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18-09-2011 | Orthopaedics | Article

Customized sport shoe orthoses effective for injured runners


Free abstract

MedWire News: Customized foot orthoses are effective for treating running-related overuse injuries, show results of a randomized controlled study.

"Overuse injuries are the main pathologic conditions to prevent competitive runners from training or competition," say Anja Hirschmüller (University Freiburg, Germany) and co-authors. "The results of our study justify the prescription of orthoses as a single-measure approach for runners that are still able to continue their training activity."

A total of 99 runners with running-related injuries were randomly assigned to receive either custom-made, semi-rigid running shoe orthoses, or to continue their regular training activity without any treatment, for 8 weeks. All participants were aged between 18 and 60 years and ran over 20 miles (32 km) per week.

To evaluate the influence of the foot orthoses on pain and impairment of daily life, the researchers used the pain disability index (PDI), the Subjective Pain Experience Scale (SES), and the comfort index of orthoses (ICI). The outcome measures were assessed at the end of every week.

As reported in the British Journal of Sports Medicine, the most common injury in the patients was Achilles tendinopathy (26 patients), followed by patellar tendinopathy (18 patients), patellofemoral pain syndrome (14 patients), iliotibial band syndrome (13 patients), plantar fasciitis, and periostitis tibiae (both in seven patients).

After 8 weeks, there were significant differences in the PDI and SES between the orthoses and control groups.

In the orthoses group, the mean PDI sum score, which assesses the degree to which pain interferes with functioning across a range of activities including family/home responsibilities and social activity, decreased from 4.0 to 1.6 (range from 0 [no interference] to 10 [total interference]) after 8 weeks of treatment. By contrast, the mean PDI sum score slightly increased in the control group, from 4.1 to 4.8.

Similarly, the mean SES score, which quantifies "pain quality" on measurement days and during the intervention period, decreased from 29.9 to 25.9 (out of a maximum of 48 which indicates the highest pain) in the orthoses group, while in the control group it increased from 31.6 to 32.5.

Of note, the SES sum score in the orthoses group initially slightly increased, say the researchers. Therefore, "it seems important to prepare patients for a possible pain increase at the beginning of an orthoses therapy so that they do not immediately stop using the orthoses."

Nevertheless, the patients with orthoses reported a rising wearing comfort, with ICI scores increasing from 69 (out of 100 to indicate maximum comfort) pre-treatment, to 83 post-treatment.

Only one patient preferred running without the orthoses than with them, suggesting the orthoses were highly accepted among the runners, conclude Hirschmüller et al.

By Nikki Withers

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