Effectiveness of foot exercises and orthoses in PFP
Adding foot exercises and orthoses to knee-targeted exercises in patients with patellofemoral pain (PFP) and everted foot posture produced a greater pain decrease when compared with knee exercises alone at 4 months. However, this difference was not present at 12 months after the intervention. Thus, although foot exercises and orthoses may be an important additional treatment in PFP, the authors alert that these results may not be generalized to people without an everted foot posture.
PFP is a common condition that frequently proves difficult to manage and shows frequent recurrence. As such, different subgroups have been researched in order to optimize management and outcomes. Although high midfoot mobility has been identified as one of these subrgoups, the evidence of the effect of foot exercises and orthoses of PFP is conflicting.
40 participants 16-80 years old with PFP and calcaneal eversion over 6º were randomly assigned to follow a program of knee exercises or knee exercises plus foot exercises and orthosis use. Pain levels were assessed with the KOOS scale. Outcomes were measured at baseline and at 4 and 12 months follow up.
Participants in the intervention group showed a greater reduction in knee pain at 4 months but no difference at 12 months. Other outcomes (quality of life, function) showed the same trend but differences were not significant. It is suggested that foot exercises and orthoses be considered for the management of PFP in people with distal biomechanical alterations.