Clinical Tests of Tibialis Posterior Tendinopathy: Are They Reliable, and How Well Are They Reflected in Structural Changes on Imaging?

Ross, Megan H.; Smith, Michelle D.; Mellor, Rebecca; Durbridge, Gail; Vicenzino, B.

doi:10.2519/jospt.2021.9707

Cited by 9 publications

(8 citation statements)

References 33 publications

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“…The paper highlighted that, after using clinical findings, a diagnosis can be confirmed with US. However, US and clinical findings on their own are not sufficient [17]. The findings of this paper related to the PTE contradicts the findings of one paper, which found that, compared to magnetic resonance imaging (MRI), PTE had a sensitivity of 86% and a specificity of 100% [26].…”

Section: • Physical Assessmentscontrasting

confidence: 90%

“…A combination of tests, such as the SLHR, palpation, swelling, and weakness, have also been compared to MRI and/or US. However, none of the tests have been shown to be 100% effective in the diagnosis of PTTD; therefore, it is advised to use a mixture of MSK assessment and imaging to provide a complete picture of the damage/inflammation present, as well as the functional deficit with which the patient presents [17,29].…”

Section: Discussionmentioning

confidence: 99%

“…Other participants were included based on signs and symptoms, such as localized oedema, asymmetric acquired flatfoot deformity, and pain [23]. Other papers described a physical examination, some of which provided details of how this was undertaken [17,20,22,24,25,28,29], and others only defining that an examination took place [26,27,30]. The tests used within the physical examination were a combination of the tests previously described in this review, as well as other measurements of foot posture and/or localized weakness.…”

Section: General Characteristics Of the Studies Assessedmentioning

confidence: 99%

“…The physical examinations included as comparisons were the following: posterior tibial oedema sign (PTE) [17,26], first metatarsal rise (FMR) sign [31], first ray mobility test [22], unipedal standing balance test (USBT) [25], pain on palpation TP tendon [17], weakness with contraction [17], single-heel rise test (SHRT) [17,21,25], double-heel rise test (DHRT) [31], and the too-many-toes (TMT) sign [31].…”

Section: • Physical Assessmentsmentioning

confidence: 99%

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Assessments Associated with the Diagnostics and Non-Surgical Treatment of Posterior Tibialis Tendon Dysfunction: A Systematic Review

Banwell,

Ramos-Petersen,

Gatt

et al. 2024

Applied Sciences

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Objectives: To investigate the efficacy of the assessment methods that are used to diagnose posterior tibialis tendon dysfunction (PTTD) and investigate how the results of these assessments can be used to instruct non-surgical treatments. Design: Systematic review. Data sources: Searches were conducted up to January 2023 in the PubMed, Scopus, Science Direct, Embase, Web of Science and Lilacs databases. Study eligibility criteria: Studies which included patients over 18 years of age, diagnosed with PTTD, which describe the assessments used to aid in the non-surgical treatment of PTTD in comparison with another type of assessment. All types of studies apart from protocols, letters to editor and other systematic reviews and meta-analysis were included. Study appraisal and synthesis methods: Two blinded reviewers performed screening, data extraction, and methodological quality assessments using the QUADAS-2. Results: A total of 15 observational studies were included in the review. Assessment methods included were verbal assessments, physical examinations, and imaging (magnetic resonance imaging (MRI), ultrasound (US), and radiographs). The single-heel rise test was a commonly mentioned physical examination, showing reliability in one study but contradicting in another. MRI was frequently described as the “gold standard”. However, US showed both comparable accuracy and advantages compared to MRI, such as cost-effectiveness and real-time examinations. Conclusions: There are many assessment methods described in the literature and, due to the lack of accuracy of the tests, a mixture of tests should be used to assess PTTD. The parameters from the tests can provide a diagnosis of PTTD, but do not offer detail on how they assist the non-surgical treatment of the condition.

