New work on biomechanical research of the foot

On the following page, we present some current research on the foot as well as a historical study from 1988 on the effect of foot orthotics.

Clinical Evaluation of Custom 3D-Printed Foot Orthotics

This study assessed the effectiveness of personalized, AI-designed 3D-printed meshed-silicone orthotic insoles. A cohort of 21 participants underwent four weeks of testing comparing pre- and post-intervention foot function, posture, pain, and gait. While functional scores (VAS, FFI) showed little change, notable biomechanical improvements were recorded, including better alignment of the hip, knee, and ankle and effective redistribution of plantar pressure—specifically reduced heel loading and increased metatarsal pressure. The findings suggest that integrating artificial intelligence with 3D-printing technology supports more precise and individualized orthotic design for clinical use.

Kubach J, Pasurka  M, Luegand J, Betsch M: Clinical Evaluation of Novel Custom 3D-Printed Meshed-Silicone Orthotics Utilizing Standing Foot Scans and Dynamic Gait Data; Biomedical Engineering and Computational Biology Volume 16: 1–10; https://doi.org/10.1177/11795972251371476

 

Effects of customized orthoses on patients with accessory navicular syndrome

This randomized controlled study evaluated the long-term effects of customized orthoses versus conventional insoles in 54 professional athletes with accessory navicular syndrome (ANS). Over 12 months, the custom orthotic group showed significant improvements in foot structure—greater arch height and angle, reduced heel eversion, and less navicular prominence—along with better plantar pressure distribution and reduced medial loading. Pain levels (VAS) decreased notably compared to controls. The results indicate that personalized orthoses effectively enhance foot morphology, optimize pressure distribution, and provide faster pain relief for athletes with ANS-related arch collapse.

Xiaopeng Pu et al.:  Effects of customized orthoses on foot morphology and pressure in patients with accessory navicular syndrome;  Pu et al. BMC Musculoskeletal Disorders (2025) 26:491; https://doi.org/10.1186/s12891-025-08689-7

 

New Sensor for Diabetic Foot Orthotics

This study developed and tested a flexible, wearable pressure sensor integrated into an insole for monitoring diabetic foot ulcer (DFU) pressures. Using carbon nanotube (CNT) composites with Ecoflex and PDMS elastomers, researchers analyzed the materials’ mechanical and electrical properties through advanced microscopy and repeated pressure tests. The CNT/Ecoflex composite outperformed CNT/PDMS in stability, sensitivity, and capacitance consistency. A prototype insole with 12 embedded CNT/Ecoflex sensors successfully recorded real-time pressure variations under different body weights. The findings demonstrate this sensor system’s potential for continuous, accurate plantar pressure monitoring in diabetic orthotic applications.

Elumalai, M.; Childs, A.; Williams, S.; Arguello, G.; Martinez, E.; Easterling, A.; Luis, D.S.; Rajaraman, S.; Didier, C.M. Application of Carbon Nanotube-Based Elastomeric Matrix for Capacitive Sensing in Diabetic Foot Orthotics. Micromachines 2025, 16, 804. https://doi.org/10.3390/mi16070804

 

Systematic Review: Progressive Collapsing Foot Deformity

The posterior tibial tendon (PTT) is a key muscle–tendon unit that plantarflexes and inverts the foot and dynamically stabilizes the medial longitudinal arch during walking, especially in early stance. It maintains arch integrity, controls pronation, and stabilizes the transverse tarsal joints to support efficient force transmission and propulsion in gait. Damage or degeneration of the PTT from overload, poor blood supply, trauma, collagen disorders, or aging can lead to progressive collapsing foot deformity (PCFD), formerly called posterior tibial tendon dysfunction, whose true prevalence (estimated 3.3–10 %) is likely underestimated due to late diagnosis.

This study systematically reviewed 14 studies on orthotic treatment for PCFD and found that orthoses substantially reduced pain and disability and increased patient satisfaction. Orthotics improved foot kinematics by decreasing hindfoot eversion by 3–5°, increasing forefoot plantarflexion by 6–9°, and, with ankle–foot orthoses featuring lateral extensions or articulated designs, enhancing forefoot adduction and hindfoot inversion. Meta-analysis showed a 56.84 % improvement in Foot Functional Index scores and a 28.53‑point increase in the AOFAS Ankle/Hindfoot Scale, confirming that orthotic interventions effectively improve function and correct pathological mechanics in PCFD.

Khaliliyan H et al.: Clinical and biomechanical outcomes of orthotic devices for progressive collapsing foot deformity: a systematic review and meta-analysis; Foot and Ankle Surgery, Volume 32, Issue 1, January 2026, Pages 1-10;

 

From the early days of orthotics research:

The effectiveness of foot orthotics has frequently been the subject of scientific research in recent years. The study presented here, published in 1988, appears to be one of the first to examine the effect of orthotics on patients with foot problems. It was able to demonstrate impressive results. 

Abstract:
Foot orthotics are becoming recognized as an important consideration in the correction of lower extremity alignment and mechanical dysfunctions. There are many different foot orthotics on the market today claiming to relieve pain and enhance foot function. Unfortunately, minimal research has been conducted investigating the effectiveness of foot orthotics in adult patient populations. The purpose of this study was to determine the degree of pain relief experienced by patients, the ability of patients to return to their previous levels of activity associated with the duration of use of the orthotics, and patient compliance. This study also discusses the specific deformity for which the orthotic was prescribed and the degree of posting necessary to compensate for the deformity. Fifty-three subjects, 20 males and 33 females, responded to a questionnaire survey. The type of foot deformity and the orthotic prescription are also presented for each subject. The responses to the questions were correlated with an individual patient chart review. In addition, chi-square analysis was used to determine the level of significance between the specific deformity and the age and weight of the patients. The level of significance was determined between the patient's ability to adjust to the orthotics and their continued use of the orthotics. Finally, the significance of the orthotic treatment was compared to four other treatment interventions. Ninety-six percent of the patients reported relief from pain with the use of the prescribed foot orthotic. Ninety-four percent of the patients were still wearing the orthotic, and 52% reported that they would not leave home without them in their shoes at the time the survey was conducted. Seventy percent of the patients reported that they were able to return to their previous level of activity with the use of the foot orthotics.

ROBERT DONATELLI, MA,  CINDY HURLBERT,  DAVID CONAWAY: Biomechanical Foot Orthotics: A Retrospective Study, Journal of Orthopaedic & Sports Physical Therapy®, 01 96-601l /88/10 05-0205$02.00/

The complete study can be found here; https://pubmed.ncbi.nlm.nih.gov/18796957/