title: Use and effectiveness of orthotics in hyperpronated dancers.
abstract: Hyperpronation is a common foot problem in dancers. The aim of this study was to investigate the usage and effectiveness of orthotics in the management of symptomatic hyperpronation among dancers. A prospective cohort study of all dancer-patients in the investigators' practice who were prescribed orthotics for new symptoms related to hyperpronation between July 2008 and January 2009 was conducted. In this group, the longitudinal medial arch angle of the foot was measured by the foot build registration system (FBRS), both barefoot and while wearing the orthotics. In addition, patients filled out questionnaires addressing perceived effectiveness of the orthotics for pain reduction and dance ability, among other items. A second retrospective study was conducted in order to obtain longitudinal data regarding dancers' compliance with, and subjective evaluation of, wearing orthotics over the preceding 6 years. Among participating dancers who met criteria for the prospective (N = 24) or retrospective (N = 81) aspects of the study (total N = 105), 67% wore orthotics at the time of follow-up. The average compliance in usage was 6.0 (± 1.5 ) days per week and 7.5 (± 3) hours per day. The average rate of satisfaction was 67.9 (± 26.5), average degree of relief in symptoms was 58.3 (± 28.3), and self-reported degree of improvement in dance ability was 45.7 (± 27.9) on a 100 mm Visual Analogue Scale (VAS). There was a significant decrease in pain from the day of orthotics prescription to follow-up (25.9%, or 18.9 mm decrease on the VAS, CI 6.6-30.9, p = 0.005) in the prospective group (N = 24). Orthotics were found to decrease the medial longitudinal arch angle significantly during static stance with the orthotic in place (CI 0.08-1.65, p = 0.03). It is concluded that the dancers in this study demonstrated a high rate of compliance in obtaining and wearing their orthotics and experienced a significant decrease in pain.
authors.affiliation: Maastricht University Medical Center, 6224 CE Maastricht, The Netherlands. r.nowacki@alumni.maastrichtuniversity.nl
authors.forename: Rélana M E
authors.initials: RM
authors.lastname: Nowacki
authors.forename: Mary E
authors.initials: ME
authors.lastname: Air
authors.forename: A B M
authors.initials: AB
authors.lastname: Rietveld
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003615:Dancing / Q000293:injuries*; D005260:Female; D061826:Foot Orthoses; D006801:Humans; D008297:Male; D060051:Occupational Injuries / Q000628:therapy*; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D017060:Patient Satisfaction; D011403:Pronation; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016474:Weight-Bearing; D055815:Young Adult