Insole Research Articles

Effects of Application of Night Splint in the Management of Plantar Fasciitis

Background: Plantar fasciitis is one of the most common causes of heel pain. The condition usually comes on gradually without any injury. Clinically there is pain and tenderness in the sole of the foot, mostly under the heel, with standing or walking. The diagnosis of patient with planter fasciitis is essentially clinical. Treatment options for planter fasciitis include rest, stretching, strengthening exercise, shoe modification, arch supports, orthotics, night splints, anti- inflammatory agents, and surgery. Although injections and Non-steroidal anti-inflammatory drugs (NSAIDs) bring relief, their effects are often only temporary. Stretching of the calf and plantar fascia may provide some benefit. In chronic planter fasciitis, surgical treatment is only advocated where adequate conservative management fails.
 Objective: The aim of this study is to evaluate the effects of the application of night splint in the management of plantar fasciitis.
 Materials and Methods: This randomised clinical trial included 50 (fifty) patients with planter fasciitis who were seen in the Physical Medicine and Rehabilitation department of the National Institute of Traumatology and Orthopedic Rehabilitation (NITOR) in Dhaka. The patients were divided randomly into two groups, Group A and Group B. Patients in Group A were treated with NSAID, ADL and Night splint, whereas Group B patients were treated with NSAID and ADL. The patients were evaluated clinically, and data was collected from both groups in a pre-designed data collection sheet for Pain score, Tenderness index, and Visual analogue scale in every 2 weeks interval from the first visit for up to 6 weeks. All the data were analyzed by SPSS version 16.1.
 Results: The present study showed pain and tenderness were significantly improved in Group A, who were treated with Night Splint, NSAID & ADL instructions than in Group B who were treated with NSAID & ADL instructions after 6 weeks( P<0.05).
 Conclusion: Night splint is an easy, non-surgical and cost-effective one which can be applied with other modalities. Night Splint, along with NSAIDs and ADL instructions, is more effective in the reduction of pain and other symptoms in a patient with planter fasciitis.

Immediate Effects of Silicone Arch Support Insoles on Postural Balance in Children with Flexible Flat Feet

Immediate Effects of Silicone Arch Support Insoles on Postural Balance in Children with Flexible Flat Feet

Empirical Study on Human Movement Classification Using Insole Footwear Sensor System and Machine Learning.

This paper presents a plantar pressure sensor system (P2S2) integrated in the insoles of shoes to detect thirteen commonly used human movements including walking, stooping left and right, pulling a cart backward, squatting, descending, ascending stairs, running, and falling (front, back, right, left). Six force sensitive resistors (FSR) sensors were positioned on critical pressure points on the insoles to capture the electrical signature of pressure change in the various movements. A total of 34 adult participants were tested with the P2S2. The pressure data were collected and processed using a Principal Component Analysis (PCA) for input to the multiple machine learning (ML) algorithms, including k-NN, neural network and Support-Vector Machine (SVM) algorithms. The ML models were trained using four-fold cross-validation. Each fold kept subject data independent from other folds. The model proved effective with an accuracy of 86%, showing a promising result in predicting human movements using the P2S2 integrated in shoes.

Does insole hardness affect the dynamic postural stability of basketball athletes during jump landing?

This study aimed to examine the effects of shoe insole hardness on the dynamic postural stability of basketball athletes during jump landing manoeuvres. Twenty college basketball athletes were recruited to complete a single-leg jump landing task on a force plate in three insole conditions (soft-, rigid- and no-insole). Kistler force plate and Pedar-X insole system were used to collect the ground reaction force (GRF) and plantar pressure data. Dynamic Postural Stability Index (DPSI), Anterior-Posterior Stability Index (APSI), Medial-Lateral Stability Index (MLSI), and Vertical Stability Index (VSI) were then calculated from GRF data. DPSI, APSI, MLSI, and VSI were statistically conducted among the three insole conditions by a one-way ANOVA with repeated measures. MLSI were decreased when wearing soft- and rigid insoles compared with no-insole condition (p < 0.05). However, there were no significant differences in APSI and VSI among the three insole conditions. In the midfoot region, contact areas were increased in the soft- and rigid insole than the no-insole condition (p < 0.0001). Dynamic balance of basketball athletes in the medial-lateral direction could be enhanced by wearing insoles during jump landings tasks. However, the postural stability of basketball athletes did not increase with insole hardness increasing.

