Non-operative management of posterior tibialis tendon dysfunction: design of a randomized clinical trial [NCT00279630]

Abstract

Background: Posterior tibialis tendon dysfunction (PTTD) is a common cause of foot pain and dysfunction in adults. Clinical observations strongly suggest that the condition is progressive. There are currently no controlled studies evaluating the effectiveness of exercise, orthoses, or orthoses and exercise on Stage I or IIA PTTD. Our study will explore the effectiveness of an eccentric versus concentric strengthening intervention to results obtained with the use of orthoses alone. Findings from this study will guide the development of more efficacious PTTD intervention programs and contribute to enhanced function and quality of life in persons with posterior tibialis tendon dysfunction.

Methods/design: This paper presents the rationale and design for a randomized clinical trial evaluating the effectiveness of a treatment regime for the non-operative management of Stage I or IIA PTTD.

Discussion: We have presented the rationale and design for an RCT evaluating the effectiveness of a treatment regimen for the non-operative management of Stage I or IIA PTTD. The results of this trial will be presented as soon as they are available.

Trial registration: ClinicalTrials.gov NCT00279630.

Figure 1

A) Standing gastrocnemius stretch. B) Standing soleus stretch.

Figure 2

Exercise unit for isolated tibialis posterior exercise. (1) LED displaying static plantar flexion from pressure sensors under forefoot; (2) Constant force extension spring for dynamic adduction; (3) Lever to allow passive adduction or abduction of the foot.