Compliance Wearing a Heel Lift During 8 Weeks of Military Training in Cadets With Limb Length Inequality

Abstract

Study Design: Retrospective descriptive study. Objectives: To examine compliance in wearing heel lifts during 8 weeks of military training in cadets identified with limb length inequalities. Background: Lack of compliance can be blamed for countless poor outcomes in the medical community. Reported compliance with intervention protocols has been reported to range from 11% to 95%. All 1100 new cadets in the class of 2005 were screened for a limb length inequality. One hundred ninety-eight out of 1100 cadets were identified to have a limb length inequality on physical exam and volunteered to participate. Cadets were randomly assigned to a heel lift or control group. Cadets in the heel lift group were instructed to wear a heel lift at all times throughout cadet basic training to attempt to prevent overuse injuries. There was no difference (PϾ.05) between the heel lift group or the control group on injury rate or excusal days. Methods and Measures:In an attempt to discern whether the preventive intervention was ineffective by design or if noncompliance was to blame, investigators asked cadets via electronic mail survey to report compliance with heel lift wear as a percentage (0%-100%). Results: Seventy-six out of 99 (76.8%) cadets in the heel lift group responded to the electronic mail survey. Mean reported compliance was 38%. Eighteen cadets reported between 70% and 100% compliance. The remaining 58 cadets reported less than 70% compliance. Conclusions: Cadet compliance was poor with the use of a heel lift. Physical therapists throughout the military often prescribe heel lifts, therapeutic exercises, or medication and assume good to excellent compliance. This study reminds providers that good compliance should not be assumed in any setting.

Limb length discrepancy in cutis marmorata telangiectatica congenita: an audit of assessment and management in a multidisciplinary setting

“…[18][19][20] Vitale et al 21 found quality-of-life scores to be significantly lower in patients with an LLD of ≥ 2 cm compared with those with a smaller discrepancy. There are a number of publications that note LLD as a common feature of CMTC; 2,16,17 however, these do not quantify the LLD, or describe its progress over time or the need for operative intervention.…”

Functional leg length discrepancy between theories and reliable instrumental assessment: a study about newly invented NPoS system

“…In a retrospective descriptive study included 1100 cadets revealed that compliance was poor with the use of a heel lift 18 ; this lack of compliance can be blamed for countless poor outcomes in the medical community, moreover it highlights as previously discussed in this section that un-customized heel lift may harm rather than treat the condition.…”

An observational study of Australian private practice physiotherapy consultations to explore the prescription of self‐management strategies

“…An overwhelming majority of patients (96%) received a self‐management strategy, with physiotherapists observed to prescribe from a range of 9 different strategies to their patients. This prescribed range has been supported to varying degrees in the literature, with exercise and heat commonly being prescribed to patients with lower back pain (Crowe, Whitehead, Jo Gagan, Baxter, & Panckhurst, ), as well as advice (Liddle et al, ), splints (Sandford, Barlow, & Lewis, ), heel lifts (Goss & Moore, ), ice (Bassett & Prapavessis, ) and braces (Page et al, ). Given the range and frequency of self‐management prescription by physiotherapists in past research (Peek et al, , ) and the current study, it could be argued that physiotherapists consider self‐management strategies to be an important part of the overall patient treatment plan.…”