title: Nonsurgical management of posterior tibial tendon dysfunction with orthoses and resistive exercise: a randomized controlled trial.
abstract: OBJECTIVE
  Tibialis posterior tendinopathy can lead to debilitating dysfunction. This study examined the effectiveness of orthoses and resistance exercise in the early management of tibialis posterior tendinopathy.
  
  
  METHODS
  Thirty-six adults with stage I or II tibialis posterior tendinopathy participated in this study.
  
  
  METHODS
  Participants were randomly assigned to 1 of 3 groups to complete a 12-week program of: (1) orthoses wear and stretching (O group); (2) orthoses wear, stretching, and concentric progressive resistive exercise (OC group); or (3) orthoses wear, stretching, and eccentric progressive resistive exercise (OE group). Pre-intervention and post-intervention data (Foot Functional Index, distance traveled in the 5-Minute Walk Test, and pain immediately after the 5-Minute Walk Test) were collected.
  
  
  RESULTS
  Foot Functional Index scores (total, pain, and disability) decreased in all groups after the intervention. The OE group demonstrated the most improvement in each subcategory, and the O group demonstrated the least improvement. Pain immediately after the 5-Minute Walk Test was significantly reduced across all groups after the intervention.
  
  
  CONCLUSIONS
  People with early stages of tibialis posterior tendinopathy benefited from a program of orthoses wear and stretching. Eccentric and concentric progressive resistive exercises further reduced pain and improved perceptions of function.
authors.affiliation: Division of Biokinesiology and Physical Therapy, University of Southern California, 1540 E Alcazar St, CHP-155, Los Angeles, CA 90033, USA. kulig@usc.edu
authors.forename: Kornelia
authors.initials: K
authors.lastname: Kulig
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Reischl
authors.forename: Amy B
authors.initials: AB
authors.lastname: Pomrantz
authors.forename: Judith M
authors.initials: JM
authors.lastname: Burnfield
authors.forename: Susan
authors.initials: S
authors.lastname: Mais-Requejo
authors.forename: David B
authors.initials: DB
authors.lastname: Thordarson
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D052580:Muscle Stretching Exercises; D009989:Orthotic Devices; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement; D037081:Posterior Tibial Tendon Dysfunction / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D020127:Recovery of Function; D055070:Resistance Training; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology