Footwear and foot orthoses for calcaneal apophysitis

NewsBot · Feb 25, 2016

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Effectiveness of footwear and foot orthoses for calcaneal apophysitis: a 12-month factorial randomised trial
Alicia M James, Cylie M Williams, Terry P Haines
Br J Sports Med doi:10.1136/bjsports-2015-094986

Objective Calcaneal apophysitis, is a relatively common cause of heel pain in children. Very few randomised studies have evaluated treatment options. This trial compared the effectiveness of currently employed treatment options for the relief of pain and disability associated with calcaneal apophysitis.

Design Factorial 2?2 randomised comparative effectiveness trial with 1, 2, 6 and 12-month follow-up.

Setting Participants were recruited from the caseload of podiatrists at Monash health and Peninsula Health.

Participants Children aged 8?14 years with clinically diagnosed calcaneal apophysitis.

Interventions Treatment factor 1: two different types of in-shoe orthoses: a heel raise or prefabricated orthoses. Treatment factor 2: footwear replacement or no footwear replacement.

Outcomes Our primary outcome was functional disability, the secondary outcomes were pain and ankle dorsiflexion range.

Results A total of 133 children and their parents responded to the recruitment advertisement, 124 participated in the trial.

At the 1 and 2-month follow-up points, there was a main effect of the shoe insert (heel raise) in only the physical domain for the Oxford ankle foot questionnaire (p=0.04). At the 6 and 12-month follow-up points, there was no main effect or interaction effect for any outcome measure.

Conclusion This trial indicates at the 2-month time point there is a relative advantage in the use of heel raises over prefabricated orthoses for the treatment for calcaneal apophysitis. At 12 months there was no relative advantage to any one of the investigated treatment choices over another. Therefore, if a physical impact is experienced for greater than 2 months, the selection of treatment choice may defer to clinical judgement, cost-minimisation and or patient preference.
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Admin2 · Feb 25, 2016

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NewsBot · Feb 2, 2022

Effectiveness of custom-made foot orthoses vs heel lifts in children with Calcaneal Apophysitis (Sever disease): a CONSORT-compliant randomized trial
Gómez-Bernal A, Alfaro-Santafé J, Lanuza-Cerzócimo C, Alfaro-Santafé JV, Pérez-Morcillo A, Almenar-Arasanz AJ
Research Square, 09 Apr 2020

Background: Calcaneal apophysitis (Sever disease) is a benign ailment which causes heel pain in children. Conservative treatment strategies are widely popular and the prescription of prefabricated orthoses and heel-lifts is very widespread. The aim of the present research was to determine the effectiveness to relieve calcaneal apophysitis pain using “off-the-shelf” heel-lifts and custom-made orthotics. Methods: Two intervention modalities were evaluated and compared in a 12-week follow-up randomized comparative effectiveness trial. Inclusion criteria included 9 to 12 years old boys or girls diagnosed of calcaneal apophysitis, primary exclusion criteria included children who had suffered from foot trauma on the heel or had received previous treatment. Children were stratified randomized into experimental (custom-made polypropylene foot orthoses) and control (“off-the-shelf” heel-lifts) group. The primary outcome was calcaneal apophysitis pain perception, which was assessed by the Visual Analogical Scale (VAS), the algometry threshold and the Sport Activity Pain perception. Points of measure were at baseline and after the follow-up period. Analysis was performed according to the intention-to treat principles.Results: A total of 208 patients were included. Overall, 9 patients were lost to follow-up. Experimental group showed an increase in threshold algometry by 53.4% (95% CI 47.1% to 59.7%), a decrease in VAS by -68.6% (95% CI -74.5% to -62.7%) and a 20.8 times higher probability of improvement of Sport Activity (95% CI 8.9 to 48.6), compared with control group (p <0.001).Conclusions: Calcaneal apophysitis pain perception was improved in both groups custom-made foot orthoses and heel-lifts, but the experimental group revealed significant changes compared with control group. Children who used custom-made foot orthoses had greater probabilities to improve. Physicians should consider these findings in order to prescribe the most effective treatment in the approach of the calcaneal apophysitis.
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NewsBot · Oct 5, 2021

Effects of custom-made insoles on foot pressure redistribution, gait parameters, and pain in calcaneal apophysitis—a pretest and posttest study
Feyzioğlu, Özlem1; Öztürk, Özgül1; Muğrabi, Selim2
Prosthetics and Orthotics International: September 21, 2021 - Volume - Issue -

Background:
Calcaneal apophysitis is a self-limiting disorder that often affects adolescents with a high level of activity and leads to increased pain severity, impairments in gait parameters, and poor health-related quality of life.

Objective:
To investigate the combination of custom-made insoles and exercise on foot pressure distribution, spatial–temporal gait parameters, and pain intensity in patients with calcaneal apophysitis.

Study design:
A one-group pretest–posttest design.

Methods:
Forty patients, aged between 8 and 15 years, diagnosed with calcaneal apophysitis, were included in this study. Patients were asked to use the custom-made insoles and to perform a home exercise program for 3 days a week. The duration of treatment was 4 weeks. The pain severity was evaluated with the Visual Analog Scale. The spatial–temporal gait parameters and foot pressure distribution were assessed with the Zebris FDM-THM-S treadmill system before and after the treatment.

Results:
At posttreatment assessment, there were significant changes in step length, stance phase percentage, swing phase percentage, and gait speed (P < 0.05), except step width and cadence (P > 0.05). Moreover, significant differences were found in forefoot, midfoot, and rearfoot pressure distribution (P < 0.05). There was also a significant decrease in pain intensity during activity compared to the pretreatment (P < 0.05).

Conclusion:
Our study results suggest that the combination of the custom-made insoles and exercise program created improvements in spatial–temporal gait parameters and foot pressure distribution by reducing the pain severity.
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NewsBot · Oct 5, 2023

Sever’s Disease – a common cause of heel pain among sport-active children
Per Øllgaard
Source

Objectives:
Sever’s disease (Calcaneal Apophysitis) is the most common cause of heel pain in growing and active children and adolescents. Studies imply that the prevalence is increasing for children attending sports with repetitive running and jumping. These children are advised to pause their sport when heel pain occurs. However, activity modifications, immobilization, or absolute rest often has a negative impact and can lead to total drop-out.
The objective of the study is to examine whether an intervention based on information and custom-made insoles can decrease pain levels in children between 6-14 years with Sever’s disease and make them return faster to sport activities instead of the conservative treatment with rest and/or activity modification.
Methods:
The study is a descriptive observational study based on a database from a physiotherapeutic clinical practice. This included 469 children between 6-14 years with diagnosed Sever’s disease who sought an expert in sports physiotherapy due to severe pain and limited sport activity. Baseline information was collected by the physiotherapist. Parents filled a questionnaire as follow up 3 months after the intervention.
Results:
The children experienced pain for 10,4 months on average. They all reported that their sport activities had been reduced or stopped entirely due to heel pain. All children received an intervention which included information about Sever’s disease and the physiology of the foot, combined with a customized insole that suspend the heel to relieve pressure on the apophysis of the calcaneus. The intervention helped most of the children to resume their sport activity.
Conclusion:
Sever’s disease is a painful, discomforting condition which causes reduced activity level in sport-active children and even ceasing sports completely, but customized insoles can ease pain and avert or limit immobilization.
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