[show abstract][hide abstract] ABSTRACT: The literature suggests mechanical interventions such as foot orthoses and night splints are effective in reducing pain from plantar fasciitis. There is, however, a lack of controlled trials. We studied the effects of foot orthoses and night splints, alone or combined, in a prospective, randomized trial with 1-year followup.
Forty-three patients (34 women and nine men with a mean age of 46 years) with plantar fasciitis were randomized to receive foot orthoses (n = 13), foot orthoses and night splints (n = 15), or night splints alone (n = 15). Data were available for 34 (79%) patients after treatment (12 weeks), and for 38 (88%) at 1-year followup. Pain, functional limitations, and quality of life were evaluated with the Foot and Ankle Outcome Score.
All groups improved significantly in all outcomes evaluated across all times (p < 0.04). At 12 weeks, pain reduction of 30% to 50% compared to baseline were seen (p < 0.03). At 52 weeks, pain reduction of 62% was seen in the two groups using foot orthoses compared to 48% in the night splint only group (p < 0.01). Better compliance and fewer side effects were reported for orthosis use. At 12 months, 19 of 23 patients reported still using foot orthoses compared to 1 of 28 still using the night splint.
Foot orthoses and anterior night splints were effective both short-term and long-term in treating pain from plantar fasciitis. Parallel improvements in function, foot-related quality of life, and a better compliance suggest that a foot orthosis is the best choice for initial treatment plantar fasciitis.
Foot & Ankle International 08/2006; 27(8):606-11. · 1.47 Impact Factor
[show abstract][hide abstract] ABSTRACT: Achilles tendinopathy is common and treatment with eccentric exercises seems promising. We designed a prospective randomized clinical trial to test the hypothesis that eccentric calf muscle exercises reduce pain and improve function in patients with Achilles tendinopathy. Forty-four patients were recruited from primary care (mean age: 45 years; 23 women; 65% active in sports) and randomized to three treatment groups for 12 weeks: eccentric exercises, a night splint or a combination of both treatments. Pain and function were evaluated at 6, 12, 26 and 52 weeks by the Foot and Ankle Outcome Score. At 6 weeks, the eccentric group reported a significant pain reduction (27% compared with baseline, P = 0.007) which lasted for 1 year (42%, P = 0.001). The two groups treated with a night splint also reported significant but less pain reduction than the eccentric group. Differences between all the three groups were not significant. At 12 weeks, the eccentric group reported significantly less pain than the splint-only group (P = 0.04). More patients in the eccentric group than in the splint group returned to sport after 12 weeks. We conclude that eccentric exercises seem to reduce pain and improve function in patients with Achilles tendinopathy. Our results are in line with previous studies and strengthen the recommendation that patients should undergo an eccentric exercise program prior to considering other treatments such as surgery.
Scandinavian Journal of Medicine and Science in Sports 11/2004; 14(5):286-95. · 3.21 Impact Factor