Modeling the influence of rolled profile strengtheners on the arch support load-bearing capacity

Purpose.Increasing the load-bearing capacity of metal arch supports used to maintain the mine workings due to strengthening in places with the highest bending moment. Methods. The stress-strain state of the rock mass and support is analyzed using the ANSYS software package. The problem is studied in three variants: a support without strengtheners, a support with one strengthener in the area with the maximum bending moment, and a support with three strengtheners in the areas with the highest bending moments. To determine the bending moments and normal forces in a three-section metal arch support, the finite element method is used for specific and existing conditions, which is followed by the selection of the required standard size of the support. Findings. The conducted research gives reasons to believe that the proposed variant for increasing the load-bearing capacity of the support, made from a special replaceable rolled profile (SCP), can significantly improve the state of mine workings. Obviously, the proposed solution can be applied not only to arch supports, but also to other structures of rolled metal support. Originality. The pattern of changes in the values of internal forces arising in metal arch frame supports, depending on the deformation characteristics, the location of the strengtheners, as well as on the geometric characteristics of the mine working and the ratio of lateral and vertical loads on the support, has been determined. Practical implications. The proposed variant for increasing the load-bearing capacity of the support can be used to sustainably maintain mine workings in difficult mining-geological conditions of the Karaganda Coal Basin mines.

Effect of shoe insole on the dynamics of lower extremities in individuals with leg length discrepancy during walking

IntroductionThe aim of the present study was to investigate the effect of Internal and External Heel Lift Insoles (IHLI, EHLI) on pelvic kinematics and lower extremity joint moments in subject with mild leg length discrepancy (LLD) during the Stance Phase of walking. MethodsFrom twenty-eight men with mild LLD, kinematic and kinetic data were collected while they walked under each of three conditions (IHLI, EHLI and shoe). Data were collected for both limbs using a six-camera system synchronized with a force platform. For comparisons the dependent variables among the conditions, repeated measures ANCOVA and Bonferroni's post hoc test were used (P ≤ 0.05). ResultsFor both IHLI and EHLI, there were significant decreases in peak long leg lateral and anterior pelvic tilt, long leg hip and knee abduction moments, and short leg ankle plantar flexor moment (P ≤ 0.001). Furthermore, significant increases in peak lateral and anterior pelvic tilt of the short leg were observed in the IHLI and EHLI conditions as compared to the shoe (SH) condition (p ≤ 0.01). In addition, a significant difference was observed between the IHLI and EHLI conditions in the peak values of anterior pelvic tilt of the long leg (p = 0.043) and ankle plantar flexor moment of the short leg (p = 0.044). ConclusionFindings suggest that the use of IHLI and EHLI may be effective in improving pelvic movements (lateral and anterior tilt) and gait dynamics in individuals with LLD. The EHLI could reduce more the peak plantar flexor moment of the short leg and peak anterior pelvic tilt of the long leg than IHLI during stance phase of walking.

Advancement of the Monitoring System for Arch Support Geometry and Loads

As part of the RFCS project, which aimed to improve transport safety in mines, ITG KOMAG proposed a system for monitoring loads and geometric of arch support. The system’s function is to control safety, mainly during suspended monorail runs. This paper presents a hardware model and a measurement method based on the use of vibrating wire strain gauges and draw-wire sensors. The challenge was to properly adapt the vibrating wire strain gauge operation to the requirements of the ATEX directive on the safe use of electrical equipment in underground mines. The signal transducer algorithm and potential mounting locations for the proposed sensors were discussed. The results of tests carried out using the ŁP arc support are presented, reflecting the actual behavior of the casing during loading in accordance with the test methodology proposed by the Central Mining Institute. In order to compare the results with another measurement method, film strain gauges were additionally applied. The results confirm the usefulness of the proposed method for testing in real conditions. The speed and simplicity of installation of vibrating wire strain gauges provides an advantage over the use of film strain gauges, which are very difficult to install in underground conditions.

