Effectiveness of foot orthoses to treat plantar fasciitis - A randomized trial
Effectiveness of foot orthoses to treat plantar fasciitis - A randomized trial
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DOI：
10.1001/archinte.166.12.1305
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发表时间：
2006-06-26
影响因子：
--
通讯作者：
Herbert, RD
中科院分区：
文献类型：
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作者：
Landorf, KB;Keenan, AM;Herbert, RD
背景：足底筋膜炎是最常见的足部主诉之一。它通常用足部矫形器治疗；然而，关于矫形器效果的研究通常质量很差，据我们所知，还没有试验调查长期效果。本试验的目的是评价足底矫形器治疗足底筋膜炎的近期和远期疗效。方法：从1999年4月至2001年7月，进行一项务实、随机、参与者盲法试验。每个参与者的随访期为12个月。来自当地社区的135名足底筋膜炎患者被招募到一所大学的诊所，并被随机分配到接受假矫形器(软、薄泡沫)、预制矫形器(坚硬泡沫)或定制矫形器(半硬塑料)的组。结果：经过3个月的治疗，预制和定制矫形器对疼痛和功能的影响优于假矫形器，尽管只有对功能的影响具有统计学意义。与假矫形器相比，预制矫形器的疼痛评分(0~100分)平均提高8.7分(95%可信区间-0.1~17.6；P=0.05)，定制矫形器平均疼痛评分(95%可信区间-1.4~16.2；P=0.10)。与假矫形器相比，预制矫形器的平均功能评分(0~100分)提高了8.4分(95%可信区间为1.0~15.8；P=0.03)，定制矫形器的平均功能评分(95%可信区间为0.3~14.7；P=0.04)。结论：足底矫形器在功能上产生了很小的短期益处，也可能对足底筋膜炎患者产生轻微的疼痛减轻，但与假装置相比，它们没有长期的益处。本试验中使用的定制矫形器和预制矫形器在治疗足底筋膜炎方面具有类似的效果。
Background: Plantar fasciitis is one of the most common foot complaints. It is often treated with foot orthoses; however, studies of the effects of orthoses are generally of poor quality, and to our knowledge, no trials have investigated long-term effectiveness. The aim of this trial was to evaluate the short- and long-term effectiveness of foot orthoses in the treatment of plantar fasciitis.Methods: A pragmatic, participant-blinded, randomized trial was conducted from April 1999 to July 2001. The duration of follow-up for each participant was 12 months. One hundred and thirty-five participants with plantar fasciitis from the local community were recruited to a university-based clinic and were randomly allocated to receive a sham orthosis (soft, thin foam), a prefabricated orthosis (firm foam), or a customized orthosis (semirigid plastic).Results: After 3 months of treatment, estimates of effects on pain and function favored the prefabricated and customized orthoses over the sham orthoses, although only the effects on function were statistically significant. Compared with sham orthoses, the mean pain score ( scale, 0-100) was 8.7 points better for the prefabricated orthoses (95% confidence interval, -0.1 to 17.6; P = .05) and 7.4 points better for the customized orthoses ( 95% confidence interval, -1.4 to 16.2; P = .10). Compared with sham orthoses, the mean function score (scale, 0-100) was 8.4 points better for the prefabricated orthoses (95% confidence interval, 1.0-15.8; P = .03) and 7.5 points better for the customized orthoses (95% confidence interval, 0.3-14.7; P = .04). There were no significant effects on primary outcomes at the 12-month review.Conclusions: Foot orthoses produce small short-term benefits in function and may also produce small reductions in pain for people with plantar fasciitis, but they do not have long-term beneficial effects compared with a sham device. The customized and prefabricated orthoses used in this trial have similar effectiveness in the treatment of plantar fasciitis.