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Foot orthoses and patellofemoral pain syndrome

Discussion in 'Biomechanics, Sports and Foot orthoses' started by NewsBot, Feb 28, 2008.

  1. NewsBot

    NewsBot The Admin that posts the news.


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    Study protocol
    Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: a randomised clinical trial

    Bill Vicenzino , Natalie Collins , Kay Crossley , Elaine Beller , Ross Darnell and Thomas McPoil
    BMC Musculoskeletal Disorders 2008, 9:27doi:10.1186/1471-2474-9-27
     
    Last edited: Feb 28, 2008
  2. Admin2

    Admin2 Administrator Staff Member

    Trial registration :
    ACTRN012605000463673
    ClinicalTrials.gov NCT00118521
     
  3. Admin2

    Admin2 Administrator Staff Member

  4. Craig Payne

    Craig Payne Moderator

    The full results of this study are eagerly awaited. A sneak peak at the results at last yrs SMA mtg showed the foot orthotic group did better than the placebo group, which is a relief in the context of:
     
  5. matt owen

    matt owen New Member

    hi- I'm a final year pod student currently swimming in piles of journals as i write up my lit review (on mcconnell taping vs orthoses in the contol of PFPS). I'm interested in what was said about the preliminary results of the new RCT - is there anything in writing i could look at (or quote!) and when are the full details expected.

    thanks

    matt owen
    UUJ (northern ireland)
     
  6. Craig Payne

    Craig Payne Moderator

    Nothing in writing released by researchers yet.
     
  7. Trent Baker

    Trent Baker Well-Known Member

    Hopefully this is a case of turning anecdotal evidence into research based evidence. There are so many areas like this within orthotic therapy. Will we ever get all the bases covered? I only wish I had the research abilities to help.

    I'm very keen to see the results of this study. When are the results due Craig?

    Trent
     
  8. dmulkeen

    dmulkeen New Member

    Hi folks, any news on this yet?
     
  9. Craig Payne

    Craig Payne Moderator

    :welcome:
    AFAIK, its still under review at BMJ.
     
  10. NewsBot

    NewsBot The Admin that posts the news.

    The full text of the results are now available:

    Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: randomised clinical trial.
    Collins N, Crossley K, Beller E, Darnell R, McPoil T, Vicenzino B.
    BMJ. 2008 Oct 24;337:a1735. doi: 10.1136/bmj.a1735.
     
  11. matt owen

    matt owen New Member

    Interesting to hear the results of that one. I spent a few months immersed in knee pain and orthoses literature for my dissertation.

    However, it is frustrating that there is little evidence out there of casted orthoses (in a randomised trial) in treating knee pain. Its obviously easier to do studies on off-the-shelf stuff, but we need to advance our knowledge of custom FO as well.

    Anyone heard of any studies in the pipeline to look at this?
     
  12. Kent

    Kent Well-Known Member

    I agree Matt. I saw this paper presented at the recent Sports Medicine Australia conference. It's frustrating that OTC orthoses were used for this trial but then in the discussion they talked about "orthotics". I would have liked them stick with the terminology OTC orthoses or something similar throughout.

    In this trial they compared the "gold standard" physiotherapy approach to an OTC orthotic. Obviously we'd like to see a similar study with custom foot orthoses (i.e. everyone gets a customised prescription, not just a casted orthotic all made from subo with a 4 deg RF post) but then everyone is really getting a different treatment - not a RCT. What's the answer???

    Finally, can we assume that custom foot orthoses would do a better job for anterior knee pain than OTC orthotics? Also, I'd like to see a cost-benefit analysis done - if foot orthoses do as good as physio, can we do it cheaper?
     
  13. admin

    admin Administrator Staff Member

    There has been an interesting, informative and educational exchange on this study in the BMJ:

    In the same edition as the original study was this editorial:
    Editorial
    Patellofemoral pain syndrome
    Usually resolves over time, and intervention offers only limited benefit

    C Niek van Dijk and Willem M van der Tempel
    BMJ 2008; 337: a1948
    Link to editorial and references.

    This was the response from the authors:
    Patellofemoral Pain Syndrome: Important Considerations
    Link to response and references.
     
