The Impact of a Foot-Toe Orthosis on Dynamic Balance: An Exploratory Randomized Control Trial

J Sport Rehabil. 2020 Sep 1;29(7):871-878. doi: 10.1123/jsr.2017-0321. Epub 2019 Sep 30.


Context: The influence of custom and over-the-counter foot orthoses on dynamic balance has been investigated in the past. However, there has not been an exploration of the use of a foot-toe orthosis for improving balance. The ability of clinicians to influence balance could have important implications for injury prevention and rehabilitation.

Objective: To determine the impact of a foot-toe orthosis on dynamic balance in healthy, young adults.

Design: Randomized control trial.

Setting: Athletic training laboratory.

Participants: In total, 64 healthy, recreationally active participants aged 18-29 years were randomly allocated to one of the following groups: the foot-toe orthosis and laboratory-issued shoe group, the laboratory-issued shoe only (SO) group, or the control group.

Interventions: Subjects in the intervention group wore the foot-toe orthosis and laboratory-issued shoe with activities of daily living for 4 weeks. Subjects in the SO intervention group wore the laboratory-issued shoe with activities of daily living for 4 weeks. Participants in the control group did not receive any intervention.

Main outcome measures: The instrumented version of the Star Excursion Balance Test, known as the Lower Quarter Y-Balance Test, was used to quantify the dynamic balance at baseline and follow-up. Reaches were normalized for leg length.

Results: There were statistically significant differences in postintervention scores on the Lower Quarter Y-Balance Test for both the dominant (P = .03, effect size = 0.84; 95% confidence interval, 0.25 to 1.43) and nondominant (P = .002, effect size = 0.74; 95% confidence interval, 0.15 to 1.32) legs when comparing dynamic balance scores of the foot-toe orthosis and laboratory-issued shoe group with the SO and control groups. No significant differences were observed when comparing dynamic balance between the SO and control groups.

Conclusions: A 4-week intervention with a foot-toe orthosis and laboratory-issued shoe resulted in improved dynamic balance in a healthy young adult population. These findings suggest a novel intervention for increasing balance.

Keywords: bunion; orthoses; orthotic device; postural stability.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Foot Joints / physiology
  • Foot Orthoses*
  • Healthy Volunteers
  • Humans
  • Male
  • Postural Balance / physiology*
  • Shoes*
  • Toe Joint / physiology*
  • Young Adult