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Progressive Collapsing Foot DeformityNCT07756372

Three Foot Orthosis Interventions for Progressive Collapsing Foot Deformity

A study testing Customized foot orthoses, Exercise and Podiatric Education in people with Progressive Collapsing Foot Deformity, run by Université du Québec à Trois-Rivières at 2 sites in Canada.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Background Progressive collapsing foot deformity (PCFD) is a painful musculoskeletal disorder leading to a progressively developing flat foot, which affects mobility and function and negatively impairs quality of life. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Progressive Collapsing Foot Deformity
What is being tested?
Customized foot orthoses, Exercise and Podiatric Education
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
198 participants
Where
2 sitesCanada
Study dates
1 Jan 2027to 1 Dec 2030
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Present with PCFD according to Myerson et al. (M. S. Myerson et al., 2020) classification
  • Report medial ankle or foot pain lasting six weeks or more with a pain score of ≥ 3 out of 10 on a Visual Analogue Scale (VAS) and pain to the posterior tibial tendon
  • Are aged 18 to 70 years,
  • Can walk without assistive devices (e.g., cane, walker),
  • Are willing to wear shoes that accommodate their FOs daily,
  • Are willing to minimize the use of other interventions (e.g., pain medications, physical therapy) during the trial period.
  • Obtain a positive result on the single and/or double heel rise test (important pain during the test or inability to perform the test).

Who cannot join

  • Are classified as having Stage II rigid deformities according to Myerson classification,
  • Have a history of musculoskeletal surgery to the foot and ankle,
  • Present cognitive impairment,
  • Are currently pregnant or breastfeeding,
  • Have worn FOs within the past year.

Trial locations and contacts

2 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Canada2 sites
  • Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Cirris)

    Québec, Quebec, G1M 2S8

  • Université du Québec à Trois-Rivières

    Trois-Rivières, Quebec, G9A 5H7

Other trials in Canada

About this study

Official title: Protocol for a Multicenter, Superiority Randomized Controlled Trial of Three Different Interventions for Patients With a Progressive Collapsing Foot Deformity

Background Progressive collapsing foot deformity (PCFD) is a painful musculoskeletal disorder leading to a progressively developing flat foot, which affects mobility and function and negatively impairs quality of life. Foot orthoses (FOs) are often prescribed to attenuate pain and improve function in patients with PCFD. However, no study has yet investigated the impact of adding FOs, whether custom (CFOs) or prefabricated (PFOs), to the usual treatment for PCFD. Thus, the primary objective of this trial will be to compare three different non-surgical interventions combining foot exercises and education with either CFOs, PFOs or sham FOs (SFOs).

Methods/Design This participant-blinded multicentric superiority randomized controlled trial with three parallel groups will be conducted at the Université du Québec à Trois Rivières (UQTR) and the Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris) in Canada. One hundred and ninety-eight participants with PCFD will be recruited via referral from physiotherapy and podiatry clinics and targeted advertising on social media. Participants will be randomized to receive CFOs, PFOs or SFOs. All groups will also receive a foot and ankle exercises program and education about their condition. They will be evaluated at four time points: baseline, 12 weeks, 24 weeks and 52 weeks. The primary outcome will be the subcategories of pain from the Foot Function Index (FFI) questionnaire. The secondary outcomes will be: foot pain and limitations (other categories of FFI, mean and maximal pain during walking for the most painful foot during the past week), self-assessed clinical progress (Global Rating Of Change), health-related quality of life (5-Level EQ-5D), gait biomechanics, fear avoidance (Fear avoidance Scale), supination resistance and ankle and hip endurance and force.

Discussion This trial first aims to determine whether FOs treatment is effective, and second, whether one of the three FO interventions is more effective than the others. This trial will help guide FOs prescription recommendations for managing foot pain, function, and biomechanical outcomes in individuals with PCFD in the future.

Read the detailed description

Progressive collapsing foot deformity (PCFD) was historically described under the terminology posterior tibial tendon dysfunction (PTTD), later expanded through the adult acquired flatfoot deformity (AAFD) framework, before being reclassified in 2020 as PCFD to better reflect its progressive, multiplanar nature. Beyond pain, PCFD carries substantial functional and social consequences: patients report marked difficulty with activities such as climbing stairs, walking fast, or running, along with challenges finding comfortable or fashionable footwear, all of which negatively affect quality of life.

