Nonsurgical management of posterior tibial tendon dysfunction with orthoses and resistive exercise: a randomized controlled trial.

Abstract

BACKGROUND AND PURPOSE:

Tibialis posterior tendinopathy can lead to debilitating dysfunction. This study examined the effectiveness of orthoses and resistance exercise in the early management of tibialis posterior tendinopathy.

SUBJECTS:

Thirty-six adults with stage I or II tibialis posterior tendinopathy participated in this study.

METHODS:

Participants were randomly assigned to 1 of 3 groups to complete a 12-week program of: (1) orthoses wear and stretching (O group); (2) orthoses wear, stretching, and concentric progressive resistive exercise (OC group); or (3) orthoses wear, stretching, and eccentric progressive resistive exercise (OE group). Pre-intervention and post-intervention data (Foot Functional Index, distance traveled in the 5-Minute Walk Test, and pain immediately after the 5-Minute Walk Test) were collected.

RESULTS:

Foot Functional Index scores (total, pain, and disability) decreased in all groups after the intervention. The OE group demonstrated the most improvement in each subcategory, and the O group demonstrated the least improvement. Pain immediately after the 5-Minute Walk Test was significantly reduced across all groups after the intervention.

DISCUSSION AND CONCLUSION:

People with early stages of tibialis posterior tendinopathy benefited from a program of orthoses wear and stretching. Eccentric and concentric progressive resistive exercises further reduced pain and improved perceptions of function.

• Authors: Kornelia Kulig, Stephen F Reischl, Amy B Pomrantz, Judith M Burnfield, Susan Mais-Requejo, David B Thordarson, Ronald W Smith
• Journal: Physical therapy (Phys Ther) Vol. 89 Issue 1 Pg. 26-37 (Jan 2009) ISSN: 1538-6724 [Electronic] United States
• PMID: 19022863 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Aged
• Cohort Studies
• Female
• Humans
• Male
• Middle Aged
• Muscle Stretching Exercises
• Orthotic Devices
• Pain (etiology, prevention & control)
• Pain Measurement
• Posterior Tibial Tendon Dysfunction (complications, physiopathology, therapy)
• Recovery of Function
• Resistance Training
• Treatment Outcome
• Walking (physiology)