## 4 Discussion
\begin{table}
\begin{tabular}{c c c c c c} \hline \hline
**Outcome Measures** & **Interventions** & **Rank 1** & **Rank 2** & **Rank 3** & **Rank 4** \\ \hline \multirow{3}{*}{Forefoot plantar pressure} & Control & 0.02 & 0.37 & 0.25 & 0.36 \\  & Lace-up ankle-support brace & 0.08 & 0.26 & 0.34 & 0.32 \\  & Semirigid brace & 0.09 & 0.27 & 0.34 & 0.30 \\  & Custom foot orthotics & 0.81 & 0.10 & 0.07 & 0.02 \\ \hline \multirow{3}{*}{Midfoot plantar pressure} & Control & 0.45 & 0.20 & 0.33 & 0.02 \\  & Lace-up ankle-support brace & 0.24 & 0.28 & 0.23 & 0.25 \\  & Semirigid brace & 0.28 & 0.27 & 0.26 & 0.19 \\  & Custom foot orthotics & 0.02 & 0.26 & 0.17 & 0.54 \\ \hline \multirow{3}{*}{MLA} & Control & 0.36 & 0.46 & 0.14 & 0.04 \\  & Hard custom foot orthotic & 0.55 & 0.31 & 0.10 & 0.03 \\ \cline{1-1}  & Soft custom foot orthotics & 0.05 & 0.13 & 0.44 & 0.38 \\ \cline{1-1}  & Off-the-shelf foot orthotics & 0.03 & 0.09 & 0.32 & 0.55 \\ \hline \hline \end{tabular} Control: regular footwear.  
\end{table} 
Table 3: The ranking probability of each comparison between mixed interventions. index. They found that the direction of foot pressure changes exhibited similarities to that observed in individuals with normal feet. The findings demonstrate the positive influence and potential advantages of custom foot orthotics in enhancing gait characteristics and effectively distributing plantar pressure among pes cavus patients [40]. In addition, In a study published in 2021 by [PERSON] et al. [41], it was proposed that pes cavus could reduce foot pain by using custom foot orthotics, which was also related to the redistribution of plantar pressure by custom foot orthotics, resulting in a change in load bearing on each joint. The second finding of this review is that the ankle brace had an effect on plantar pressure distribution but in pes cavus of any etiology we chose, the performance of ankle braces did not show a significant advantage over custom foot orthotics. However, at present, there are limited numbers of previous studies investigating the effect of ankle brace in patients with pes cavus and the results are various and some of them are in controversy [42; 43; 44]. These studies provided limited evidence for clinical practice. The reason might be that in the pes cavus population, compared to the direct effect of custom foot orthotics, the proximal fixation of the proximal joint (ankle joint) caused much less internal force on the distal arch than the ground reaction. Nevertheless, it had some effect. In patients with pes cavus, the choice of ankle brace provides ankle control, alleviates ankle compensation due to foot abnormalities, mainly reduces the risk of an ankle injury, and does not directly affect the foot surface [45; 46]. Our results also showed that Lace-up ankle braces and semirigid ankle braces had similar effects on foot pressure distribution, indicating that the selection of categories had no significant impact on the results. Moreover, we found that previous studies, which did not target pes cavus treatment but chose Lace-up ankle brace and Semirigid brace to explore foot pressure distribution [21; 47; 48], did not give significantly different results caused by different categories. This may suggest that the effect of different categories is weak. While lace-up ankle-support braces and semirigid braces may lower the risk of lower limb injury, their effects on treating foot pressure imbalance in pes cavus, particularly in patients with pes cavus or other foot abnormalities, require further evaluation. Based on current evidence, it is premature to conclude whether ankle supports represent a viable treatment option for foot pressure imbalance, though future research may shed light on their potential as a therapeutic tool. The third finding of this review indicates that custom foot orthotics significantly impacted the height of the medial longitudinal arch (MLA) compared to the condition where participants wore shoes without orthotics.