Mechanism of orthotic therapy for the painful cavus foot deformity

Persistent Link:
http://hdl.handle.net/10150/610181
Title:
Mechanism of orthotic therapy for the painful cavus foot deformity
Author:
Najafi, Bijan; Wrobel, James; Burns, Joshua
Affiliation:
Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Southern Arizona Limb Salvage Alliance (SALSA), University of Arizona College of Medicine, Tucson, AZ, USA; Arizona Center on Aging, University of Arizona College of Medicine, Tucson, AZ, USA; Internal Medicine; Metabolism, Endocrinology and Diabetes Division, University of Michigan Medical School, Ann Arbor, MI, USA; The University of Sydney and The Children’s Hospital at Westmead, Sydney, Australia
Issue Date:
2014
Publisher:
BioMed Central
Citation:
Najafi et al. Journal of Foot and Ankle Research 2014, 7:2 http://www.jfootankleres.com/content/7/1/2
Journal:
Journal of Foot and Ankle Research
Rights:
© 2014 Najafi et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0)
Collection Information:
This item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.
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
EISSN:
1757-1146
DOI:
10.1186/1757-1146-7-2
Keywords:
Foot pain; Pes cavus; Plantar pressure; Modeling pain relief; Probability distribution of peak pressure; Dynamic plantar loading index
Version:
Final published version
Additional Links:
http://www.jfootankleres.com/content/7/1/2

Full metadata record

DC FieldValue Language
dc.contributor.authorNajafi, Bijanen
dc.contributor.authorWrobel, Jamesen
dc.contributor.authorBurns, Joshuaen
dc.date.accessioned2016-05-20T09:00:28Z-
dc.date.available2016-05-20T09:00:28Z-
dc.date.issued2014en
dc.identifier.citationNajafi et al. Journal of Foot and Ankle Research 2014, 7:2 http://www.jfootankleres.com/content/7/1/2en
dc.identifier.doi10.1186/1757-1146-7-2en
dc.identifier.urihttp://hdl.handle.net/10150/610181-
dc.description.abstractBACKGROUND: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: ISRCTN84913516en
dc.language.isoenen
dc.publisherBioMed Centralen
dc.relation.urlhttp://www.jfootankleres.com/content/7/1/2en
dc.rights© 2014 Najafi et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0)en
dc.subjectFoot painen
dc.subjectPes cavusen
dc.subjectPlantar pressureen
dc.subjectModeling pain reliefen
dc.subjectProbability distribution of peak pressureen
dc.subjectDynamic plantar loading indexen
dc.titleMechanism of orthotic therapy for the painful cavus foot deformityen
dc.typeArticleen
dc.identifier.eissn1757-1146en
dc.contributor.departmentInterdisciplinary Consortium on Advanced Motion Performance (iCAMP), Southern Arizona Limb Salvage Alliance (SALSA), University of Arizona College of Medicine, Tucson, AZ, USAen
dc.contributor.departmentArizona Center on Aging, University of Arizona College of Medicine, Tucson, AZ, USAen
dc.contributor.departmentInternal Medicine; Metabolism, Endocrinology and Diabetes Division, University of Michigan Medical School, Ann Arbor, MI, USAen
dc.contributor.departmentThe University of Sydney and The Children’s Hospital at Westmead, Sydney, Australiaen
dc.identifier.journalJournal of Foot and Ankle Researchen
dc.description.collectioninformationThis item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.en
dc.eprint.versionFinal published versionen
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