Validity and Reliability of the Insole3 Instrumented Shoe Insole for Ground Reaction Force Measurement during Walking and Running.

Pressure-detecting insoles such as the Insole3 have potential as a portable alternative for assessing vertical ground reaction force (vGRF) outside of specialized laboratories. This study evaluated whether the Insole3 is a valid and reliable alternative to force plates for measuring vGRF. Eleven healthy participants walked overground at slow and moderately paced speeds and ran at a moderate pace while collecting vGRF simultaneously from a force plate (3000 Hz) and Insole3 (100 Hz). Intraclass correlation coefficients (ICC) demonstrated excellent vGRF agreement between systems during both walking speeds for Peak 1, Peak 2, the valley between peaks, and the vGRF impulse (ICC > 0.941). There was excellent agreement during running for the single vGRF peak (ICC = 0.942) and impulse (ICC = 0.940). The insoles slightly underestimated vGRF peaks (−3.7% to 0.9% bias) and valleys (−2.2% to −1.8% bias), and slightly overestimated impulses (4.2% to 5.6% bias). Reliability between visits for all three activities was excellent (ICC > 0.970). The Insole3 is a valid and reliable alternative to traditional force plates for assessing vGRF during walking and running in healthy adults. The excellent ICC values during slow walking suggests that the Insole3 may be particularly suitable for older adults in clinical and home settings.

Different Design Feature Combinations of Flatfoot Orthosis on Plantar Fascia Strain and Plantar Pressure: A Muscle-Driven Finite Element Analysis With Taguchi Method.

Customized foot orthosis is commonly used to modify foot posture and relieve foot pain for adult acquired flexible flatfoot. However, systematic investigation of the influence of foot orthotic design parameter combination on the internal foot mechanics remains scarce. This study aimed to investigate the biomechanical effects of different combinations of foot orthoses design features through a muscle-driven flatfoot finite element model. A flatfoot-orthosis finite element model was constructed by considering the three-dimensional geometry of plantar fascia. The plantar fascia model accounted for the interaction with the bulk soft tissue. The Taguchi approach was adopted to analyze the significance of four design factors combination (arch support height, medial posting inclination, heel cup height, and material stiffness). Predicted plantar pressure and plantar fascia strains in different design combinations at the midstance instant were reported. The results indicated that the foot orthosis with higher arch support (45.7%) and medial inclination angle (25.5%) effectively reduced peak plantar pressure. For the proximal plantar fascia strain, arch support (41.8%) and material stiffness (37%) were strong influencing factors. Specifically, higher arch support and softer material decreased the peak plantar fascia strain. The plantar pressure and plantar fascia loading were sensitive to the arch support feature. The proposed statistics-based finite element flatfoot model could assist the insole optimization and evaluation for individuals with flatfoot.

Study on mechanical characteristics of support system for Shallow-buried Single-Arch subway station in rock stratum

During the construction of shallow-buried single-arch subway station, because of unstable surrounding rock and lack of design experience, failure and hazard phenomena, such as large deformation, collapse and instability of soils/rocks often occur, substantially affecting the safety of tunnel structure and construction. In the case of the Xinggongjie Station subway tunnel, Dalian, Liaoning Province, Northeast China, mechanical and deformation characteristics of support system are analyzed by numerical simulations and in-situ monitoring data. Additionally, comparative analyses are conducted for internal force of arch support in different surrounding rock pressure and in-situ monitoring result. It is concluded that the single-arch subway station usually cannot form a pressure arch characterized by shallow-buried tunnel properties; the double initial support of stacked loaded arch bear full load together in construction process, and the outer initial support bear the main load; the up-step excavation of middle pilot and dismantling temporary support are key processes in the construction control. It is found that the structure will stabilize upon the completion of the stacked loaded arch. The stacked loaded arch structure can control the stratum deformation to an acceptable range; meanwhile, it has certain safety margin and stratum adaptability. The study method and conclusions can provide references for support in-site construction and similar projects and can enrich and improve design method of the large-span single-arch station.

The Effect Of Using Medial Arch Support On Dynamic Balance

Background: Pes planus is a clinical orthopedic condition in which the medial longitudinal arch is not visible from birth and the area is covered with fatty tissue, by using medial arch support it is hope that it can encourage the formation of the medial longitudinal arch and position the sole of the foot in the correct potition The arch normally forms from the first 5 years with an age range of 2-6 years. The critical period for arch formation is 6 years of age (Campbell, 2012). In the early school years, 28% - 35% of children have pes planus deformities, 80% of whom are categorized as "moderate". This study aims to illustrate that the incidence of pes planus at the age of shildren requires early sedation because 80% of the pes planus in children is categorized as moderate .
 Methods: This research is a true experimental type with a ype of pre and post test design which aims to determine the effect of using medial arch support on the dynamic balance of pes planus students of MI Nurul Karim Colomadu. The subjects used were grade 1 - 5 students with the condition of pes planus who had determined the inclution and exclution criteria. The number of subjects was 29 people with male and female gender from a total population of 92 student 
 Results: Using the Wolcoxon Correlation Test, it is known that the value of p = 0.000 (P <0.05) shows that there is an effect of the use of medial arc support on dynamic balance in flat foot patients.
 Conclution: The use of medial arch support has an effect on increasing dynamic balance in children with flat foot , so it is recommended to use medial arch support in children with flat foot.

Enhancing Locomotor Learning With Transcutaneous Spinal Electrical Stimulation and Somatosensory Augmentation: A Pilot Randomized Controlled Trial in Older Adults.

This study investigated locomotor learning of a complex terrain walking task in older adults, when combined with two adjuvant interventions: transcutaneous spinal direct current stimulation (tsDCS) to increase lumbar spinal cord excitability, and textured shoe insoles to increase somatosensory feedback to the spinal cord. The spinal cord has a crucial contribution to control of walking, and is a novel therapeutic target for rehabilitation of older adults. The complex terrain task involved walking a 10-meter course consisting of nine obstacles and three sections of compliant (soft) walking surface. Twenty-three participants were randomly assigned to one of the following groups: sham tsDCS and smooth insoles (sham/smooth; control group), sham tsDCS and textured insoles (sham/textured), active tsDCS and smooth insoles (active/smooth), and active tsDCS and textured insoles (active/textured). The first objective was to assess the feasibility, tolerability, and safety of the interventions. The second objective was to assess preliminary efficacy for increasing locomotor learning, as defined by retention of gains in walking speed between a baseline visit of task practice, and a subsequent follow-up visit. Variability of the center of mass while walking over the course was also evaluated. The change in executive control of walking (prefrontal cortical activity) between the baseline and follow-up visits was measured with functional near infrared spectroscopy. The study results demonstrated feasibility based on enrollment and retention of participants, tolerability based on self-report, and safety based on absence of adverse events. Preliminary efficacy was supported based on trends showing larger gains in walking speed and more pronounced reductions in mediolateral center of mass variability at the follow-up visit in the groups randomized to active tsDCS or textured insoles. These data justify future larger studies to further assess dosing and efficacy of these intervention approaches. In conclusion, rehabilitation interventions that target spinal control of walking present a potential opportunity for enhancing walking function in older adults.

Influence of Weight Bearing on Postoperative Complications after Surgical Treatment of the Lower Extremity.

In order to prevent implant failure and secondary fracture dislocation, it is often recommended that patients perform partial weight-bearing after surgery of the lower extremity. Previous examinations showed that patients are often not able to follow these instructions. In this study, patients who had undergone surgery of the lower extremity were studied in order to analyze whether incorrect loading influenced the number and severity of complications. Fifty-one patients were equipped with electronic shoe insoles, which measure loading and other parameters. The measurement period was 24 to 102 hours. Median duration of follow-up was 490 days. The primary outcome parameter was postoperative complications leading to revision surgery. Statistical analysis was performed using the chi-square and Fisher exact tests with significance set at a p<0.05. Seven out of fifty-one patients had postoperative complications. Four wound complications, one implant failure, chronic instability after fracture of the tibia, and one implant loosening of a hip prosthesis were recorded. In total, 26 of 39 patients were not able to follow the postoperative instructions. Five of the twenty-six patients with difficulties in partial weight-bearing suffered a postoperative complication. In comparison, only 2 of the other 25 patients were affected. There was no statistically significant correlation between high weight-bearing and occurrence of complications (p=0.29). Most of the patients were unable to follow the surgeon's instructions for partial weight-bearing. Excessive loading did not seem to influence the number and severity of postoperative complications, especially regarding implant failure. Therefore, we should continue with measurements and reevaluate the "partial weight-bearing doctrine".

Fiber-Optic System for Monitoring Pressure Changes on Mine Support Elements

The paper presents the developed fiber-optic sensors for monitoring pressure measurement on the elements of mine supports. The sudden destruction of the support leads to the collapse of the mine workings and poses a serious threat to the life and safety of underground workers. A fiber-optic system for monitoring changes in pressures on the elements of mine supports will increase the share of mining automation and reduce the share of manual labor, as well as eliminate measurement errors associated with the human factor. Systematic monitoring of the state of the working elements of the support will allow timely tracking of their deformations caused by an increase in rock pressure on them. Implementation of the system at mining enterprises will expand the use of digital technologies in mining. Timely warning of a mine collapse threat will significantly increase the level of safe mining operations, as well as reduce the cost of supporting mine workings, since elimination of the consequences of destruction is associated with significant material costs. This work presents a developed laboratory testbench that simulates a mine working and elements of an arch support on which are installed the fiber-optic sensors connected to an automated measuring system. The developed hardware and software complex provides the processing of a light spot falling on the surface of a television matrix that is installed at the exit from the optical fiber. The results of visual processing are converted into numerical values, which are used to make a decision about the state of the considered object. In addition to automatic monitoring of the structural integrity condition of the considered object, the system is equipped with a function of a visual display for monitoring results, which makes it possible to track sharp fluctuations and bursts of pressure parameters, based on which the prediction of pre-emergency and emergency situations is performed.

3D customized triboelectric nanogenerator with high performance achieved via charge-trapping effect and strain-mismatching friction

We developed a high-performance triboelectric nanogenerator (TENG) synergistically integrated with three-dimensional customized interfaces. Based on an electrospun ferroelectric poly(vinylidene fluoride-trifluoroethylene) (PVDF-TrFE) nanofiber mat, an interfusion with a charge-trapping layer was proposed to create an integrative negative tribo-interface component, in which a polydimethylsiloxane (PDMS) layer was partially interfused with a nanofibrous mat. The nanofiber-interfused tribo-surface notably enhanced the output performance via the charge-trapping effect, which minimized intrinsic losses in the triboelectric charges. The overall device, targeted for use in shoe insoles, was ergonomically designed based on foot geometry and fabricated accordingly via 3D printing using flexible and rigid materials. The conformal 3D customized interface provided wear comfort, even tribo-contact per foot pressure, and more importantly, augmented tribo-effect from strain-mismatching friction. Through the strain difference between the flexible and rigid parts at the contacting interface, the tribo-interface can generate additional lateral frictions as it is squeezed during foot stepping. As a result, the 3D customized TENG generated a significantly high output voltage and current of 880 V and 3.75 mA, respectively. In addition, durability of the TENG was experimentally confirmed based on at least 1500 cycles of foot stepping, in which high output performance was also sustained. The results of this study are expected to provide insights for the practical design and fabrication of 3D customized TENG systems.

