Contoured in-shoe foot orthoses increase mid-foot plantar contact area when compared with a flat insert during cycling

ObjectivesTo determine the effect of contouring of an in-shoe foot orthosis on plantar contact area and surface pressure, as well as perceived comfort and support at the foot-orthosis interface during stationary cycling.DesignA randomised, repeated measures control study.MethodsTwelve cyclists performed steady-state seated cycling at a cadence of 90 rpm using a contoured orthosis and a flat insert of similar hardness. Contact area (CA) and plantar mean pressure (PP) were measured using the PEDAR® system, determined for seven discrete plantar regions and represented as the percentage of the total CA and PP respectively (CA% and PP%). Perceived comfort and support were rated using a visual analogue scale (VAS).ResultsThe contoured orthosis produced a significantly greater CA% at the medial midfoot (p = 0.001) and lateral midfoot (p = 0.009) with a standardised mean difference (SMD) of 1.3 and 0.9 respectively. The contoured orthosis also produced a significantly greater PP% at the hallux (p = 0.003) compared to the flat insert with a SMD of 1.1. There was a small non-significant effect (SMD < 0.4) for the perceived comfort measures between conditions, but perceived support was significantly greater at the arch (p = 0.000) and heel (p = 0.013) with the contoured orthoses (SMD of 1.5 and 0.9, respectively).ConclusionsContoured orthoses influenced the plantar surface of the foot by increasing contact area as well as a perception of greater support at the midfoot while increasing relative pressure through the hallux when compared to a flat insert during stationary cycling. No difference in perceived comfort was noted.