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01-12-2014 | Research | Uitgave 1/2014 Open Access

Journal of Foot and Ankle Research 1/2014

Mechanism of orthotic therapy for the painful cavus foot deformity

Tijdschrift:
Journal of Foot and Ankle Research > Uitgave 1/2014
Auteurs:
Bijan Najafi, James S Wrobel, Joshua Burns
Belangrijke opmerkingen

Electronic supplementary material

The online version of this article (doi:10.​1186/​1757-1146-7-2) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

JB conducted the main study and shared the data for the purpose of this study. He also contributed in the exploration of data, writing the manuscript, and discussion. BN explored and analyzed the data and wrote the manuscript. He developed the main algorithm used to assess the dynamic planar loading behavior during walking. JW contributed in exploring the data and writing the manuscript and discussion. All authors read and approved the final manuscript.

Abstract

Background

People who have extremely high arched feet or pes cavus often suffer from substantial foot pain. Custom-made foot orthoses (CFO) have been shown to be an effective treatment option, but their specificity is unclear. It is generally thought that one of the primary functions of CFO is redistributing abnormal plantar pressures. This study sought to identify variables associated with pain relief after CFO intervention.

Methods

Plantar pressure data from a randomized controlled trial of 154 participants with painful pes cavus were retrospectively re-analyzed at baseline and three month post CFO intervention. The participants were randomized to a treatment group given CFO or a control group given sham orthoses.

Results

No relationship between change in pressure magnitude and change in symptoms was found in either group. However, redistribution of plantar pressure, measured with the Dynamic Plantar Loading Index, had a significant effect on pain relief (p = 0.001). Our final model predicted 73% of the variance in pain relief from CFO and consisted of initial pain level, BMI, foot alignment, and changes in both Dynamic Plantar Loading Index and pressure–time integral.

Conclusion

Our data suggest that a primary function of effective orthotic therapy with CFO is redistribution of abnormal plantar pressures. Results of this study add to the growing body of literature providing mechanistic support for CFO providing pain relief in painful foot conditions. The proposed model may assist in better designing and assessing orthotic therapy for pain relief in patients suffering painful cavus foot deformity.

Trial registration

Randomized controlled trial: ISRCTN84913516

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Extra materiaal
Authors’ original file for figure 1
13047_2013_594_MOESM1_ESM.pdf
Authors’ original file for figure 2
13047_2013_594_MOESM2_ESM.tif
Authors’ original file for figure 3
13047_2013_594_MOESM3_ESM.tif
Authors’ original file for figure 4
13047_2013_594_MOESM4_ESM.tif
Authors’ original file for figure 5
13047_2013_594_MOESM5_ESM.tif
Literatuur
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