Foot Orthoses Help Patellofemoral Pain Syndrome

For persons with patellofemoral pain syndrome (PFPS), the combination of 3 of 4 predictors-poor footwear motion control properties, less usual pain, reduced ankle dorsiflexion range of motion, and reduced pain during a single-leg squat-increases the probability of showing marked improvement with foot orthoses. A preliminary clinical prediction rule may help clinical reasoning when foot orthosis prescription is considered.

Barton and associates studied 60 patients with PFPS. Prefabricated foot orthoses were issued, and patients entered in a diary their daily physical activity completed, what footwear they wore, and how often they used the foot orthosis. At 12 weeks, each patient rated the perceived improvement in symptoms using a 5-point Likert scale.

Marked improvement at 12 weeks was reported by 14 patients. The greatest accuracy in predicting marked improvement was produced by positive findings on 3 of the 4 variables (footwear motion control properties score of less than 5.0, usual pain less than 22 mm, ankle dorsiflexion range of motion less than 41.3°, and reduced single-leg squat pain when wearing the orthoses).

The authors noted that this is the first clinical prediction rule study to evaluate the association of footwear properties, functional performance measures, and compliance with orthoses use.


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