Department of Physical Therapy and Assistive Technology, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan, Republic of China.
Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan.
BMC Musculoskelet Disord. 2019 May 31;20(1):264. doi: 10.1186/s12891-019-2648-3.
Foot orthoses are widely used to manage plantar heel pain (PHP). However, the evidence concerning the effect of foot orthoses on PHP is not conclusive. The study aims to identify the characteristics of patients with PHP likely to achieve a positive outcome after customized foot orthoses and to verify the concept that patients who respond positively to anti-pronation taping would achieve a positive prognosis after wearing foot orthoses for six months.
This is a prospective observational cohort study. Seventy-four patients with PHP underwent a baseline examination and received anti-pronation taping to their painful feet. The taping effects on pain and function were assessed at the 7-day follow-up visit. Then, all patients received an intervention for their PHP with customized foot orthoses for six months. Outcome was assessed with a numeric pain rating scale, the patient-specific functional scale, the foot function index, and the global rating of perceived change. Significant reduction of pain, increase of function, and perception of a meaningful improvement were considered a positive response.
Of 74 patients, 49 had a positive response to the customized foot orthosis treatment. Five predictors were identified: (1) the average pain intensity decreased by over 1.5 points with taping, (2) the range of ankle plantarflexion > 54 degrees, (3) the strength of ankle plantarflexors on the symptomatic side was equal to or stronger than that on the other side, (4) the range of hip internal rotation < 39 degrees, and (5) the range of hip external rotation > 45 degrees. The presence of three or more predictors increased the rate of achieving positive outcome from 66 to 89%.
The predictors of customized foot orthosis outcome in patients with PHP are related to several physical measures of a lower extremity. Findings of the study can be used to screen and select patients with PHP for foot orthosis intervention. Moreover, patients who respond positively to anti-pronation taping would also benefit from the customized foot orthoses. However, since there was no control group in the current study, it is inappropriate to draw conclusions about the effectiveness of the foot orthoses treatment.
The trial was retrospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN 12617000119392 ).
足部矫形器被广泛用于治疗足底跟痛症（PHP）。然而，关于足部矫形器对 PHP 疗效的证据并不确定。本研究旨在确定哪些 PHP 患者使用定制足部矫形器后可能获得良好疗效，并验证这样一种观点，即对足旋前抑制贴扎有积极反应的患者，在佩戴足部矫形器 6 个月后也会获得良好的预后。
这是一项前瞻性观察队列研究。74 例 PHP 患者接受基线检查，并对其疼痛的足部进行足旋前抑制贴扎。在第 7 天随访时评估贴扎对疼痛和功能的影响。然后，所有患者均接受定制足部矫形器治疗 PHP 6 个月。使用数字疼痛评分量表、患者特定功能量表、足功能指数和整体感知改善评分来评估疗效。疼痛明显减轻、功能明显改善和自我感觉有明显改善被认为是积极反应。
74 例患者中，有 49 例对定制足部矫形器治疗有积极反应。确定了 5 个预测因素：（1）贴扎后平均疼痛强度下降超过 1.5 分；（2）踝关节跖屈范围>54 度；（3）患侧踝关节跖屈肌力量与对侧相等或更强；（4）髋关节内旋范围<39 度；（5）髋关节外旋范围>45 度。存在 3 个或更多预测因素时，获得积极疗效的比例从 66%增加至 89%。
预测 PHP 患者定制足部矫形器治疗效果的因素与下肢的几个物理测量值有关。本研究的发现可用于筛选和选择 PHP 患者进行足部矫形器干预。此外，对足旋前抑制贴扎有积极反应的患者也将从定制足部矫形器中获益。但是，由于本研究中没有对照组，因此不能得出关于足部矫形器治疗效果的结论。
本试验在澳大利亚和新西兰临床试验注册中心（ACTRN 12617000119392）进行了回顾性注册。
