Custom insoles versus sham and GP-led usual care in patients with plantar heel pain: results of the STAP-study - a randomised controlled trial.

Autor:	Rasenberg N; Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands., Bierma-Zeinstra SMA; Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands., Fuit L; Podiatrist practice: Podotherapie Fuit en van Houten, Rijswijk, The Netherlands., Rathleff MS; Center for General Practice in Aalborg, Aalborg University, Aalborg, Denmark., Dieker A; Dutch Association of Podiatrists, Hilversum, The Netherlands., van Veldhoven P; Department of Sports Medicine, Haaglanden Medical Centre, Leidschendam, The Netherlands., Bindels PJE; Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands., van Middelkoop M; Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands m.vanmiddelkoop@erasmusmc.nl.
Jazyk:	angličtina
Zdroj:	British journal of sports medicine [Br J Sports Med] 2021 Mar; Vol. 55 (5), pp. 272-278. Date of Electronic Publication: 2020 Sep 02.
DOI:	10.1136/bjsports-2019-101409
Abstrakt:	Objectives: To compare custom-made insoles to sham insoles and general practice (GP)-led usual care in terms of pain at rest and during activity at 12 weeks follow-up in individuals with plantar heel pain. Methods: In this randomised clinical trial 185 patients aged 18 to 65 years, with a clinical diagnosis of plantar heel pain for at least 2 weeks, but no longer than 2 years were recruited. Patients were randomly allocated into three groups: (1) GP-led treatment, plus an information booklet with exercises (usual care; n=46), (2) referral to a podiatrist for treatment with a custom-made insole plus an information booklet with exercises (custom-made insole; n=70) and (3) referral to a podiatrist and treatment with a sham insole plus an information booklet with exercises (sham insole; n=69). As well as the primary outcome of pain severity (11-point Numerical Rating Scale) we used the Foot Function Index (0 to 100) as a secondary outcome. Results: Of 185 randomised participants, 176 completed the 12-week follow-up. There was no difference in pain or function between the insole and the sham groups at 12 weeks. Participants in the GP-led usual care group reported less pain during activity at 12 weeks, (mean difference (MD) 0.94, 95% CI 0.23 to 1.65), less first step pain (MD 1.48, 95% CI 0.65 to 2.31), better function (MD 7.37, 95% CI 1.27 to 13.46) and higher recovery rates (RR 0.48, 95% CI 0.24 to 0.96) compared with participants in the custom insole group. Conclusions: Referral to a podiatrist for a custom-made insole does not lead to a better outcome compared to sham insoles or compared to GP-led usual care. Trial Registration Number: NTR5346. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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