title: Effectiveness of customised foot orthoses for Achilles tendinopathy: a randomised controlled trial.
abstract: OBJECTIVE
  To evaluate the effectiveness of customised foot orthoses in chronic mid-portion Achilles tendinopathy.
  
  
  METHODS
  This was a participant-blinded, parallel-group randomised controlled trial at a single centre (La Trobe University, Melbourne, Australia). One hundred and forty participants aged 18-55 years with mid-portion Achilles tendinopathy were randomised to receive eccentric calf muscle exercises with either customised foot orthoses (intervention group) or sham foot orthoses (control group). Allocation to intervention was concealed. The Victorian Institute of Sports Assessment-Achilles (VISA-A) questionnaire was completed at baseline, then at 1, 3, 6 and 12 months, with 3 months being the primary end point. Differences between groups were analysed using intention to treat with analysis of covariance.
  
  
  RESULTS
  After randomisation into the customised foot orthoses group (n=67) or sham foot orthoses group (n=73), there was 70.7% follow-up of participants at 3 months. There were no significant differences between groups at any time point. At 3 months, the mean (SD) VISA-A score was 82.1 (16.3) and 79.2 (20.0) points for the customised and sham foot orthosis groups, respectively (adjusted mean difference (95% CI)=2.6 (-2.9 to 8.0), p=0.353). There were no clinically meaningful differences between groups in any of the secondary outcome measures.
  
  
  CONCLUSIONS
  Customised foot orthoses, prescribed according to the protocol in this study, are no more effective than sham foot orthoses for reducing symptoms and improving function in people with mid-portion Achilles tendinopathy undergoing an eccentric calf muscle exercise programme.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry: number ACTRN12609000829213.
authors.affiliation: Faculty of Health Sciences, Department of Podiatry, La Trobe University, Melbourne, Victoria, Australia Lower Extremity & Gait Studies Program, La Trobe University, Melbourne, Victoria, Australia.
authors.forename: Shannon E
authors.initials: SE
authors.lastname: Munteanu
authors.affiliation: Faculty of Health Sciences, Department of Podiatry, La Trobe University, Melbourne, Victoria, Australia Lower Extremity & Gait Studies Program, La Trobe University, Melbourne, Victoria, Australia.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Scott
authors.affiliation: Faculty of Health Sciences, Department of Podiatry, La Trobe University, Melbourne, Victoria, Australia Lower Extremity & Gait Studies Program, La Trobe University, Melbourne, Victoria, Australia.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Bonanno
authors.affiliation: Faculty of Health Sciences, Department of Podiatry, La Trobe University, Melbourne, Victoria, Australia Lower Extremity & Gait Studies Program, La Trobe University, Melbourne, Victoria, Australia.
authors.forename: Karl B
authors.initials: KB
authors.lastname: Landorf
authors.affiliation: Lower Extremity & Gait Studies Program, La Trobe University, Melbourne, Victoria, Australia Faculty of Health Sciences, Department of Physiotherapy, La Trobe University, Melbourne, Victoria, Australia.
authors.forename: Tania
authors.initials: T
authors.lastname: Pizzari
authors.affiliation: Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Victoria, Australia.
authors.forename: Jill L
authors.initials: JL
authors.lastname: Cook
authors.affiliation: Faculty of Health Sciences, Department of Podiatry, La Trobe University, Melbourne, Victoria, Australia Lower Extremity & Gait Studies Program, La Trobe University, Melbourne, Victoria, Australia.
authors.forename: Hylton B
authors.initials: HB
authors.lastname: Menz
mesh_terms: D000125:Achilles Tendon; D000293:Adolescent; D000328:Adult; D004867:Equipment Design; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D061826:Foot Orthoses; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D052256:Tendinopathy / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Achilles; Eccentric; Physiotherapy; Podiatry; Soft tissue