Effect of Custom-Molded Insole With New Technique on Pain and Function in Females With Flexible Flat Foot: A Pilot Study

Abstract

Objective A flat foot is a complex postural deformity in which the medial longitudinal arch is decreased. It is associated with diverse symptoms and varying degrees of deformity and disability. This disorder can sometimes contribute to problems in the ankles and knee as it can alter the alignment. Conservative treatments are used to treat patients with a flat foot. One common treatment is the use of insoles with medial heel skive technique. The purpose of this study was to evaluate the effect of custom-molded insoles with new technique on pain and function in females with a flexible flat foot. Materials & Methods This research is a quasi-experimental study of before-and-after type that included 12 subjects with a flexible flat foot from the Social Welfare and Rehabilitation Sciences University of Tehran. To provide a negative cast, plaster cast impressions were taken for each participant's foot. According to the method of modification (medial heel skive) that was introduced by Kirby, the positive cast of the foot was corrected. Each person received an insole with medial heel skive technique. The pain and function of each foot were evaluated with a visual analogue scale and Foot and Ankle Outcome Score before applying the treatment and at six weeks follow-up. Paired t-test and non-parametric tests were used for statistical analysis. Results It was found that the pain and function significantly improved after 6 weeks of using insoles with medial heel skive technique in subjects with flat foot (P<0.001). Conclusion According to our findings, there was a significant difference in pain and function in patients with a flat foot through medial heel skive technique. Therefore, it seems that the insoles can be an effective prescription for subjects with a flat foot.

Effects of Custom-mold Insole by Medial Heel Skive Technique on Physical Function in Flexible Flat Foot

“…The validity and reliability of the FAAM were supported in previous studies [32]. The research participants' foot and ankle function was assessed at the beginning of the study when no foot orthosis was used and at the end of the study (after 6 weeks of using orthotic insole) [24].…”

“…The inclusion criteria of the study were as fol-A lows: the age range of 18-60 years [25]; +6 foot posture index or more [24], and having flexible and mobile flat feet according to the tiptoe test data [26]. The ones having rigid flat feet, a history of trauma, fracture, or surgery in the lower limb, neurological disorders, such as Cerebral Palsy (CP), Polio, spina bifida [24], or any neurological conditions in the foot and lower limb length discrepancy [27] were excluded from this study. This study was approved by the Ethics Committee of the University of Social Welfare and Rehabilitation Sciences (Code: IR.USWR.REC.1399.135).…”

“…Negative casting was performed for manufacturing custom-mold foot orthoses for all study participants in the none weight-bearing and neutral position of the subtalar joint [24]. In addition to medial longitudinal arch support, the medial heel skive technique was applied to the positive cast.…”

“…Moreover, -2 to +2 points can be dedicated to each item; thus, the total score ranges from -12 to +12.0 score, indicating normal foot; tending toscores reflects supinated foot, and + scores represent pronated foot [31]. Individuals obtaining +6 or more positive foot scores were considered as flat feet and entered this study [24]. The mobility of the flat foot was checked by tiptoe test when having arch height back by standing on toes [13].…”

“…Kirby claimed that the medial heel skive technique is useful to control pronated feet [23]. Bahramian studied the effect of medial heel skive technique on flat feet function; however, they only assessed women's feet in a pilot study, i.e., documented in Persian [24]. The current study aimed to assess both genders with flat feet using a different measuring tool intervening foot orthoses with medial heel skive technique.…”