Static and dynamic effects of customized insoles on attenuating arch collapse with pregnancy: A randomized controlled trial

• Published in: Foot (Edinburgh, Scotland) Scotland), 2018-12, Vol.37, p.16-22
• Main Authors: Segal, Neil A., Neuman, Lauren N., Hochstedler, Maria C., Hillstrom, Howard L.
• Format: Article
• Language: English
• Subjects: Foot arch; Orthosis; Pregnancy
• ISSN: 0958-2592; 1532-2963
• DOI: 10.1016/j.foot.2018.07.007

•Those randomized to receive customized arch support in this study did not have statistically significant changes in static foot structure or dynamic arch function nor did those who used self-selected footwear.•The lack of significant differences between the randomized groups may be due to the self-selected footwear group using shoes with arch support or neither group being predisposed to arch drop during pregnancy. Anthropometric changes to the feet with pregnancy may increase risk for musculoskeletal disease. Customized arch-supportive orthoses to prevent anthropometric changes could potentially provide an inexpensive means to prevent musculoskeletal impairments and improve quality of life for women during their post-reproductive years. The objective of this prospective, randomized controlled trial was to determine whether customized foot orthoses can prevent arch collapse during pregnancy. Seventy-two first trimester women (age 18–40) were randomized to wear either their usual footwear (control) or their usual footwear with custom-molded arch-supportive orthoses. Each participant in the customized orthosis group had orthoses customized by a certified orthotist. Baseline assessments were completed during the first trimester and follow-up assessments were completed approximately 8 weeks postpartum. The primary outcome measurements were static arch height index (AHI), arch drop, arch rigidity index, and center of pressure excursion index (CPEI). There were no statistically significant differences in the change in static foot structure or dynamic arch function between baseline and follow-up within either group. Comparing the customized orthosis and control groups, no significant differences were detected in change in AHI sitting (p=.44), AHI standing (p=.48), arch drop (p=.67), arch rigidity (p=.68) or CPEI (p=.77). There was no difference in arch change when comparing women who were randomized to wear customized orthoses or self-selected footwear. The finding of no arch drop in either group may indicate that both groups supported their arches during the study period or that neither group was predisposed to lose arch height with pregnancy.