Biomechanical and clinical effects of customized foot orthoses and biomechanical taping in patients with plantar heel pain

All patients in this study will receive the individualized biomechanical taping applied to both feet by an experienced physical therapist. The biomechanical taping consisted of 2 components, arch taping and calcaneal taping. The physical therapist apply 2-4 straps of tape over the longitudinal arch according to navicular drop test to reach the optimal goal that the distance of the navicular drop was less than 10 mm or reduced 50 % after taping. Each piece of tape follows the similar pattern, from the lateral aspect of the fifth metatarsal head and runs medially around the medial longitudinal arch to end on the navicular tuberosity, with overlap of approximately one third of the tape. Calcaneal taping will be applied when the physical therapist found the presence of calcaneal valgus exceeding 5 degrees. Application of the tape in this study will be 3.8-cm-wide Leuko Sports Tape (Beiersdorf Australasia Ltd, North Ryde, Sydney, Australia). Patients will be advised to maintain usual activity within the limits of symptoms and removed the tape after 3 days. After 1 week, all participants will be randomized into either the intervention group (n=30) or the control group (n=30), and each group will not be aware of the existence of the other one. Intervention group will receive customized foot orthoses (Vasyli International), which were fitted to their shoes with comfort as a primary goal, and home exercise instructions by an experienced physical therapist. These orthoses are customisable to some degree to optimise comfort through heat moulding and by adding wedge or heel raises. All patients in the intervention group will wear the foot orthoses for 3 months. The control group will only receive home exercises instructions by the same experienced physical therapist. Home exercises include calf muscles stretching and plantar fascia stretching, Each stretching will be performed 30 seconds for one repetition, 20 repetitions per day for the 3 month intervention period. After 1 week, 1 month and 3 months, all patients will return back for follow-ups and assessment by another physical therapist. There is no specific frequency/duration for which the shoes with fitted orthoses are to worn for the intervention group, but the frequency and duration were recorded. At each follow-up, we will encourage the intervention group to wear the foot orthoses as much time as possible and record the duration of wearing. We will encourage the control group to record the exercise diary every day. The format of instructions will be paper-based. Two different physical therapists will be an assessor and a treatment provider respectively. Before the end of the study, the assessor will be not aware of the group of each patient..