A comparison of semi-custom and custom foot orthotic devices in high- and low-arched individuals during walking.

Background: Orthotic devices can be a successful treatment for lower extremity injuries. However, the high cost of custom devices prevents some patients from purchasing them. Some orthotic companies have begun to offer a less expensive, semi-custom alternative. The purpose of this study was to examine whether the semi-custom devices can provide similar rearfoot control and comfort as custom devices in individuals with excessively high- and low-arches.

Methods: Thirty-seven subjects walked through the motion analysis lab under three conditions: no-orthotic, custom orthotics, and semi-custom orthotics. Rearfoot kinematics and comfort were collected in each device.

Findings: Both devices were effective at reducing eversion velocity and excursion. As compared to the no-orthotic condition, the custom device significantly decreased eversion velocity (P=0.03), while the semi-custom device showed a trend toward decreased eversion velocity (P=0.09). Eversion excursion was significantly reduced in both orthotic conditions (P<0.01). In terms of comfort, high-arched individuals tended to be more comfortable in the semi-custom device in the heel and arch regions. However, the differences in comfort between the devices were generally small (<7%).

Interpretation: Overall, with respect to a comfort and ability to control rearfoot motion, the semi-custom orthotic device is a feasible alternative to the custom orthotic device for high- and low-arched individuals.