Gait retraining versus foot orthoses for patellofemoral pain

NewsBot · Oct 2, 2017

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Gait retraining versus foot orthoses for patellofemoral pain: a pilot randomised clinical trial
Jason Bonacci, Michelle Hall, Natalie Saunders, Bill Vicenzino
Journal of Science and Medicine in Sport; 2 October 2017

Objectives
To determine the feasibility of a clinical trial that compares a 6-week, physiotherapist-guided gait retraining program with a foot orthoses intervention in runners with patellofemoral pain.

Design
Pilot randomised controlled trial.

Methods
Runners aged 18-40 years with clinically diagnosed patellofemoral pain were randomly allocated to either a 6-week gait retraining intervention of increasing cadence and use of a minimalist shoe or prefabricated foot orthoses. Outcomes at baseline and 12-weeks included recruitment, retention, adherence, adverse events, global improvement, anterior knee pain scale, worst and average pain on a 100 mm visual analogue scale.

Results
Of the 16 randomised participants, two withdrew prior to commencing treatment due to non-trial related matters (n = 1 from each group) and 14 completed the pilot trial. Minor calf muscle soreness was reported by 3 participants in the gait retraining group while no adverse events were reported in the foot orthoses group. There were no deviations from the treatment protocols. There was a large between-group difference favouring gait retraining at 12-weeks in the anterior knee pain scale and the worst pain in the past week, which was reflected in the number needed-to-treat of 2.

Conclusions
This study supports the feasibility of a trial comparing gait retraining with foot orthoses and provides point estimates of effect that informs the design and planning of a larger clinical trial. It appears that a 6-week gait retraining program has a clinically meaningful effect on runners with patellofemoral pain when compared to an evidence-based treatment of foot orthoses.
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Admin2 · Oct 2, 2017

Related Threads:
Gait retraining for the treatment of patellofemoral pain
Foot orthoses and patellofemoral pain syndrome

William Fowler · Oct 2, 2017

what were the orthotics they used?

Craig Payne · Oct 2, 2017

William Fowler said: ↑

what were the orthotics they used?
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Vasyli

davidh · Oct 3, 2017

14 subjects, minimalist shoe, otc orthoses?

I remain unconvinced.

Question - is gait retraining the new barefoot running?

NewsBot · Apr 6, 2020

Does foot mobility affect the outcome in the management of patellofemoral pain with foot orthoses versus hip exercises? A randomised clinical trial
Mark Matthews et al
British Journal of Sports Medicine Published Online First: 26 March 2020

Objectives To test (i) if greater foot pronation (measured as midfoot width mobility) is associated with better outcomes with foot orthoses treatment, compared with hip exercises and (ii) if hip exercises are superior to foot orthoses, irrespective of midfoot width mobility.

Methods A two-arm parallel, randomised superiority clinical trial was conducted in Australia and Denmark. Participants (18–40 years) were included who reported an insidious onset of knee pain (≥6 weeks duration); ≥3/10 numerical pain rating, that was aggravated by activities (eg, stairs, squatting, running). Participants were stratified by midfoot width mobility (high ≥11 mm change in midfoot width) and site, randomised to foot orthoses or hip exercises and blinded to objectives and stratification. Success was defined a priori as much better or better on a patient-perceived 7-point scale at 12 weeks.

Results Of 218 stratified and randomised participants, 192 completed 12-week follow-up. This study found no difference in success rates between foot orthoses versus hip exercises in those with high (6/21 vs 9/20; 29% vs 45%, respectively) or low (42/79 vs 37/72; 53% vs 51%) midfoot width mobility. There was no association between midfoot width mobility and treatment outcome (Interaction effect p=0.19). This study found no difference in success rate between foot orthoses versus hip exercises (48/100 vs 46/92; 48% vs 50%).

Conclusion Midfoot width mobility should not be used to help clinicians decide which patient with patellofemoral pain might benefit most from foot orthoses. Clinicians and patients may consider either foot orthoses or hip exercises in managing patellofemoral pain.
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