Effect of foot orthoses on balance among individuals with flatfoot: A systematic review and meta-analysis

Individuals with flatfoot have impaired proprioception owing to ligament laxity and impaired tendons, which can result in poor balance. Foot orthoses (FOs) have been reported to stimulate plantar mechanical receptors and are used to manage foot overpronation in individuals with flatfoot. However, the results of the use of FOs to improve balance are inconsistent. In this systematic review and meta-analysis, we aimed to identify and investigate the effects of FOs on balance in individuals with flatfoot. Electronic databases were searched for articles published before March 2023. Peer-reviewed journal studies that included adult participants with flexible flatfoot and reported the effects of FOs on balance were included and classified based on the study design: randomized control trials (RCT) and non-RCTs. Four RCT studies were retained, and their methodological quality was assessed (mean, 63.2%; range 47.3%-73.1%: high), as were three non-RCT studies (mean, 54.1%; range, 42.1%-68.4%: high). Meta-analysis was performed by calculating the effect size using the standardized mean differences between the control and FO conditions. Transverse-arch insoles immediately improved static balance after use. However, no immediate significant effect was found for medial archsupport FOs, cuboid-posting FOs, or University of California Berkeley Laboratory FOs during the study period (2-5 weeks) when compared with the controls. The transverse-arch insole is the most effective FO feature for improving static balance. However, the high heterogeneity between study protocols contributes to the lack of evidence for the effects of FO on balance in people with flatfoot.

Immediate and short-term effects of kinesiotaping and lower extremity stretching on pain and disability in individuals with plantar fasciitis: a pilot randomized, controlled trial

Background: Plantar fasciitis (PF) can disturb individual's weight-bearing activities. Hence, conservative treatments with immediate effect in reducing pain and improving foot function is required.Objective: This study compared the effect of kinesiotaping and stretching exercise in individuals with PF.Methods: Thirty patients with PF were randomly divided into three groups, and received kinesiotaping, stretching exercise, and a combination of the two aforementioned interventions. Pain intensity and foot disability were measured at baseline, immediately after the first treatment, and at one week.Results: Immediately after the first treatment, all groups showed significant changes in heel pain intensity (p ≤ .012) with the standardized response mean (SRM) of 2.85, 1.96, and 1.43 for the taping, stretching, and the combination groups, respectively. Nevertheless, no significant change in foot disability was found (p > .05). At the one week, all groups continued to demonstrate significant reduction in heel pain (p ≤ .012) with the SRM of 1.78, 2.84, and 2.09 for the taping, stretching, and the combination groups, respectively. While the combination group showed significant reduction in foot disability (p = .024). However, there was no significant difference of the change score in all parameters among the three groups (p > .05).Conclusion: Improvement in heel pain was observed in all groups after the first treatment. However, improvement in foot function over one week was observed only among those who received the combined treatment. Further studies on larger samples are required to establish the superiority of the combined treatment over kinesiotaping or stretching alone.

Physical and psychological predictors on pain intensity in conscripts with plantar fasciitis

BACKGROUND

Plantar fasciitis is commonly found among the physically active population, including conscripts. Some studies have reported that being overweight and having psychological symptoms contribute to pain from plantar fasciitis. However, there is a lack of information regarding the physical predictors, and more research is needed to determine the relationship between such predictors and pain intensity from plantar fasciitis in conscripts.

OBJECTIVE

To determine which physical and psychological variables act as predictors of pain intensity among Thai novice conscripts with plantar fasciitis.

METHODS

Two hundred and seventy Thai novice conscripts without musculoskeletal pain completed the Depression, Anxiety and Stress Scale short version and then received baseline assessment of ankle dorsiflexion angle, ankle plantarflexor strength, and quality of lower extremity movement from a physical therapist. After 10 weeks of military training, 71 of these Thai conscripts developed pain from plantar fasciitis. Multiple linear regression analysis with the forward stepwise method was used to explore the predictors of pain intensity due to plantar fasciitis.

RESULTS

Using a forward regression analysis, anxiety (B=0.13; 95% CI, 0.06-0.20; p<0.01) and quality of movement score (B=0.87; 95% CI, 0.28-1.47; p=0.01) were significant predictors of pain intensity. The regression model with these predictors explained 25% of the variability in pain intensity from plantar fasciitis.

CONCLUSION

Higher scores of anxiety and movement quality on the lateral step-down task were associated with pain intensity from plantar fasciitis after the completion of a 10-week military program. However, lower ankle dorsiflexion angle and ankle plantarflexor strength did not predict pain intensity.

