Exercise therapy and custom-made insoles are effective in patients with excessive pronation and chronic foot pain--a randomized controlled trial.
Excessive foot pronation is one of the causal mechanisms often described in relation to foot injuries. Excessive pronation may develop from lack of muscle strength and stability or from overuse. Triceps surae, Peronei, Tibialis posterior and anterior muscles are known extrinsic dynamic supporters of the medial longitudinal arch. Fatigue of the intrinsic foot muscles has shown increased pronation in the foot measured by navicular drop Furthermore pronated feet are associated with lower EMG amplitude for evertor muscles such as Peroneus longus compared to normal or supinated foot posture.
The aim of this study was to investigate the effect of exercise and insoles to patients with excessive pronation and chronic pain conditions in the foot at one year follow-up. Method: Single blinded RCT with 80 subjects randomized: (1) Standard Intervention, (2) Insole, (3) Exercise, and (4) Insole + Exercise.
A signiﬁcant pain reduction was seen in all four groups at both short term and long term follow-up. The results at 12 months follow-up should be viewed with caution due to the risk of cross contamination. None of the treatment modalities seem to be superior with the number of patients available in this study and therefore different approaches seem to have an effect in treating orthopaedic outpatients in daily clinical practice. Only a weak cor relation between changes in pain scores and changes in structural and biomechanical outcome measures of the foot was seen > from Andreasen et al.; The Foot 23 (2013) 22–28. All rights reserved to Elsevier Ltd.
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