Leg Length Discrepancy and Nonspecific Low Back Pain: 3-D Stereophotogrammetric Quantitative Posture Evaluation Confirms Positive Effects of Customized Heel-Lift Orthotics.

Background: The literature reports evidence of leg length discrepancy (LLD) associated with musculoskeletal disorders, alterations in spinopelvic alignment, and body posture, leading to low back pain and lumbar scoliosis. The most common conservative treatment for LLD is the use of internal or external shoe lifts although no treatment guidelines have been established. Aim: The study aimed to contribute to low back pain–LLD relationship comprehension, highlighting the benefits of LLD correction in the nonspecific low back pain (NSLBP) population. Methods: A cross-sectional observational study recruited a cohort of 80 NSLBP patients (48 females, 32 males) with LLD, age (μ = 35 ± 17.2). Entire body posture, including 3-D spine shape reconstruction, was measured using a nonionizing 3-D optoelectronic stereophotogrammetric approach. After the first 3-D posture evaluation, patients were provided with customized orthotics, including 100% LLD heel lift correction. No other therapeutic interventions were considered. Pain level was assessed using the numerical pain rating scale (NPRS). The gender, age-related, and time-dependent effects of LLD equalization treatment in NSLBP patients was investigated during 2 years of follow-up. The statistical analysis was performed at the global level using multivariate methods by Hotelling T 2 tests and intrasubject-level using t-test. Results and Discussion: An initial average NPRS = 7.8 was determined. In the medium-term follow-up group (4 months), the NPRS dramatically decreased (NPRS = 1.1). The pain disappeared in the long-term (2 years) follow-up group (NPRS = 0). The study results highlight that LLD equalization treatment led to clear statistically significant improvements in all the postural parameters of the frontal plane, including the underfoot load asymmetry. No worsening has been detected. An adaptation period long enough is needed to obtain progressive pain relief improvements and structural posture changes. Younger NSLBP patients showed slightly better improvements than older ones. Minimal differences between healthy young adults’ and NSLBP patients’ postures were found either in natural erect standing posture or when LLD equalization is applied. Conclusion: Heel-lift customized orthotics with 100% LLD correction are an effective short- and long-term treatment in patients with nonspecific LBP, inducing pain symptom recession and stimulating the improvement of postural parameters without contraindications.

Dominican Larimar Mining—Current State and Future Prospects

This paper presents basic mineralogical and petrological data of the rocks hosting larimar deposit from the Sierra de Bahoruco, in the SW part of the Dominican Republic. Larimar is a unique ornamental stone with a wealth of decorative qualities. The Las Filipinas Larimar Mine in Barahona Province is the only place of this type in the world. Its production and distribution require radical action; hence, the paper also provides current information on the extraction of this raw material and prospects for the future. The paper indicates the possibility of using a new adit support system based on a mixed support (arch support and shotcrete). Numerical analysis shows the need to create a shotcrete coating around the entire circumference, about 15 cm thick. The variable geotechnical situation around the excavation, caused by the planned operation, prompts the use of slightly different solutions in the field of support. The article presents an outline of the technology using Polish experience. It is a support-bolt casing system with the latest achievements in this field.