Effects of weight-bearing exercise on a mini-trampoline on foot mobility, plantar pressure and sensation of diabetic neuropathic feet; a preliminary study

Objective: Foot and ankle exercise has been advocated as a preventative approach in reducing the risk of foot ulceration. However, knowledge about the appropriate types and intensity of exercise program for diabetic foot ulcer prevention is still limited. The current study aimed to examine the effects of an eight-week mini-trampoline exercise on improving foot mobility, plantar pressure and sensation of diabetic neuropathic feet.

Methods: Twenty-one people with diabetic peripheral neuropathy who had impaired sensation perception were divided into two groups. The exercise group received a foot-care education program plus an eight-week home exercise program using the mini-trampoline (n = 11); whereas a control group received a foot-care education only (n = 10). Measurements were undertaken at the beginning, at the completion of the eight-week program and at a 20-week follow-up.

Results: Both groups were similar prior to the study. Subjects in the exercise group significantly increased the range of the first metatarsophalangeal joint in flexion (left: p = 0.040, right: p = 0.012) and extension (left: p = 0.013) of both feet more than controlled subjects. There was a trend for peak plantar pressure at the medial forefoot to decrease in the exercise group (p = 0.016), but not in the control group. At week 20, the number of subjects in the exercise group who improved their vibration perception in their feet notably increased when compared to the control group (left: p = 0.043; right: p = 0.004).

Conclusions: This is a preliminary study to document the improvements in foot mobility, plantar pressure and sensation following weight-bearing exercise on a flexible surface in people with diabetic neuropathic feet. Mini-trampoline exercise may be used as an adjunct to other interventions to reduce risk of foot ulceration. A larger sample size is needed to verify these findings. This trial is registered with COA No. 097.2/55.

Prevalence of and factors associated with musculoskeletal symptoms in the spine attributed to computer use in undergraduate students

OBJECTIVE

This study aimed to investigate the 3-month prevalence of musculoskeletal symptoms at the spine attributed to computer use and to identify biopsychosocial factors associated with the prevalence in undergraduate students.

PARTICIPANTS

Undergraduate students who studied at a public university in Thailand.

METHODS

A cross-sectional survey was conducted with a self-administered questionnaire delivered to 3,545 students.

RESULTS

A total of 2,511 students (73.7%) returned the questionnaires. Cervical symptoms (22.3%) were the most frequently reported, followed by thoracic (11%) and lumbar symptoms (10.7%). Females, daily computer use greater than three hours and too-high keyboard's position were significantly associated with a high prevalence of cervical symptoms. A significant association was found between higher undergraduate year of the study and too-high keyboard's position and a high prevalence of thoracic symptoms. Higher undergraduate year of the study and daily computer use greater than three hours were significantly related to a high prevalence of lumbar symptoms. Better-than-normal mental health status was associated with a low prevalence of lumbar symptoms.

CONCLUSION

Spinal symptoms are common among undergraduate students. Various factors were identified to be associated with high prevalence of spinal symptoms. Further research investigating the causal relation between these factors and musculoskeletal symptoms should be conducted.

Are religious beliefs and practices of Buddhism associated with disability and salivary cortisol in office workers with chronic low back pain?

Background

Low back pain (LBP) is common among office workers. A number of studies have established a relationship between Christianity and physical and mental health outcomes among chronic pain patients. The purpose of this study was to examine the relationship between the religious beliefs and practices of Buddhism and disability and psychological stress in office workers with chronic LBP.

Methods

A cross-sectional survey was conducted with a self-administered questionnaire delivered by hand to 463 office workers with chronic LBP. Saliva samples were collected from a randomly selected sub-sample of respondents (n=96). Disability due to LBP was assessed using the Roland-Morris Disability Questionnaire and psychological stress was assessed based on salivary cortisol. Two hierarchical regression models were built to determine how much variance in disability and psychological stress could be explained by religious beliefs and practices of Buddhism variables after controlling for potential confounder variables.

Results

Only 6% of variance in psychological stress was accounted for by the religious beliefs and practices of Buddhism. Those with high religiousness experienced lower psychological stress. No association between the religious beliefs and practices of Buddhism and disability level was found. Depressive symptoms were attributed to both psychological stress and disability status in our study population.

Conclusions

The findings suggest that, although being religious may improve the psychological condition in workers with chronic LBP, its effect is insufficient to reduce disability due to illness. Further research should examine the role of depression as a mediator of the effect of psychological stress on disability in patients with chronic LBP.