These functional limitations are caused by specific gait alterations, including increased forefoot abduction, greater hindfoot eversion and internal rotation, reduced ankle inversion and dorsiflexion, and a medial shift in plantar pressure during walking. Foot orthoses (FOs) are thought to counteract these alterations: a systematic review found that most studies report improvements in kinetics, and kinematics following FO use. These biomechanical effects have supported the widespread clinical use of FOs as part of first-line conservative management for PCFD.

However, whether these biomechanical improvements translate into a clinical benefit specifically attributable to FOs remains unclear. In all prior RCTs reporting pain and functional improvements with FOs in this population, orthoses were provided as part of a broader multimodal program that also included education and exercise therapy, meaning the additional contribution of FOs alone has never been isolated. Furthermore, no RCT has directly compared custom CFOs and PFOs in individuals with PCFD. A recent retrospective cohort analysis reported meaningful pain reduction and functional improvement with CFOs, but the absence of a control group limits the extent to which this improvement can be attributed to the orthotic intervention itself rather than to natural symptom evolution.

By comparing CFOs, PFOs, and SFOs against a common background of standardized education and exercise, this randomized controlled trial design will allow us to determine whether, beyond their known biomechanical effects, FOs provide an additional clinical benefit for individuals with PCFD, and whether this benefit differs according to orthosis design.

Being tested
Customized foot orthoses, Exercise, Podiatric Education, Sham foot orthoses, Prefabricated foot orthoses
Keywords
Foot orthoses, Gait biomechanics, Conservative treatment, Foot Function, Randomized Controlled Trial

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Customized foot orthosesOther

    Individually customized bilateral 3D-printed foot orthoses will be designed from each participant's foot morphology and manufactured at UQTR using a Nylon-11 shell, with shell thickness individualized according to body mass and sex. Orthoses will incorporate a rearfoot-forefoot post (neutral, 3°, or 6° medial inclination, determined by supination resistance) and a medial heel skive (0 or 6 mm, determined by subtalar joint axis position) to provide individualized mechanical support. Participants will wear the orthoses during weight-bearing activities for 24 weeks.

  • ExerciseOther

    Participants will complete a progressive home-based strengthening program targeting the tibialis posterior, tibialis anterior, and triceps surae muscles. The program will consist of six progressive levels prescribed by a podiatrist according to the participant's baseline clinical presentation. Exercise sessions will last approximately 30 minutes and will be performed at least four times per week for 12 weeks. Progression to the next level will occur after successful completion of four sets of 20 repetitions at the current level.

  • Podiatric EducationOther

    All participants will receive the same evidence-based information and clinical guidance at the start of the trial, and will follow a 7-day familiarization protocol with progressive FO wear time, starting at 1 hour per day and increasing by 1 hour daily up to 5 hours per day. Following familiarization, participants will be instructed to wear their assigned FOs during all standing activities, targeting a minimum of 5 hours per day, for the 24-week intervention period. FO-wearing instructions, the exercise program, and study information will be available at any time on the study website : "projetpied.com".

  • Sham foot orthosesOther

    Participants will receive bilateral 3D-printed sham foot orthoses manufactured from low-stiffness FilaForm material. The sham orthoses will have an appearance similar to the customized orthoses but will provide negligible mechanical support, thereby maintaining participant blinding. Participants will wear the orthoses during weight-bearing activities for 24 weeks.

  • Prefabricated foot orthosesOther

    A pair of commercially available PFOs (Powerstep Pinnacle Maxx support, United States of America), in the proper size, will be provided to each participant. The top cover will be made of a polyester fabric. The structural arch support will consist of a polypropylene shell incorporating a 2° medial post. A dual-layer system composed of a black foam top layer and a black ethylene-vinyl acetate (EVA) base layer will also be included (Figure 2). An additional 1 mm black vinyl surface layer will be manually added to the PFOs to keep participants blinded to the condition they are allocated to.

Study groups in NCT07756372
Study groupRoleWhat they receive
Control GroupSham comparatorParticipants randomized to this group will receive 3D printed sham foot orthoses in combination with standardized podiatric education and a home-based progressive exercise program.
Receives: Other: Exercise; Other: Podiatric Education; Other: Sham foot orthoses
Customized GroupExperimentalParticipants randomized to this group will receive customized 3D printed foot orthoses in combination with standardized podiatric education and a home-based progressive exercise program.
Receives: Other: Customized foot orthoses; Other: Exercise; Other: Podiatric Education
Prefabricated GroupExperimentalParticipants randomized to this group will receive prefabricated foot orthoses covered by in combination with standardized podiatric education and a home-based progressive exercise program.
Receives: Other: Exercise; Other: Podiatric Education; Other: Prefabricated foot orthoses

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Foot pain

    Foot Function Index pain subscale (FFI) , compose of 9 items, scored from 0 to 100, 0 being no pain and 100 representing maximum pain and dysfunction

    Measured: From baseline to the end of follow-up at 52 weeks

Secondary outcomes (9)
  1. Mean and maximal pain during walking for the most painful foot during the past week

    Visual Analog Scale (VAS) (from 0 to 10; 0 being no pain and 10 worst pain imaginable).

