Randomized Controlled Trial Comparing Orthosis Augmented by Either Stretching or Stretching and Strengthening for Stage II Tibialis Posterior Tendon Dysfunction

Houck, Jeff; Neville, Christopher; Tome, Josh; Flemister, Adolph S.

doi:10.1177/1071100715579906

Cited by 31 publications

(52 citation statements)

References 34 publications

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“…in-shoe foot orthoses and braces) [13–15]. There is a lack of high quality evidence for these treatments, which relegates physical therapy treatment decisions to one that targets presenting impairments and are based largely on the clinical reasoning skills of the clinician.…”

Section: Introductionmentioning

confidence: 99%

Self‐reported social and activity restrictions accompany local impairments in posterior tibial tendon dysfunction: a systematic review

Ross

Smith

Plinsinga

et al. 2018

Journal of Foot and Ankle Research

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BackgroundPosterior tibial tendon dysfunction (PTTD) is a painful, progressive tendinopathy that reportedly predominates in middle-age, overweight women. There is no evidence based guidelines that clinicians can use to guide treatment planning, which leaves clinicians to make decisions on the basis of presenting clinical impairments and self-reported pain and disability. The purpose of this systematic review was to quantify clinical impairments, pain and disability in individuals with PTTD compared with controls.MethodsFive databases were searched for terms referring to the posterior tibial tendon and flatfoot up to and including 11 March 2018. The systematic review was registered with PROSPERO (CRD: 42016046951). Studies were eligible if they were published in the English language and contained data on clinical impairments, pain or disability compared between participants diagnosed with PTTD and pain-free individuals. Standardised mean differences (SMDs) were calculated where possible and meta-analysis was performed when homogeneity of outcomes allowed.ResultsTen eligible studies were identified and pooled in the meta-analyses. Strong effects were revealed for poor heel rise endurance (SMD -1.52, 95% CI -2.05 to − 0.99), less forefoot adduction-inversion strength (SMD -1.19, 95% CI -1.68 to − 0.71) and lower arch height (SMD -1.76, 95% CI -2.29 to − 1.23). Compared to controls, individuals with PTTD also had more self-reported stiffness (SMD 1.45, 95% CI 0.91 to 1.99), difficulties caused by foot problems (SMD 1.42, 95% CI 0.52 to 2.33) and social restrictions (SMD1.26, 95% CI 0.25 to 2.27).ConclusionThere is evidence of impaired tibialis posterior capacity and lowered arch height in individuals with PTTD compared to controls. Further to addressing the expected impairments in local tendon function and foot posture, pain, stiffness, functional limitations and social participation restrictions should be considered when managing PTTD.Electronic supplementary materialThe online version of this article (10.1186/s13047-018-0292-z) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Self‐reported social and activity restrictions accompany local impairments in posterior tibial tendon dysfunction: a systematic review

Ross

Smith

Plinsinga

et al. 2018

Journal of Foot and Ankle Research

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“…Could not retrieve full text = 1 made, there were outcomes specified in the trial protocol that were omitted from the final analyses and manuscript. 90 kg/m 2 . All studies had a predominance of women, with percentage of females ranging from 77.7 90 92 to 100%.…”

Section: Risk Of Biasmentioning

confidence: 99%

“…All studies had a predominance of women, with percentage of females ranging from 77.7 90 92 to 100%. 91 Two trials 91 92 included individuals with stage I or II TPT and one trial 90 included those with only stage II TPT. Key: * = mean (SD), NR = not reported, italics = same comparator group, ^ = pre-randomisation (includes drop-outs)…”

Section: Risk Of Biasmentioning

confidence: 99%

“…Imaging was not utilised in any trial to confirm diagnosis or exclude other potential sources of pain. Only one trial 92 reported a minimum duration of symptoms and one reported restrictions in function (able to walk >15m) and age (>40 years) 90 as study selection criteria. the American Orthopaedic Foot and Ankle Society (AOFAS) score which combines both patient self-report and clinician physical examination findings into one aggregate score.…”

Section: Selection Criteriamentioning

confidence: 99%

“…Participants in the Kulig 92 trial were randomly assigned to either an eccentric or concentric exercise group (combined with stretching and orthoses) or a stretching and orthoses only group (3 groups in total). Houck 90 used an isotonic strengthening regime combined with stretching and orthoses compared to stretching and orthoses only.…”

Section: Interventionsmentioning

confidence: 99%

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Exploring the clinical presentation of tibialis posterior tendinopathy

Ross¹

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Foot pain is a common musculoskeletal complaint, that is associated with significant functional limitations and is often accompanied by systemic co-morbidities. Pain on the medial aspect of the foot and ankle between the medial malleolus and navicular is often diagnosed as dysfunction of the tibialis posterior tendon. Tibialis posterior tendinopathy (TPT) is considered to constitute the early stages of a condition that progresses to an acquired flatfoot deformity. Surgical intervention is recommended when conservative approaches are unsuccessful, with invasive and costly procedures recommended when significant deformity and dysfunction are present. Effective management in the early stages when tendon signs and symptoms predominate is desirable in order to prevent or delay progression of the condition. The overarching objective of this thesis was to inform the future development of targeted interventions for TPT. Specific thesis aims were to systematically synthesise current evidence in relation to terminology, clinical presentation and management of TPT (Part A) and to address current gaps in the literature in relation to diagnosis, and to explore the presentation of TPT using the ICF framework (Part B). iv Publications included in this thesis Ross MH, Smith MD, Vicenzino B. Reported selection criteria for adult acquired flatfoot deformity and posterior tibial tendon dysfunction: Are they one and the same? A systematic review. PLoS One. 2017;12(12):e0187201. Ross MH, Smith MD, Vicenzino B. Self-reported social and activity restrictions accompany local postural and strength impairments in posterior tibial tendon dysfunction: a systematic review. v Submitted manuscripts included in this thesis Ross MH, Smith MD, Durbridge, G, Vicenzino B. The diagnostic accuracy of clinical tests to diagnose ultrasound-confirmed tibialis posterior tendinopathy in patients presenting with medial foot/ankle pain. Submitted to BJSM. vi Other publications during candidature (as at May 2019) Peer-Reviewed PapersRoss MH, Setchell J. People who identify as LGBTIQ+ can experience assumptions, discomfort, some discrimination, and a lack of knowledge while attending physiotherapy: a survey.Plinsinga ML, Ross MH, Coombes BK, et al. Physical findings differ between individuals with greater trochanteric pain syndrome and healthy controls: A systematic review with meta-analysis.

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