  14. admin

    admin Administrator Staff Member

  15. Kevin Kirby

    Kevin Kirby Well-Known Member


    I just love the researchers that use this line as a defense for not treating pathologies. What do you tell the 16 year old female runner that develops patellofemoral pain syndrome while eagerly training with her cross-country team and desires to continue her training and improve her times? Sorry Sally, none of the treatments are 100% and your pain will resolve over time (yeah, once you stop running it will resolve and will come back again once you start running!!):bang::bang::bang:

    Sounds to me like another excuse for governmments with socialized medicine and health maintenance organizations to have a reason to not treat pathologies that are easily treatable by experienced and skilled clinicians.
     
  16. CraigT

    CraigT Well-Known Member

    Yep- 100% agree.
    This approach would not make good business sense- not because you don't treat them and therefore don't charge them, but because you wouldn't get much in the way of 'word of mouth' referalls. Patient satisfaction would be pretty poor.
    They come to you because they are in pain and want help....
    I don't think that I would be visiting either C Niek van Dijk or Willem M van der Tempel if I had PFJ pain...
    With respect to the study- I am somewhat surprised that there was no apparent combined effect with Physio and the OTC orthos. I feel these are usually very complementry.
     
    Last edited: Nov 2, 2008
  17. NewsBot

    NewsBot The Admin that posts the news.

    The Efficacy of Foot Orthoses in the Treatment of Individuals with Patellofemoral Pain Syndrome: A Systematic Review
    Barton, Christian J.; Munteanu, Shannon E.; Menz, Hylton B.; Crossley, Kay M.
    Sports Medicine: 1 May 2010 - Volume 40 - Issue 5 - pp 377-395
     
  18. David Smith

    David Smith Well-Known Member

    Cynical but oh so true:craig:

    Dave
     
  19. NewsBot

    NewsBot The Admin that posts the news.

    The immediate effects of foot orthoses on functional performance in individuals with patellofemoral pain syndrome
    C J Barton, H B Menz, K M Crossley
    Br J Sports Med doi:10.1136/bjsm.2009.069203
     
  20. NewsBot

    NewsBot The Admin that posts the news.

    Foot orthoses for patellofemoral pain in adults.
    Hossain M, Alexander P, Burls A, Jobanputra P.
    Cochrane Database Syst Rev. 2011 Jan 19;1:CD008402.
     
  21. DaVinci

    DaVinci Well-Known Member

    Because of the dates of data that this Cochrane Review covers, it was out-of-date before it even got published because of this one which was not included:
     
  22. davidh

    davidh Podiatry Arena Veteran

    Sloppy title (no mention of which specific foot orthoses used) - I'm pleased I didn't bother to read this one.

    If researchers can't even bother to give an accurate title why would I think that the research (carried out mostly by Physio's) is going to be impartial?
     
  23. NewsBot

    NewsBot The Admin that posts the news.

    A randomised control trial of short term efficacy of in-shoe foot orthoses compared with a wait and see policy for anterior knee pain and the role of foot mobility
    Kathryn Mills, Peter Blanch, Priya Dev, Michael Martin, Bill Vicenzino
    Br J Sports Med doi:10.1136/bjsports-2011-090204
     
  24. CraigT

    CraigT Well-Known Member

    I hope that these gentlemen-
    Read this paper!
     
  25. NewsBot

    NewsBot The Admin that posts the news.

    Comfort and midfoot mobility rather than orthosis hardness or contouring influence their immediate effects on lower limb function in patients with anterior knee pain.
    Mills K, Blanch P, Vicenzino B.
    Clin Biomech (Bristol, Avon). 2011 Sep 14
    [/QUOTE]
     
  26. NewsBot

    NewsBot The Admin that posts the news.

    Effects of prefabricated foot orthoses on pain and function in individuals with patellofemoral pain syndrome: a cohort study.
    Barton CJ, Menz HB, Crossley KM
    Phys Ther Sport. 2011 May;12(2):70-5
     
  27. NewsBot

    NewsBot The Admin that posts the news.

