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- Author or Editor: Anne-Maree Keenan x
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Clinicians often use foot orthoses to manage the symptoms of plantar fasciitis. Although there has been considerable research evaluating the effectiveness of orthoses for this condition, there is still a lack of scientific evidence that is of suitable quality to fully inform clinical practice. Randomized controlled trials are recognized as the “gold standard” when evaluating the effectiveness of treatments. We discuss why randomized controlled trials are so important, the features of a well-conducted randomized controlled trial, and some of the problems that arise when trial design is not sound. We then evaluate the available evidence for the use of foot orthoses, with particular focus on published randomized controlled trials. From the evidence to date, it seems that foot orthoses do have a role in the management of plantar fasciitis and that prefabricated orthoses are a worthwhile initial management strategy. At this time, however, it is not possible to recommend either prefabricated or customized orthoses as being better, and it cannot be inferred that customized orthoses are more effective over time and therefore have a cost advantage. Additional good-quality randomized controlled trials are needed to answer these questions. (J Am Podiatr Med Assoc 94(6): 542–549, 2004)
Abnormal foot morphology has been suggested to contribute to overuse injuries in athletes. This study investigated the relationship between foot type and injury incidence in a large sample of competitive triathletes not wearing foot orthoses during a 6-month retrospective analysis and a 10-week prospective cohort study. Foot alignment was measured using the Foot Posture Index and the Valgus Index, and participants were assigned to supinated, pronated, and normal foot-type groups. Overall, 131 triathletes sustained 155 injuries during the study. Generally, foot type was not a major risk factor for injury; however, there was a fourfold increased risk of overuse injury during the competition season in athletes with a supinated foot type. The results of this study show that triathletes with a supinated foot type are more likely to sustain an overuse injury. (J Am Podiatr Med Assoc 95(3): 235–241, 2005)
Low-Dye taping is often used as a short-term treatment for plantar fasciitis. We evaluated the short-term effectiveness of low-Dye taping in relieving pain associated with plantar fasciitis. In this comparative study conducted at a university-based clinic, 65 participants with plantar fasciitis who received low-Dye taping for 3 to 5 days were compared with 40 participants who did not receive taping. Pain before and after treatment was measured using a visual analog pain scale. Analysis of the data was by the intention-to-treat principle, and a linear regression approach to analysis of covariance was used to compare effects. The visual analog pain scale score improved by a mean of 20 mm (from 44 to 24 mm) in the taping group and worsened by a mean of 6 mm (from 51 to 57 mm) in the control group. The analysis of covariance–adjusted difference in therapeutic effect favored the taping group by 31.7 mm (95% confidence interval, 23.6–39.9 mm) and was statistically significant (t = 7.71). In the short term, low-Dye taping significantly reduces the pain associated with plantar fasciitis. These findings are the first quantitative results to demonstrate the significant therapeutic effect of this treatment modality in relieving the symptoms associated with plantar fasciitis. (J Am Podiatr Med Assoc 95(6): 525–530, 2005)
