Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: randomised clinical trial.
Collins N, Crossley K, Beller E, Darnell R, McPoil T, Vicenzino B
The objective of this study ws to compare the clinical efficacy of foot orthoses in the management of patellofemoral pain syndrome with flat inserts or physiotherapy, and to investigate the effectiveness of foot orthoses plus physiotherapy. 179 participants with a clinical diagnosis of patellofemoral pain syndrome of greater than six weeks' duration, who had no previous treatment with foot orthoses or physiotherapy in the preceding 12 months underwent either six weeks of physiotherapist intervention with off the shelf foot orthoses, flat inserts, multimodal physiotherapy (patellofemoral joint mobilisation, patellar taping, quadriceps muscle retraining, and education), or foot orthoses plus physiotherapy.
While foot orthoses are superior to flat inserts according to participants' overall perception, they are similar to physiotherapy and do not improve outcomes when added to physiotherapy in the short term management of patellofemoral pain. Given the long term improvement observed in all treatment groups, practitioners may seek to hasten recovery by prescribing prefabricated orthoses.
BMJ, 2008 24 Oct, online article
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