An exploration of the factors predicting clinical responses to customized foot orthoses in individuals with plantar heel pain.

There was no control group, so the 6-month changes could be due to time, natural recovery, expectation, or the footwear given to all participants. All participants wore Crocs off Court Clog footwear with the orthoses, so the contribution of the orthoses and the footwear cannot be separated. Only 13 participants were non-responders, and the sample was below the estimated requirement for the planned regression model. This limits confidence in predictor findings. A single examiner performed all physical assessments and was not blinded to whether it was before or after treatment, which could bias measurements. Pain, foot function, and response were self-reported, so recall and subjective interpretation could affect the results. The Global Rating of Change response definition of +4 or higher differed from other studies, so responder rates cannot be directly compared. Adherence was recorded in logbooks, but the paper says adherence and psychosocial factors were not comprehensively assessed.

The authors declared no potential conflicts of interest. The study was funded by Mahidol University and the National Science Research and Innovation Fund.

Do not conclude that custom foot orthoses alone caused the improvement. The study had no control group, and all participants also received Crocs off Court Clog footwear, so neither the orthoses nor the footwear can be separated from time or other changes.