A Prospective Study of Incidence and Risk Factors for the Onset and Persistence of Low Back Pain in Thai University Students

This study aimed to examine the 12-month incidence and risk factors for the onset and persistence of low back pain (LBP) in undergraduate students. A 1-year prospective study was carried out among 684 healthy students in a large public university in Thailand. Data were collected using a self-administered questionnaire and a physical examination. Follow-up data were collected every 3 months. A total of 524 (77%) students were followed for 1 year. A total of 31% reported a new onset of LBP, of whom 31% reported persistent LBP. Having no low back support during computer work was a significant predictor for the onset and persistence of LBP. The onset of LBP was also associated with quadriceps muscle tightness. LBP is common among undergraduate students, and many of them may have persistent symptoms. Physical risk factor plays a significant role for the onset and persistence of LBP among the study population.

Prevalence of and biopsychosocial factors associated with low back pain in commercial airline pilots

PURPOSE

The aim of this study was to examine the 12-mo prevalence of low back pain (LBP) and to identify individual, flight-related, and psychosocial factors associated with the prevalence of LBP in commercial airline pilots.

METHODS

A cross-sectional survey was conducted with a self-administered questionnaire delivered by hand to 708 Thai airline pilots visiting the Institute of Aviation Medicine, Royal Thai Air Force, for their regular medical examinations. A multivariable logistic regression model was used to assess the associations between the prevalence of LBP and statistically significant factors.

RESULTS

A total of 684 subjects (97%) returned the questionnaires. The 12-mo prevalence of self-reported LBP among commercial airline pilots was 55.7%. An elevated risk of experiencing LBP was associated with occasionally to frequently encountering turbulence in the previous year, lifting luggage four or more times per duty period, perception of noise in the cockpit as being too loud, and perception of work hazards at intermediate to high levels, assessed by the JCQ Thai version. On the other hand, the factors that reduced the risk of experiencing LBP were performing vigorous exercise regularly and having 5-23 h rest breaks between flights.

CONCLUSIONS

LBP is common among commercial airline pilots. Our findings suggest that LBP in commercial airline pilots is occupation-related. Interventions aimed at reducing the occurrence of LBP in commercial airline pilots should focus on work condition adjustment and mental stress reduction.

Development of a risk score for low back pain in office workers--a cross-sectional study

Background

Low back pain (LBP) is common among office workers and is the most common cause of work-related disability in people under 45 years of age. The aetiology of LBP is widely accepted to be multi-factorial. Prognostic research into office workers at risk of developing LBP has received limited attention. The aims of this study were to develop a risk score to identify office workers likely to have LBP and to evaluate its predictive power.

Methods

397 office workers filled out a self-administered questionnaire and underwent physical examination. The questionnaire gathered data on individual, work-related physical and psychosocial data as well as the presence of low back pain in the previous 4 weeks. The physical examination included measurement of body weight, height, waist circumference, hamstrings length, spinal scoliosis, spinal curve, Backache Index and lumbar stability. Logistic regression was used to select significant factors associated with LBP to build a risk score. The coefficients from the logistic regression model were transformed into the components of a risk score.

Results

The model included six items: previous history of working as an office worker, years of work experience, continuous standing for >2 hrs/d, frequency of forward bending during work day, chair having lumbar support and Backache Index outcome. The risk score for LBP in office workers (The Back pain Risk score for Office Workers: The BROW) was built with a risk score ranging from 0 to 9. A cut-off score of ≥4 had a sensitivity of 80% and a specificity of 58%. The positive predictive value and negative predictive values were 70% each.

Conclusions

The BROW is easy and quick to administer. It appears to have reasonable sensitivity, specificity, positive predictive value and negative predictive values for the cut-off point of ≥4. The BROW is a promising tool for use to identify office workers in need of early interventions. Further prospective study is needed to validate the predictive performance of the BROW.

Biopsychosocial risk factors for musculoskeletal symptoms of the spine in salespeople

This study aimed to identify biopsychosocial factors associated with the self-reported prevalence of musculoskeletal symptoms in the spine in saleswomen in department stores. A cross-sectional survey was conducted in which 1310 saleswomen in 18 department stores received a self-administered questionnaire. Returns were 1200 (92%) questionnaires, and after screening for exclusion criteria, 1189 saleswomen were eligible for the study. Standing/walking for > 10 hours/day, as well as frequent working in static postures and twisting the body during work were each significantly associated with a high prevalence of experiencing head/neck symptoms. A significant association was found between standing/walking for > 10 hours/ day and a high prevalence of experiencing upper back symptoms. Working for > 10 hours/day, standing/walking for > 5 hours/day without rest breaks, as well as frequent working in static postures and sitting during work were each significantly related to a high prevalence of experiencing lower back symptoms. Surprisingly, poor self-rated perceptions of physical work environments significantly correlated with a low prevalence of musculoskeletal symptoms in all spinal regions.

