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01-12-2013 | Research | Uitgave 1/2013 Open Access

Journal of Foot and Ankle Research 1/2013

Foot orthoses for the management of low back pain: a qualitative approach capturing the patient’s perspective

Tijdschrift:
Journal of Foot and Ankle Research > Uitgave 1/2013
Auteurs:
Anita E Williams, Lindsay A Hill, Christopher J Nester
Belangrijke opmerkingen

Competing interests

'The authors declare that they have no competing interests.

Authors’ contributions

AW – conceived the idea for a qualitative approach – co-analysed the data and created the paper; LH - carried out the data collection and the primary data analysis – contributed to the presentation of the results in the paper; CN- co-analysed the data and contributed to the paper. All authors read and approved the final manuscript.

Abstract

Background

The onset of non specific low back pain is associated with heavy lifting, age, female gender, and poor general health, with psychological factors being predictors of it becoming chronic. Additionally, it is thought that altered lower limb biomechanics are a contributory factor, with foot orthoses increasingly being considered as an appropriate intervention by physiotherapists and podiatrists. However, research into the effect of foot orthoses is inconclusive, primarily focusing on the biomechanical effect and not the symptomatic relief from the patient’s perspective. The aim of this study was to explore the breadth of patients’ experiences of being provided with foot orthoses and to evaluate any changes in their back pain following this experience.

Method

Following ethical approval, participants (n = 25) with non-specific low back pain associated with altered lower limb biomechanics were provided with customised foot orthoses. At 16 weeks after being provided with the foot orthoses, conversational style interviews were carried out with each patient. An interpretivistic phenomenological approach was adopted for the data collection and analysis.

Results

For these participants, foot orthoses appeared to be effective. However, the main influence on this outcome was the consultation process and a patient focussed approach. The consultation was an opportunity for fostering mutual understanding, with verbal and visual explanation reassuring the patient and this influenced the patient’s beliefs, their engagement with the foot orthoses (physical) and their experience of low back pain (psychological).

Conclusion

Clinicians need to adopt ‘psychologically informed practice’ in relation to the provision of foot orthoses. Likewise, researchers should consider all the influencing factors found in this study, both in relation to their study protocol and the outcomes they plan to measure.

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