The International Society for Prosthetics and Orthotics Canada

Orthotics Education Spotlight

Interviewee: Megan Balsdon, MSc., P.Eng., SoleScience Inc.

Article: Custom-made foot orthoses with and without heel plugs and their effect on plantar pressures during treadmill walking
Megan E.R. Balsdon, Colin E. Dombroski
SoleScience Inc., Fowler Kennedy Sports Medicine Clinic, Western University, London, ON, Canada
Department of Mechanical and Materials Engineering, Western University, London, ON, Canada
Faculty of Health Sciences, School of Physical Therapy, Western University, London, ON, Canada Corresponding a

Key Takeaways

• Heel plugs in orthotics significantly decreased average plantar pressure, peak plantar pressure, and pressure contact area in the hindfoot compared to orthotics without heel plugs
• The reduction in hindfoot pressure corresponded to an increase in midfoot pressure
• Reduction in hindfoot pressure is critical in treating certain pathologies of the foot, such as plantar fasciitis

Please tell us about your lab, your team, and your research interests
This study was conducted by Sole Science Inc., a pedorthics company based in London, ON. They have nine clinics throughout Ontario, however the clinic in London is the only one that conducts research. I am the research coordinator, and I work alongside the principal investigator and owner of Sole Science, Dr. Colin Dombroski, as well as some of the technicians to conduct research. Dr. Dombroski is an adjunct professor at the University of Western Ontario which allows us to collaborate and conduct research under that umbrella as well.
Our research focus is on quantifying the effect of orthotic interventions and examining if it aligns with the anecdotal feedback we are given from clients, which is how this current study came about. We also try to keep abreast of new technologies coming out in the orthotics field, such as 3D printing. With all of our research though our aim is to still provide our clients appropriate care and effective custom orthotic devices.

What are you working on right now that you are most excited about?
One of the conclusions of this study was that research needed to be conducted with participants with plantar heel pain, so we recently conducted a cross-over study with members of this population. Two sets of foot orthoses were given to participants in random order (one pair with and one pair without heel plugs) and each pair was worn for four weeks. Plantar pressure was measured for each pair at the end of the wear period, and a Foot Function Index and comfort assessment was also taken for each pair of orthoses. The results of this study are currently being written for publication and will be presented at the upcoming Pedorthic Association of Canada Symposium in April 2023.
We are also currently working on comparing different scanning methods (i.e. mobile apps vs. Laser scanners) for shape capturing feet and fabricating subsequent devices. Through this research we are hoping to get a better understanding of the quality of the scans obtained through different methods and determine any adjustments that would need to be made to the scans to produce orthoses of similar quality to those fabricated from the scans generated in the clinic using laser scanners.

What are next steps based on your research? How can we integrate your findings into clinical practice?
Looking forward with this research again I’ll be presenting the findings at the upcoming symposium and I am in the process of writing up the publication for the follow-up study that was conducted with a pathological population. For clinicians working with those with plantar fasciitis and plantar heel pain I hope that they take these findings into their practice so that they can design and fabricate the best foot orthoses for their patients. Working with those who have severe pain that may affect their daily function often requires custom and outside the box solutions, so the findings from this study provide clinicians with another option to incorporate into their treatment planning to improve their quality of life.