The effectiveness of direct custom-molded foot orthosis with or without medial plantar groove in treatment of chronic heel pain in plantar fasciitis

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The effectiveness of direct custom-molded foot orthosis with or without medial plantar groove in treatment of chronic heel pain in plantar fasciitis

 

Author: Chan, Wai-leung
Title: The effectiveness of direct custom-molded foot orthosis with or without medial plantar groove in treatment of chronic heel pain in plantar fasciitis
Degree: M.Sc.
Year: 2008
Subject: Hong Kong Polytechnic University -- Dissertations.
Foot -- Diseases -- Treatment.
Artificial legs.
Heel bone -- Wounds and injuries -- Treatment.
Fasciae (Anatomy) -- Inflammation -- Treatment.
Department: Dept. of Health Technology and Informatics
Pages: xii, 140 leaves : ill. (some col.) ; 30 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2305491
URI: http://theses.lib.polyu.edu.hk/handle/200/4235
Abstract: The purpose of this study was to define the effectiveness of direct custom-molded foot orthosis with or without medial plantar groove for the patient suffering from plantar fasciitis of chronic heel pain over 3 months. A total of 40 subjects participated in this randomized study. Their mean age was 50.85 years. They were divided into two groups A or B depending on their coming sequence. The duration of the study was 10 weeks. The group A subjects were treated with foot orthosis without medial plantar groove, and the group B subjects were treated with foot orthosis with medial plantar groove. A follow-up checking was scheduled for 4 week and 10 week after orthotic treatment. For the subjective outcome measurement the questionnaire of Revised Foot Function Index (FFI-R) was used at week 1, week 4 and week 10 for outcome measures assessment. It consists of foot pain, stiffness of foot, foot functioning, foot activity limitation and social functioning (quality of life) before and after of foot orthotic treatment of all subjects. The pain subscale of the FFI-R was chosen because it was validated instrument (Budiman et al., 2006). The demographic data were included age, gender, occupation, affected side of heel, BMI and previous treatments received at the session 1. The objective outcome measurement tool the F-Scan (Tekscan, Inc Boston, MA) in-shoe system was used to measure contact area and plantar pressures of the subjects during walking with shoe only and with the direct custom-molded foot orthosis immediately after orthosis fabrication and in session 2 (week 4). All the data analysis was used the two-way repeated measure of analysis of variance (ANOVA) to determine statistical differences (p<0.05). After 10 weeks treatment of within-subjects group effects, it had showed significance differences of FFI-R scores the foot pain subscale (p=0.000 by week 4 and 0.203 by week 10), foot functioning (disability) subscale (p=0.025 by week 4 and 0.00 by week 10), foot activity limitation subscale (p=0.002 by week 4 and 0.00 by week 10) and social functioning (quality of life) subscale (p=0.01 by week 4 and 0.00 by week 10) were significant differences except the stiffness of foot subscale (p=0.164 by week 4 and 0.245 by week 10) and last follow-up checking of foot pain subscale of all subjects. The between-subjects group differences showed significance for the FFI-R scores of the foot pain subscale (p=0.03), foot functioning (disability) subscale (p= 0.01), foot activity limitation subscale (p=0.0 01) and social functioning (quality of life) subscale (p=0.001). But the stiffness of foot showed no significant difference (p=0.857). The F-Scan sensors insole measurement showing the mean contact area of whole foot and mean contact area of hindfoot were significant difference of with or without foot orthosis (p=0.00 and = 0.049) of both groups. Regions of mean contact area of forefoot, medial midfoot and lateral midfoot showed no significant differences versus with or without foot orthosis. The contact area of foot was increased to 20.09% of group A subject and 17.38% of group B subject. The mean peak pressure and maximum peak pressure of forefoot and hindfoot showed significant difference of in-shoe with versus without foot orthosis (p= 0.02, 0.007 and 0.03, 0.00) respectively. They showed reducing foot pressure 25.13% and 17.21% on forefoot of group A and B, and 50.2% and 27.92% on hindfoot region of both group A and B. Moreover, both group A and B of medial and lateral midfoot of mean and maximum peak pressure those of them were shown no statistical significance differences. The p values of mean peak pressure and maximum peak pressure parameters of forefoot, medial midfoot, lateral midfoot and hindfoot of between-subjects groups were shown no significance differences of both foot orthoses (p=0.8, 0.32, 0.12 and 0.27 and o.92, 0.2, 0.19 and 0.75) respectively.

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