |
Seligman DAR, Dawson D, Streiner DL, Seligman DJ, Davis A |
Archives of Physical Medicine and Rehabilitation 2021 Mar;102(3):363-370 |
clinical trial |
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
This study compared the effectiveness of soft versus hard orthotics in treating heel pain and plantar fasciitis in adults. It also compared the level of function after orthotic use, cost, and number of visits for orthotics and explored whether age was a factor in orthotic effectiveness. Randomized controlled trial. Before randomization, patients were stratified by age (younger versus older adults) in blocks of 4 to ensure that there were an equal number of participants in each group (soft versus hard orthotics). An orthotic clinic in a community-based hospital and a private orthotic clinic. The participants were adults aged 18 years or older (N = 44) with heel pain and plantar fasciitis. Participants received hard or soft customized orthotics. Participants rated their pain intensity and pain interference before and after orthotic use using subscales from the Brief Pain Inventory. Function was similarly measured using the Late Life Function and Disability Instrument: Function component. Analyses of age, cost, and number of visits were also compared. There was a reduction in pain intensity (p = 0.010) and pain interference (p < 0.001) but no change in function over time (p = 0.333), and no difference between the groups who received hard versus soft orthotics. Age had no effect on orthotic effectiveness. Soft orthotics were less expensive (p < 0.0001) and required fewer visits for fabrication (p < 0.0001). Both soft and hard orthotics provided effective pain relief, but soft orthotics are less expensive.
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