Year 2024 / Volume 35 / Number 1

Original Papers

Qualitative pilot study on the orthotic management of tibialis posterior tendon dysfunction by podiatrists

Rev. Esp. Pod. 2024; 35(1): 30-35 / DOI: 10.20986/revesppod.2024.1686/2024

George Banwell, Eva Lopezosa Reca, Alfred Gatt, Gabriel Gijón Noguerón, Laura Ramos Petersen


ABSTRACT

Introduction: Posterior tibial tendon dysfunction (PTTD) is a progressive and disabling condition with both conservative and surgical treatment options. The aim of this qualitative pilot study was to identify the diff erences in the methods of assessment and conservative management by a group of podiatrists.
Material and methods: The data was collected through recorded structured interviews, including questions related to the treatment and methods of assessment used for the pathology of PTTD. A thematic analysis of the transcripts was carried out to identify the codes and themes. Six podiatrists were interviewed in their own clinical setting.
Results: Seven themes were extracted from the interviews after the thematic analysis. The results varied between the podiatrists, some putting more emphasis on certain aspects of assessment and treatment than others. There were diff erences between treatment methodology, the types of professionals referred to and follow up periods. There were some similarities with certain treatments, such as foot orthosis treatment, however diff erences in the materials and modifi cations used.
Conclusion: Due to the small diff erences between the assessment and treatment methodology, and the lack consensus on certain aspects, more research should be done to identify a more detailed orthotic management of PTTD and a guideline created to prevent variability in treatment.



RESUMEN

Introducción: La disfunción del tendón tibial posterior (DTTP) es una condición progresiva y discapacitante con opciones de tratamiento tanto conservadoras como quirúrgicas. El objetivo de este estudio piloto cualitativo fue identificar las diferencias en los métodos de evaluación y manejo conservador por parte de un grupo de podólogos.
Material y métodos: Los datos se recopilaron a través de entrevistas estructuradas grabadas, que incluyeron preguntas relacionadas con el tratamiento y los métodos de evaluación utilizados para la patología de la DTTP. Se realizó un análisis temático de las transcripciones para identificar los códigos y temas. Se entrevistó a seis podólogos en sus propios entornos clínicos.
Resultados: Se extrajeron 7 temas de las entrevistas después del análisis temático. Los resultados variaron entre los podólogos, algunos enfatizando más ciertos aspectos de la evaluación y el tratamiento que otros. Hubo diferencias en la metodología de tratamiento, los tipos de profesionales a los que se referían y los periodos de seguimiento. Hubo algunas similitudes con ciertos tratamientos, como el tratamiento con ortesis para el pie, sin embargo, hubo diferencias en los materiales y modifi caciones utilizados.
Conclusión: Debido a las pequeñas diferencias entre la metodología de evaluación y tratamiento, y la falta de consenso en ciertos aspectos, se debería realizar más investigación para identificar un manejo ortopédico más detallado de la DTTP y crear pautas para prevenir la variabilidad en el tratamiento.


