title: Randomized Controlled Trial Comparing Orthosis Augmented by Either Stretching or Stretching and Strengthening for Stage II Tibialis Posterior Tendon Dysfunction.
abstract: BACKGROUND
  The value of strengthening and stretching exercises combined with orthosis treatment in a home-based program has not been evaluated. The purpose of this study was to compare the effects of augmenting orthosis treatment with either stretching or a combination of stretching and strengthening in participants with stage II tibialis posterior tendon dysfunction (TPTD).
  
  
  METHODS
  Participants included 39 patients with stage II TPTD who were recruited from a medical center and then randomly assigned to a strengthening or stretching treatment group. Excluding 3 dropouts, there were 19 participants in the strengthening group and 17 in the stretching group. The stretching treatment consisted of a prefabricated orthosis used in conjunction with stretching exercises. The strengthening treatment consisted of a prefabricated orthosis used in conjunction with the stretching and strengthening exercises. The main outcome measures were self-report (ie, Foot Function Index and Short Musculoskeletal Function Assessment) and isometric deep posterior compartment strength. Two-way analysis of variance was used to test for differences between groups at 6 and 12 weeks after starting the exercise programs.
  
  
  RESULTS
  Both groups significantly improved in pain and function over the 12-week trial period. The self-report measures showed minimal differences between the treatment groups. There were no differences in isometric deep posterior compartment strength.
  
  
  CONCLUSIONS
  A moderate-intensity, home-based exercise program was minimally effective in augmenting orthosis wear alone in participants with stage II TPTD.
  
  
  METHODS
  Level I, prospective randomized study.
authors: George Fox University, Department of Physical Therapy, Newberg, OR, USA jhouck@georgefox.edu.
authors: Jeff
authors: J
authors: Houck
authors: SUNY Upstate Medical University, Syracuse, NY, USA.
authors: Christopher
authors: C
authors: Neville
authors: Ithaca College-Movement Analysis Laboratory, Ithaca, NY, USA.
authors: Josh
authors: J
authors: Tome
authors: University of Rochester Medical Center, Department of Orthopedic Surgery, Rochester, NY, USA.
authors: Adolph
authors: A
authors: Flemister
mesh_terms: D004185:Disability Evaluation; D005081:Exercise Therapy; D005260:Female; D061826:Foot Orthoses; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D052580:Muscle Stretching Exercises; D037081:Posterior Tibial Tendon Dysfunction / Q000628:therapy*; D057566:Self Report
keywords: foot; rehabilitation; tendinopathy