Comparing Effects of Custom Foot Orthotic Intervention to Foot-Core Training Protocol on Lower Extremity Kinematics in Runners With Pes Planus (CFO)

July 21, 2026 updated by: Christopher MacLean, Dalhousie University

Running is a full body movement that requires the feet to support the body and absorb forces greater than the individual's body weight in a repeated fashion. If the musculoskeletal structures of the feet cannot withstand and disperse the force applied, injury and dysfunction will occur. Without the inherent support of the foot musculature, ligaments are strained, and bones of the foot and ankle must absorb all forces, directly. When the medial longitudinal arch cannot be supported, the entire structure collapses, causing the foot to pronate. These postural signs indicate pes planus, or flat feet. Custom foot orthoses (CFOs) are commonly used to manage pes planus and research within the last 25 years has not provided clear insight on how CFOs influence running mechanics of joints and segments proximal to the foot (knee and hip). Additionally, CFO intervention has not been compared to exercise programming that focuses on strengthening the muscles that provide the foot with intrinsic strength. This study will provide insight on how these two interventions may influence foot biomechanics in the pes planus foot. We are hopeful that our findings can help to inform rehabilitation professionals in how different interventions can alter biomechanical outcomes related to pes planus. Previous literature also commonly focuses on an aging or sedentary individuals, while this study will focus on young active participants with a pes planus foot type.

Healthy recreational runners between the ages of 18-35 years old with pes planus will be recruited to participate. Participants will be randomly appointed to one of two groups: 1) the CFO group will wear CFOs for 8 weeks; and 2) the exercise group will be assigned an exercise protocol to complete each day for eight weeks. Participation will consist of completion of a prolonged run protocol in two testing sessions, pre- and post-intervention, and compliance to their assigned intervention. Three-dimensional kinematic data will be collected using a 10-camera motion capture system (Qualisys). For each data collection session, passive reflective markers will be placed on the participant both lower extremities, and participants will be instrumented with a heart rate (HR) monitor. The prolonged run protocol will consist of a five-minute warm-up phase, where participants will choose a comfortable running speed, with a desired HR at approximately 120 beats per minute (bpm). After the warm-up, participants will be permitted to stretch if desired, as they would before a typical run. Once ready, the participant will select a comfortable running pace that best represents their typical training pace. Running speed will be intermittently increased. A member of the research team will monitor the participant throughout the trial to check their HR, ask them to rate their perceived exertion on Borg's RPE scale (which will be displayed in front of them), and ask them to rate any pain they may be feeling on a scale from 1-10. The prolonged run protocol will end when any of the following occurs: 1) participant HR reaches 85% of their HR max, 2) participant rates the activity a score of 17 (very hard) on Borg's RPE Scale, or 3) the participant gives a 7/10 pain rating. Once the protocol has ended, participants will enter a cool-down phase where they will jog or walk until HR lowers. Participants will be able to stretch again following the protocol if desired.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

24

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Canada
    • Nova Scotia
      • Halifax, Nova Scotia, Canada, B3H4R2
        • School of Health and Human Performance
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • healthy recreational runners
  • aged 18-30 years old
  • pes planus foot type as characterized by the Foot Posture Index

Exclusion Criteria:

  • Individuals having any cardiovascular or neurological illnesses
  • Individuals having any chronic musculoskeletal diseases such as rheumatoid arthritis or osteoarthritis
  • Individuals who have suffered a running-related injury in the 6 months leading up to the study

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Pes planus
Individuals who have been classified as having a pes planus foot type using the Foot Posture Index.
Device: Custom foot orthoses
Custom foot orthoses constructed from a neutral suspension cast
Behavioral: Intrinsic foot muscle strengthening exercises
An 8 week, intrinsic foot muscle strengthening program focusing on the intrinsic foot muscles that stabilize the medial longitudinal arch of the foot.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Standing static, arch height
Time Frame: From enrollment to the end of the interventions at 8 weeks
The static standing arch height will be calculated using motion capture.
From enrollment to the end of the interventions at 8 weeks
Maximum three dimensional joint angles of the hip, knee and ankle
Time Frame: From enrollment to the end of each intervention at 8 weeks
Joint angle maxima for the hip, knee and ankle during the stance phase of running.
From enrollment to the end of each intervention at 8 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Dalhousie University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

September 1, 2026

Primary Completion (Estimated)

October 31, 2027

Study Completion (Estimated)

August 31, 2028

Study Registration Dates

First Submitted

July 15, 2026

First Submitted That Met QC Criteria

July 21, 2026

First Posted (Actual)

July 23, 2026

Study Record Updates

Last Update Posted (Actual)

July 23, 2026

Last Update Submitted That Met QC Criteria

July 21, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • DAL_Corkum & MacLean

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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