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Bibliografía

1. Lhoste-Trouilloud A. The tibialis posterior tendon. J Ultrasound. 2012;15(1):2-6.
2. Federer AE, Steele JR, Dekker TJ, Liles JL, Adams SB. Tendonitis and Tendinopathy: What Are They and How Do They Evolve? Foot Ankle Clin. 2017;22(4):665-76.
3. Kohls-Gatzoulis J, Angel J, Singh D. Tibialis posterior dysfunction as a cause of flatfeet in elderly patients. Foot. 2004;14(4):207-9.
4. Kulig K, Lee SP, Reischl SF, Noceti-DeWit L. Effect of posterior tibial tendon dysfunction on unipedal standing balance test. Foot Ankle Int. 2015;36(1):83-9.
5. Ross MH, Smith MD, Mellor R, Durbridge G, Vicenzino B. Clinical Tests of Tibialis Posterior Tendinopathy: Are They Reliable, and How Well Are They Reflected in Structural Changes on Imaging? J Orthop Sports Phys Ther. 2021;51(5):253-60.
6. Albano D, Martinelli N, Bianchi A, Romeo G, Bulfamante G, Galia M, et al. Posterior tibial tendon dysfunction: Clinical and magnetic resonance imaging findings having histology as reference standard. Eur J Radiol. 2018;99:55-61.
7. Hintermann B, Gächter A. The first metatarsal rise sign: A simple, sensitive sign of tibialis posterior tendon dysfunction. Foot Ankle Int. 1996;17(4):236-41.
8. Arnoldner MA, Gruber M, Syré S, Kristen KH, Trnka HJ, Kainberger F, et al. Imaging of posterior tibial tendon dysfunction - Comparison of high-resolution ultrasound and 3 T MRI. Eur J Radiol. 2015;84(9):1777-81.
9. Gonzalez FM, Harmouche E, Robertson DD, Umpierrez M, Singer AD, Younan Y, et al. Tenosynovial fluid as an indication of early posterior tibial tendon dysfunction in patients with normal tendon appearance. Skeletal Radiol. 2019;48(9):1377-83.
10. DeOrio JK, Shapiro SA, McNeil RB, Stansel J. Validity of the posterior tibial edema sign in posterior tibial tendon dysfunction. Foot Ankle Int. 2011;32(2):189-92.
11. Nallamshetty L, Nazarian LN, Schweitzer ME, Morrison WB, Parellada JA, Articolo GA, et al. Evaluation of posterior tibial pathology: Comparison of sonography and MR imaging. Skeletal Radiol. 2005;34(7):375-80.
12. Kulig K, Lederhaus ES, Reischl S, Arya S, Bashford G. Effect of eccentric exercise program for early tibialis posterior tendinopathy. Foot Ankle Int. 2009;30(9):877-85.
13. Bek N, Şimşek IE, Erel S, Yakut Y, Uygur F. Home-based general versus center-based selective rehabilitation in patients with posterior tibial tendon dysfunction. Acta Orthop Traumatol Turc. 2012;46(4):286-92.
14. Kulig K, Reischl SF, Pomrantz AB, Burnfield JM, Mais-Requejo S, Thordarson DB, et al. Nonsurgical management of posterior tibial tendon dysfunction with orthoses and resistive exercise: A randomized controlled trial. Phys Ther. 2009;89(1):26-37.
15. Alvarez RG, Marini A, Schmitt C, Saltzman CL. Stage I and II posterior tibial tendon dysfunction treated by a structured nonoperative management protocol: An orthosis and exercise program. Foot Ankle Int. 2006;27(1):2-8.
16. Houck J, Neville C, Tome J, Flemister A. Randomized Controlled Trial Comparing Orthosis Augmented by Either Stretching or Stretching and Strengthening for Stage II Tibialis Posterior Tendon Dysfunction. Foot Ankle Int. 2015;36(9):1006-16.
17. Chicoine D, Bouchard M, Laurendeau S, Moisan G, Belzile EL, Corbeil P. Biomechanical effects of three types of foot orthoses in individuals with posterior tibial tendon dysfunction. Gait Posture. 2021;83:237-44.
18. Koltak C, Yurt Y. Comparison of the effects of low level laser and insoles on pain, functioning, and muscle strength in subjects with stage 2 posterior tibial tendon dysfunction: A randomized study. J Back Musculoskelet Rehabil. 2021;34(6):1069-78.
19. Bek N, Öznur A, Kavlak Y, Uygur F. The effect of orthotic treatment of posterior tibial tendon insufficiency on pain and disability. Pain Clinic. 2003;15(3):345-50.
20. Chao W, Wapner KL, Lee TH, Adams J, Hecht PJ. Nonoperative management of posterior tibial tendon dysfunction. Foot Ankle Int. 1996;17(12):736-41.
21. Nielsen MD, Dodson EE, Shadrick DL, Catanzariti AR, Mendicino RW, Malay DS. Nonoperative Care for the Treatment of Adult-acquired Flatfoot Deformity. Journal of Foot and Ankle Surgery. 2011;50(3):311-4.
22. Neville C, Lemley FR. Effect of ankle-foot orthotic devices on foot kinematics in stage II posterior tibial tendon dysfunction. Foot Ankle Int. 2012;33(5):406-14.
23. Neville C, Flemister AS, Houck J. Effects of the airlift PTTD brace on foot kinematics in subjects with stage II posterior tibial tendon dysfunction. Journal of Orthopaedic and Sports Physical Therapy. 2009;39(3):201-9.
24. Bowring B, Chockalingam N. Conservative treatment of tibialis posterior tendon dysfunction--a review. Foot (Edinb). 2010;20(1):18-26.
25. Harradine P, Gates L, Metcalf C, Bowen C. Podiatrists’ views and experiences of using real time clinical gait analysis in the assessment and treatment of posterior tibial tendon dysfunction. J Foot Ankle Res. 2021;14(1):42.
26. Campbell RF, Morriss-Roberts C, Durrant B, Cahill S. “I need somebody who knows about feet” a qualitative study investigating the lived experiences of conservative treatment for patients with posterior tibial tendon dysfunction. J Foot Ankle Res. 2019;12:51.
27. Stevens TT, Hartline JT, Ojo O, Grear BJ, Richardson DR, Murphy GA, et al. Race and Insurance Status Association With Receiving Orthopedic Surgeon-Prescribed Foot Orthoses. Foot Ankle Int. 2021;42(7):894-901.
28. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77-101.
29. Heller GZ, Manuguerra M, Chow R. How to analyze the Visual Analogue Scale: Myths, truths and clinical relevance. Scand J Pain. 2016;13(1):67-75.
30. Bowring B, Chockalingam N. A clinical guideline for the conservative management of tibialis posterior tendon dysfunction. Foot. 2009;19(4):211-7.

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Instrucciones para citar

Banwell G, Lopezosa Reca E, Gatt A, Gijón Noguerón G, Ramos Petersen L. Qualitative pilot study on the orthotic management of tibialis posterior tendon dysfunction by podiatrists. Rev Esp Pod 2024; 35(1): 30-35 / DOI: 1020986/revesppod20241686/2024


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Recibido: 10/01/2024

Aceptado: 12/02/2024

Prepublicado: 30/05/2024

Publicado: 28/06/2024

Tiempo de revisión del artículo: 32 días

Tiempo de prepublicación: 141 días

Tiempo de edición del artículo: 170 días


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2024 Revista Española de Podología
ISSN: 0210-1238   e-ISSN: 2695-463X

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