    Measured: From baseline to the end of follow-up at 52 weeks

  2. Disability and activity limitation

    The disability and activity limitation subscales of the Foot Function Index, each ranging from 0 to 100, will be used, with higher scores indicating greater disability or activity limitation.

    Measured: From Baseline to the end of follow-up at 52 weeks

  3. Global rating of change (GROC)

    participants' perception of overall treatment effect will be measured using the self-reported global rating of change scale. This outcome will then be dichotomized into the categories of "effective" ("a very great deal better", "a great deal better", "a good deal better" and "moderately better") and "ineffective" ("somewhat better", "a little better", "about the same, hardly any better at all", "no change", "about the same, hardly any worse at all", "a little worse", "somewhat worse", "moderately worse", "a good deal worse", "a great deal worse" and 'a very great deal worse")

    Measured: From 12 weeks to the end of follow-up at 52 weeks

  4. Health-related quality of life

    the 5-level EQ-5D (EQ-5D-5L) will be used. The descriptive system comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. The participant will be asked to indicate his/her health state by ticking the box next to the most appropriate statement in each of the five dimensions. This decision results in a 1-digit number that expresses the level selected for that dimension. The digits for the five dimensions can be combined into a 5-digit number that describes the patient's health state.

    Measured: From baseline to the end of follow-up at 52 weeks

  5. Fear-Avoidance Components Scale (FACS)

    The FACS will assess pain-related fear and avoidance. It includes two main dimensions: fear of pain and avoidance of physical activities due to that fear. Each dimension is rated on a scale from 0 to 5 (0 = "strongly disagree", 5 = "strongly agree"). The total score reflects the overall level of fear-avoidance.

    Measured: From Baseline to the end of follow-up at 52 weeks

  6. Muscle strength

    Hip and foot muscle strength will be measured using a handheld dynamometer. Hip strength, will be assessed in a side-lying position for the hip abductor strength and lying on the stomach for the extension. Ankle plantarflexion and dorsiflexion strength, will be measured. Participants will perform three trials of maximal force, each maintained for 4 to 5 seconds, with 15 seconds of rest between trials.

    Measured: At delivery of FOs and at 24 weeks

  7. Endurance

    Isometric hip muscle endurance will be assessed at 10° of abduction and extension, with time to failure recorded. Ankle plantar flexor endurance will be evaluated using the bilateral heel-rise test, in which participants perform as many heel raises as possible at a self-selected rapid pace.

    Measured: At delivery of FOs and at 24 weeks

  8. Supination resistance test

    This test will be measured with the Keystone device (Interpod, Australia) using a validated method. The test will be performed 3 consecutive times on each foot.

    Measured: At delivery of FOs and at 24 weeks

  9. Gait biomechanics

    Kinematic and kinetic data will be collected using two motion capture systems, an OptiTrack system (Natural Point, Corvallis, OR, USA) at UQTR and a Vicon system (Peak, UK) at Cirris, both operating at a sampling rate of 200 Hz, synchronized with AMTI force plates (Watertown, MA, USA) sampled at 1000 Hz. The modified Oxford Foot Model will be used. Participants will perform five gait trials, with and without FOs. Forefoot-hindfoot and ankle angles and moments will be calculated.

    Measured: At delivery of FOs and at 24 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Aug 2026
  2. Study start1 Jan 2027 (estimated)
  3. Primary completion1 Jan 2029 (estimated)
  4. Study completion1 Dec 2030 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
198 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07756372
Sponsor's protocol ID
2026_UQTR_PCFD_RCT
Status last verified
Aug 2026
First submitted
4 Aug 2026
Last updated
19 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A study testing Customized foot orthoses, Exercise and Podiatric Education in people with Progressive Collapsing Foot Deformity, run by Université du Québec à Trois-Rivières at 2 sites in Canada.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 19 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Léa Tessiot (819-376-5011 ext. #3606, lea.tessiot@uqtr.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Foot pain (time frame: From baseline to the end of follow-up at 52 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Aug 2026.

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