Progressive collapsing foot deformity (PCFD) is a painful and function-limiting condition most commonly affecting middle-age and older adults. Although custom foot orthoses are routinely prescribed as a conservative intervention, a team of researchers found that evidence from large clinical cohorts remained limited. They then conducted a retrospective analysis to characterize patients with PCFD seeking orthotic care, examine demographic factors associated with pain improvement, evaluate clinical and self-reported outcomes following orthosis use, and explore potential interaction effects of the orthosis on clinical improvement across sex.
According to the study, the authors concluded that custom foot orthoses were associated with meaningful pain reduction, improved function, and high patient-reported benefit.
The analysis of clinical records between January 1, 2016, and May 31, 2025, extracted 130,365 appointments across 25 Canadian pedorthic clinics, further extrapolated into 669 PCFD encounters and 12,621 asymptomatic controls. Each assessment included pain ratings, Foot Posture Index (FPI), functional tests, gait analysis, and follow-up surveys on custom foot orthosis wear time, comfort, and recovery.
The results identified that PCFD was more prevalent in women and older adults, and unilateral PCFD limbs demonstrated significantly higher FPI scores (flatter feet) than contralateral healthy limbs.
Both sexes demonstrated significant pain reduction following use of custom foot orthoses, with women reporting higher pain at baseline and follow-up. Mean pain decreased from 6.52 ± 2.56 at assessment to 3.69 ± 2.52 at follow-up. Eighty percent of patients reported symptoms improvement, and 56 percent wore orthoses for more than six hours per day. Comfort was positively associated with both wear time and magnitude of pain reduction.
The open-access study, “Clinical outcomes of custom foot orthoses in progressive collapsing foot deformity: A retrospective cohort analysis,” was published in the Journal of Foot and Ankle Research.
