Effects of Customized Insoles in Female Patients with Patellofemoral Pain Syndrome Correlated with Pronated Foot
Date Issued
2015
Date
2015
Author(s)
Hsu, Meng-Yi
Abstract
Patellofemoral pain syndromes (PFPS) are multifactorial conditions. A successful treatment requires the understanding of the predisposing factors. Lateral tracking of the patella has been hypothesized to be the major contribution to the development of patellofemoral pain. The increases in patellofemoral joint stress from mal-alignment have been identified in these patients. The underlying mechanisms which cause maltracking of patella include factors related to the lower limb such as excessive internal femoral rotation or rear foot movements. Lately, the evidences showed that PFPS patients may exhibit more pronated foot type. However, there was limited evidence of the intervention with insoles and the results showed no significant difference. One of the possible reasons may be lack of subgroup analysis for the subject characteristics to find those subjects who will respond better to insoles. As a result, the purpose of the study was to investigate the effects of insoles in PFPS patients with pronated foot on pain reduction, functional improvement and activity level. This study was a prospective randomized control study. The experimental group received intervention with customized insoles plus general physical therapy; in contrast, the control group received sham insoles plus general physical therapy. The statistical analysis was performed using SPSS v.17.0 software. The demographic data was collected before receiving treatment, including basic data, pain level, functional status and activity level. There were totally 27 subjects recruited in this study with 13 subjects in control group and 14 subjects in experimental group. The basic dada was analyzed by independent t test. The outcome assessment was conducted and compared between groups with Mann-Whitney U test and within group at baseline and after 6 week with Wilcoxon signed-rank test. The significant level was set at 0.05 while the power was 0.8. The result showed that customized insoles are superior to flat inserts in both usual pain and worst pain reduction(p=0.005; P=0.001) and symptom relief (P=0.029), which may be an effective intervention in addition to PT exercise and kinesio-taping in female PFPS individuals with pronated foot and high activity level in 6 weeks. Foot pronation and high activity level of the subjects may be key characteristics to enhance the effects of insoles intervention in individuals with PFPS in clinical industry in addition to general physical therapeutic exercise and kinesio-taping. However, prospective studies are required to determine whether the effects can maintain in the long term.
Subjects
patellofemoral pain syndrome
pronated foot
insoles intervention
physical therapeutic exercises
McConnell approach of kinesio-taping
Type
thesis
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