Ring Kate, Otter Simon
Kent Community Health Trust, Tonbridge, TN11 0NE, UK.
Musculoskeletal Care. 2014 Mar;12(1):1-10. doi: 10.1002/msc.1053. Epub 2013 Jun 25.
Plantar heel pain is a common reason for referral to podiatric practice, and one of the key interventions is the use of orthoses. The aim of the present study was to compare the clinical efficacy of bespoke, casted foot orthoses and prefabricated foot orthoses for plantar heel pain.
People with plantar heel pain were included if, following initial assessment, foot orthoses were indicated and participants received either bespoke, casted foot orthoses or prefabricated semi-rigid orthoses (Powerstep™). Clinical efficacy was assessed at eight weeks using the Manchester Foot Pain and Disability Questionnaire (MFPDQ).
A total of 67 patients completed the trial and at baseline there were no appreciable differences in the two groups of patients in terms of the MFPDQ score; however, at eight weeks post-treatment both had significantly reduced foot pain and disability (both p < 0.0001). There was no significant difference in effectiveness between the bespoke or prefabricated orthoses. However, prefabricated devices were 38% cheaper per patient compared with the average costs of casted devices.
For most patients with plantar heel pain, prefabricated semi-rigid insoles such as the Powerstep™ devices used in the present trial provide short-term benefit equivalent to that of bespoke, casted foot orthoses, but at considerably reduced costs.
足跟痛是转诊至足病科的常见原因，关键干预措施之一是使用矫形器。本研究旨在比较定制的、铸型足矫形器和预制足矫形器治疗足跟痛的临床疗效。
纳入足跟痛患者，初始评估后若表明需要足矫形器，则参与者接受定制的铸型足矫形器或预制半刚性矫形器（Powerstep™）。使用曼彻斯特足部疼痛与残疾问卷（MFPDQ）在8周时评估临床疗效。
共有67例患者完成试验，两组患者在基线时MFPDQ评分无明显差异；然而，治疗8周后两组患者的足部疼痛和残疾均显著减轻（均p < 0.0001）。定制或预制矫形器在有效性方面无显著差异。然而，与铸型装置的平均成本相比，预制装置每位患者便宜38%。
对于大多数足跟痛患者，本试验中使用的预制半刚性鞋垫（如Powerstep™装置）提供的短期益处与定制的铸型足矫形器相当，但成本大幅降低。