Analyzing the Effect of Varus Forefoot Wedge in Addition to Arch Support on Self-Reported Pain, Function, and Quality of Life in Patients with Moderate Hallux Valgus: A Pilot Study

ABSTRACT Introduction The hallux valgus, a painful forefoot deformity, is defined as lateral deviation of the hallux, which is highly correlated with forefoot pronation. This study aimed to compare the effect of two types of foot orthoses, one with and one without a varus forefoot wedge, on self-reported outcomes of pain, function, and QOL (by FAOS questionnaire) in patients with moderate hallux valgus. Materials and Methods Sixteen patients with hallux valgus were assigned to two equal groups randomly in a before-after trial. Results The within-group comparison showed significant improvements in all subscales of the FAOS questionnaire for both groups (P &lt; 0.05). The between-group analysis showed no statistically significant difference. Conclusions It seems the addition of varus forefoot wedge to foot orthoses may have no adverse effect on self-reported outcomes. Clinical Relevance It seems in conservative treatment of hallux valgus by medical insoles to correct forefoot pronation may be useful for relieving pain.

Adolescent perspectives on participating in a feasibility trial investigating shoe inserts for patellofemoral pain

BackgroundPatellofemoral pain (PFP) affects one-quarter of adolescents, yet there are few evidence-informed recommendations to treat PFP in this population. HAPPi Kneecaps! is a randomised, controlled, participant- and assessor-blind, parallel-group feasibility trial of shoe inserts for adolescents with PFP. The aim of this qualitative study was to explore adolescents’ perspectives of participating in HAPPi Kneecaps!.MethodsAll 36 adolescents with PFP from the HAPPi Kneecaps! study were invited to participate in semi-structured interviews. We used a descriptive qualitative methodology underpinned by a relativist framework to investigate adolescents’ perspectives on participating in the trial. Inductive thematic analysis was used to examine patterns regarding how each adolescent experienced the HAPPi Kneecaps! study within their social, cultural, and historical contexts.Results14 out of 36 HAPPi Kneecaps! participants provided consent and participated in interviews (12 females; mean [SD] age 14.9 [2.4] years). Overall, most adolescents responded positively when discussing their experience, such as improvements in their knee pain and satisfaction with how the study was run. Major themes that were generated from the analysis and feedback were: (1) shoe inserts require little effort to use; (2) perceptions of the program were generally positive; (3) participation in the trial could be made easier; (4) warm weather matters; and (5) life happens.ConclusionAdolescents with PFP who participated in the HAPPi Kneecaps! study found that shoe inserts were easy to wear. Most adolescents experienced an improvement in their symptoms and enhanced participation in sport and exercise. Adolescents with PFP prefer an option for warmer climates (e.g. flip flops or sandals), access to online logbooks, and clinicians who are easily accessible.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12619000957190. Date registered: 8/07/2019.

Impact of routine footwear on foot health: A study on plantar fasciitis.

Plantar fasciitis is the most common cause of heel pain requiring medical attention. The clear understanding of the long-term impact routine footwear has on plantar fasciitis is essential as any slight changes in shoe selection could possibly prevent the wearer from substantial discomfort and disability. Thus this study was planned to investigate impact of routine footwear on foot health by highlighting different features of the shoes worn daily by the people having plantar fasciitis. A cross-sectional study was conducted in the orthopedics' outpatient department of a tertiary-care hospital in Pakistan. Data was collected using non-probability convenient sampling from 101 people diagnosed with plantar fasciitis. Their routine footwear was categorized as appropriate or inappropriate on basis of heel height, sole thickness, and insole type (hard/cushioned/arched). Data were collected using a self-designed questionnaire and analysed by applying descriptive statistics and non-parametric tests. The majority (83.2%) of the people wear inappropriate shoes, whereas only 16.8% wear the recommended shoes, i.e., with heel height between 0.5-4 cm, thick soles, and arched or cushioned insoles. About 82.2% of plantar fasciitis patients reported wearing shoes of minimal heel height and 55.5% wore shoes with hard, non-cushioned insole without built-in arch support. Participants who wear inappropriate shoes experience more severe heel pain (P 0.013) which limits their daily activities. Footwear plays an important role in causing plantar fasciitis as the majority of the diagnosed cases wear inappropriate shoes with minimal heel height, thin sole, and hard insole without any built-in arch support.