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Section: • Physical Assessmentscontrasting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: General Characteristics Of the Studies Assessedmentioning

confidence: 99%

Section: • Physical Assessmentsmentioning

confidence: 99%

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Assessments Associated with the Diagnostics and Non-Surgical Treatment of Posterior Tibialis Tendon Dysfunction: A Systematic Review

Banwell,

Ramos-Petersen,

Gatt

et al. 2024

Applied Sciences

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“…Fiftytwo people participated in the study, they were examined by 2 physiotherapists and an ultrasound examination was performed. The singleleg toeclimb test was best related to imaging findings in people with TPT (tibialis posterior tendinopathy), which is in line with modern thinking about tendinopathy as a clinical picture associated with loading [7]. PTT physiotherapy according to KaKin Ling et al helps in two ways, first, it reduces swelling in acute inflammation, and second, it contributes to strengthening the posterior ti- • gait reeducation,…”

Section: Discussionsupporting

confidence: 62%

The role of different physiotherapy methods in tibialis posterior muscle insufficiency – a literature review

Piwowar-Kuczyńska,

Zabojszcz,

Curyło

2023

Fiz Pol

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Introduction. Dysfunction or rupture of the posterior tibial tendon (PTT) is a fairly common cause of acquired adult flatfoot. Conservative and surgical treatments are used to correct PTT dysfunction. Objective. The aim of this study was to present the characteristic features of PTT dysfunction and evaluate the application and effectiveness of selected physiotherapeutic methods in the treatment of posterior tibial muscle insufficiency. Materials and Methods. Available literature was analyzed based on English-language databases such as PubMed, Scopus, ScienceDirect, Medline, and others, using the Google Scholar search engine. A total of 20 articles were analyzed out of 52 identified through the aforementioned method. Publications no older than 10 years were included as search criteria, using the following keywords: posterior tibial muscle insufficiency, orthoses, orthopedic insoles, flatfoot, physiotherapy. Results. It was not possible to specify which method of treating posterior tibial muscle insufficiency is the most effective. Conclusions. Contemporary research suggests that conservative treatment methods appear to be effective in treating posterior tibial muscle insufficiency. Although opinions on the effectiveness of orthoses are divided, the majority acknowledges that orthoses

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Non‐surgical management of posterior tibial tendon dysfunction‐ a UK survey

Miller,

Smith,

Backhouse

2024

Journal of Foot and Ankle Research

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BackgroundPosterior Tibial Tendon Dysfunction (PTTD) is commonly seen within musculoskeletal care. The condition's prevalence and management is poorly understood. This study aims to demonstrate current practice by multi‐professional clinicians across the United Kingdom within the National Health Service.MethodsA national (UK) cross‐sectional online survey was conducted among multi‐professionals who treat PTTD within their NHS practice. The survey covered assessment, management and evaluation. This was shared via social media and professional groups.ResultsTwo hundred thirteen surveys were completed, with 153 matching the eligibility criteria. The main respondents were Physiotherapists (48%) and Podiatrists (38%). Ultrasound scanning was used most frequently when considering initial imaging (67%). Many different treatment modalities were used, but a core set of education/advice, foot orthoses, and foot specific as well as general exercise were most commonly chosen. Outcome measures routinely used were pain scale (96/269) and single leg heel raise (84/269), but patient reported outcome measures were not routinely used. The most frequent reason to escalate care was failure to manage symptoms with conservative management (106/123; 86.2%), followed by fixed deformity (10/123; 8.2%).ConclusionsThis survey provides evidence on current non‐surgical management for PTTD from UK NHS practice. It provides a valuable marker for clinicians to use to compare their own practice and can be used in further research as a comparator.

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Clinical Tests of Tibialis Posterior Tendinopathy: Are They Reliable, and How Well Are They Reflected in Structural Changes on Imaging?

Cited by 9 publications

References 33 publications

Assessments Associated with the Diagnostics and Non-Surgical Treatment of Posterior Tibialis Tendon Dysfunction: A Systematic Review

Assessments Associated with the Diagnostics and Non-Surgical Treatment of Posterior Tibialis Tendon Dysfunction: A Systematic Review

The role of different physiotherapy methods in tibialis posterior muscle insufficiency – a literature review

Non‐surgical management of posterior tibial tendon dysfunction‐ a UK survey

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