Biopsychosocial factors and musculoskeletal symptoms of the lower extremities of saleswomen in department stores in Thailand

OBJECTIVES

To identify individual, work-related physical and psychosocial factors associated with the self-reported prevalence of musculoskeletal symptoms in the hip, knee and ankle/foot of saleswomen in department stores in Thailand.

METHODS

A cross-sectional survey was conducted in which 1,310 saleswomen in 18 department stores received a self-administered questionnaire. Returns were 1,200 (92%) questionnaires, and after screening for exclusion criteria, 1,189 saleswomen were found to be eligible for the study.

RESULTS

Having a child, number of working hours per day, frequency of body twisting during work and self-rated perception of light intensity in the workplace were each significantly associated with the prevalence of experiencing hip symptoms. Significant associations were found between age, number of hours per day required to stand or walk and self-rated perception of temperature in the workplace, and the prevalence of experiencing knee symptoms. The number of working hours per day and working days per week as well as frequency of working in static postures and rest breaks during work were each significantly related to the prevalence of experiencing ankle/foot symptoms.

CONCLUSIONS

Among saleswomen, various individual and work-related physical factors were identified as risks and preventive factors for musculoskeletal symptoms in the lower extremities. Further research should focus on these modifiable factors in order to develop effective strategies for reducing the occurrence of such symptoms in saleswomen.

Associations between prevalence of self-reported musculoskeletal symptoms of the spine and biopsychosocial factors among office workers

OBJECTIVES

To investigate the relationships between the self-reported prevalence of musculoskeletal symptoms in the neck, upper back and low back and certain individual, work-related physical and psychosocial factors.

METHODS

We conducted a cross-sectional survey using a descriptive questionnaire, which was distributed to 2000 office workers in 54 workplaces, in Bangkok, registered at the Social Security Office of Thailand.

RESULTS

Returns were 1,428 (71%) questionnaires, and after screening for exclusion criteria, 1,185 office workers were found to be eligible for the study. For the head/neck region, frequently working in an uncomfortable posture increased the risk of experiencing head/neck symptoms (adjusted OR=1.81, 95% CI=1.35-2.44). For the upper back region, frequent trunk bending during work increased the risk of experiencing upper back symptoms (adjusted OR=1.80, 95% CI=1.32-2.44) whereas working in a job that required little interaction with others decreased the risk of experiencing upper back symptoms (adjusted OR=0.42, 95% CI=0.25-0.68). For the low back region, working for >8 h a day showed an elevated risk for low back symptoms (adjusted OR=1.66, 95% CI=1.25-2.22).

CONCLUSIONS

Some biopsychosocial factors were associated with the prevalence of musculoskeletal symptoms in the spine among office workers. Further research should focus on these factors in order to develop specific strategies to reduce the occurrence of such symptoms in the office environment.

Physiotherapy management of low back pain in Thailand: a study of practice

BACKGROUND AND PURPOSE

Low back pain (LBP) is one of the most common musculoskeletal disorders in both developed and developing countries. Whilst there have been a number of studies investigating the current physiotherapy management of LBP in the former, little is known about such management in developing countries. The objectives of the present study were to investigate the physiotherapy management of LBP in Thailand and to compare the results with those of developed countries where applicable.

METHOD

A cross-sectional survey was undertaken to collect information on physiotherapists, LBP patients and treatment interventions used, using a Thai version of an available (English) questionnaire. Subsequent to a pilot study with 32 Thai therapists, minor revisions were made and the final questionnaires were mailed to all 776 physiotherapists currently working throughout Thailand.

RESULTS

Responses were received from 559 therapists (a 77.2% response rate), and 502 of these were currently involved in LBP management. Results indicated that LBP patients made up, on average, 37.5% of their patient caseloads. Electrophysical modalities, especially hot packs (64%), ultrasound (61%) and mechanical traction (61%), were reported to be the most commonly used treatments, particularly by hospital-based therapists, whereas those working in university-based hospitals and private clinics were more likely to use manual therapy.

CONCLUSIONS

This study provides descriptive data from the therapists' perspective about LBP management and shows that the treatments most commonly used are different from those treatments commonly used in developed countries. The potential reasons for this are explored in this paper and recommendations are made for further research.