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Foot Ankle Int. 2015 Sep;36(9):1006-16. doi: 10.1177/1071100715579906. Epub 2015 Apr 9.

Randomized Controlled Trial Comparing Orthosis Augmented by Either Stretching or Stretching and Strengthening for Stage II Tibialis Posterior Tendon Dysfunction.

Author information

1
George Fox University, Department of Physical Therapy, Newberg, OR, USA jhouck@georgefox.edu.
2
SUNY Upstate Medical University, Syracuse, NY, USA.
3
Ithaca College-Movement Analysis Laboratory, Ithaca, NY, USA.
4
University of Rochester Medical Center, Department of Orthopedic Surgery, Rochester, NY, USA.

Abstract

BACKGROUND:

The value of strengthening and stretching exercises combined with orthosis treatment in a home-based program has not been evaluated. The purpose of this study was to compare the effects of augmenting orthosis treatment with either stretching or a combination of stretching and strengthening in participants with stage II tibialis posterior tendon dysfunction (TPTD).

METHODS:

Participants included 39 patients with stage II TPTD who were recruited from a medical center and then randomly assigned to a strengthening or stretching treatment group. Excluding 3 dropouts, there were 19 participants in the strengthening group and 17 in the stretching group. The stretching treatment consisted of a prefabricated orthosis used in conjunction with stretching exercises. The strengthening treatment consisted of a prefabricated orthosis used in conjunction with the stretching and strengthening exercises. The main outcome measures were self-report (ie, Foot Function Index and Short Musculoskeletal Function Assessment) and isometric deep posterior compartment strength. Two-way analysis of variance was used to test for differences between groups at 6 and 12 weeks after starting the exercise programs.

RESULTS:

Both groups significantly improved in pain and function over the 12-week trial period. The self-report measures showed minimal differences between the treatment groups. There were no differences in isometric deep posterior compartment strength.

CONCLUSIONS:

A moderate-intensity, home-based exercise program was minimally effective in augmenting orthosis wear alone in participants with stage II TPTD.

LEVEL OF EVIDENCE:

Level I, prospective randomized study.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00756457.

KEYWORDS:

foot; rehabilitation; tendinopathy

PMID:
25857939
DOI:
10.1177/1071100715579906
[Indexed for MEDLINE]

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