    Benefits of custom-made foot orthoses in treating patellofemoral pain.
    Munuera PV, Mazoteras-Pardo R.
    Prosthet Orthot Int. 2011 Sep 26. [Epub ahead of print]
     
  28. Brahim

    Brahim Member

    With orthoses being one of the modalities of treatment in this study I have to ask, which orthoses? Is there such thing as a conventional orthosis? If yes and results indicate that intervention with so called "conventional orthoses" yield better outcomes relative to other modalities, a secondary study to compare various orthotic configurations generated from a variety of prescription workup techniques could be very useful in determining which of the orthotic modalities work best.

    With a proliferation of technologies / materials / services available to clinicians it might help to unclutter the decision process by pointing to those combinations that work best.
     
  29. Craig Payne

    Craig Payne Moderator

  30. Brahim

    Brahim Member

  31. NewsBot

    NewsBot The Admin that posts the news.

    A randomised control trial of short term efficacy of in-shoe foot orthoses compared with a wait and see policy for anterior knee pain and the role of foot mobility.
    Mills K, Blanch P, Dev P, Martin M, Vicenzino B.
    Br J Sports Med. 2012 Mar;46(4):247-52
     
  32. NewsBot

    NewsBot The Admin that posts the news.

    Effects of Medially Wedged Foot Orthoses on Knee and Hip Joint Running Mechanics in Females with and without Patellofemoral Pain Syndrome.
    Boldt AR, Willson JD, Barrios JA, Kernozek TW.
    J Appl Biomech. 2012 Jul 5.
     
  33. NewsBot

    NewsBot The Admin that posts the news.

    Medially posted insoles consistently influence foot pronation in runners with and without anterior knee pain
    Pedro Rodrigues, Ryan Chang, Trampas TenBroek, Joseph Hamill
    Gait and Posture (in press)
     
  34. NewsBot

    NewsBot The Admin that posts the news.

    Effects of medially wedged foot orthoses on knee and hip joint running mechanics in females with and without patellofemoral pain syndrome.
    Boldt AR, Willson JD, Barrios JA, Kernozek TW.
    J Appl Biomech. 2013 Feb;29(1):68-77.
     
  35. Craig Payne

    Craig Payne Moderator

    Why that? Why not use "foot orthotics of the type that are commonly used in clinical practice"?
     
  36. Craig Payne

    Craig Payne Moderator

    I in a bad mood today, so this paper gets the dumbass piece of research for the week. I finally got the full paper; the "orthoses" was a full length 6 degree EVA wedge ... who does that clinically? really dumb to use something that is not used clinically. To make it worse, the authors said in the discussion that the 6 degree wedge was to ".....elevate the first metatarsal head ..."! What were they thinking? duh? Have they not heard of the windlass mechanism that this would have inhibited and made the foot pronate even more ... really dumb! That total invalidates the study and makes the results meaningless.
     
  37. NewsBot

    NewsBot The Admin that posts the news.

    The effects of three quarter and full length foot orthoses on patellofemoral pain sufferers when walking and descending stairs
    Jim Richards, John Burston and James Selfe
    Journal of Foot and Ankle Research 2014, 7(Suppl 1):A70 doi:10.1186/1757-1146-7-S1-A70
     
  38. NewsBot

    NewsBot The Admin that posts the news.

    Masters thesis from 2000:

    THE EFFECTIVENESS OF USING FOOT ORTHOTICS AS THE SOLE
    INTERVENTION FOR THE TREATMENT OF PATELLOFEMORAL PAIN
    SYNDROME

    Byron Horner; Grand Valley State University
    Source
     
  39. Bruce Williams

    Bruce Williams Well-Known Member

    No control group. Stabilizer orthotic with only 2 degrees of varus posting. Small sample size and small length of follow up. Was he just pandering to someone at his PT school who really think orthotics don't help?
    Why do we keep testing OTC devices expecting different outcomes tha previously tested?
    This is poor science.
    Bruce
     
  40. NewsBot

    NewsBot The Admin that posts the news.

    The immediate effects of foot orthoses on hip and knee kinematics and muscle activity during a functional step-up task in individuals with patellofemoral pain
    Simon Lack, Christian Barton, Roger Woledge, Markus Laupheimer, Dylan Morrissey
    Clinical Biomechanics; Articles in Press
     
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