Objectives and relationship to conference themes
Plantar heel pain is a common foot complaint often managed with orthoses; however, bespoke foot orthoses can be time-consuming and expensive to manufacture. Therefore we aimed to compare the clinical efficacy and cost-effectiveness of bespoke foot orthoses and pre-fabricated foot orthoses for heel pain.
Presentation topic
A total of 67 patients with plantar heel pain were recruited for this study; if, following initial assessment, foot orthoses were indicated patients were randomised to receive either bespoke orthoses or pre-fabricated semi-rigid orthoses (Powerstep). Clinical efficacy was assessed at 4 and 8 weeks using the Manchester foot pain and disability questionnaire and cost-effectiveness was determined by analysing the material, manufacture and labour costs.
Participant outcomes
At baseline there were no appreciable differences in the two groups of patients in demographic or clinical parameters. At 4 and 8 weeks post intervention both types of orthoses had significantly reduced pain and disability (p <0.0001). The Powerstep insoles cost £17.45 (19.36 Euros) in total where as the bespoke orthoses were considerably more expensive at £26.86 (29.80 Euros) to provide.
Relevance
For most patients with plantar heel pain pre-fabricated semi-rigid insoles such as the Powerstep devices used in this trial provide equal benefit to bespoke, casted foot orthoses, but are considerably cheaper.
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