Effective Orthotic Therapy for the Painful Cavus Foot: A Randomized Controlled T

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J Am Podiatr Med Assoc. 2006 May-June;96(3):205-211.

Effective Orthotic Therapy for the Painful Cavus Foot: A Randomized

Controlled Trial.

Burns J, Crosbie J, Ouvrier R, Hunt A.

Institute for Neuromuscular Research, The Children's Hospital at

Westmead, Sydney, Australia.

Patients with a cavus or high-arched foot frequently experience foot

pain, which can lead to significant limitation in function. Custom

foot orthoses are widely prescribed to treat cavus foot pain.

However, no clear guidelines for their construction exist, and there

is limited evidence of their efficacy.

In a randomized, single-blind, sham-controlled trial, the effect of

custom foot orthoses on foot pain, function, quality of life, and

plantar pressure loading in people with a cavus foot type was

investigated. One hundred fifty-four participants with chronic

musculoskeletal foot pain and bilateral cavus feet were randomly

assigned to a treatment group receiving custom foot orthoses (n = 75)

or to a control group receiving simple sham insoles (n = 79).

At 3 months, 99% of the participants provided follow-up data using

the Foot Health Status Questionnaire. Foot pain scores improved more

with custom foot orthoses than with the control (difference, 8.3

points; 95% confidence interval [CI], 1.2 to 15.3 points; P = .022).

Function scores also improved more with custom foot orthoses than

with the control (difference, 9.5 points; 95% CI, 2.9 to 16.1 points;

P = .005). Quality-of-life data favored custom foot orthoses,

although differences reached statistical significance only for

physical functioning (difference, 7.0 points; 95% CI, 1.9 to 12.1

points; P = .008).

Plantar pressure improved considerably more with custom foot orthoses

than with the control for all regions of the foot (difference, -3.0

N . s/cm(2); 95% CI, -3.7 to -2.4 N . s/cm(2); P < .001).

In conclusion, custom foot orthoses are more effective than a control

for the treatment of cavus foot pain and its associated limitation in

function.