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J Sci Med Sport. 2018 May;21(5):457-461. doi: 10.1016/j.jsams.2017.09.187. Epub 2017 Oct 2.

Gait retraining versus foot orthoses for patellofemoral pain: a pilot randomised clinical trial.

Author information

1
Centre for Sports Research, School of Exercise and Nutrition Sciences, Deakin University, Australia. Electronic address: jason.bonacci@deakin.edu.au.
2
Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Australia.
3
Centre for Sports Research, School of Exercise and Nutrition Sciences, Deakin University, Australia.
4
School of Health and Rehabilitation Sciences, Physiotherapy, University of Queensland, Australia.

Abstract

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 100mm 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.

KEYWORDS:

Anterior knee pain; Cadence; Foot orthotics; Minimalist shoe; Running gait

PMID:
28993130
DOI:
10.1016/j.jsams.2017.09.187
[Indexed for MEDLINE]

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