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Self‐reported social and activity restrictions accompany local impairments in posterior tibial tendon dysfunction: a systematic review

Overview of attention for article published in Journal of Foot and Ankle Research, August 2018
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Title
Self‐reported social and activity restrictions accompany local impairments in posterior tibial tendon dysfunction: a systematic review
Published in
Journal of Foot and Ankle Research, August 2018
DOI 10.1186/s13047-018-0292-z
Pubmed ID
Authors

Megan H. Ross, Michelle Smith, Melanie L. Plinsinga, Bill Vicenzino

Abstract

Posterior tibial tendon dysfunction (PTTD) is a painful, progressive tendinopathy that reportedly predominates in middle-age, overweight women. There is no evidence based guidelines that clinicians can use to guide treatment planning, which leaves clinicians to make decisions on the basis of presenting clinical impairments and self-reported pain and disability. The purpose of this systematic review was to quantify clinical impairments, pain and disability in individuals with PTTD compared with controls. Five databases were searched for terms referring to the posterior tibial tendon and flatfoot up to and including 11 March 2018. The systematic review was registered with PROSPERO (CRD: 42016046951). Studies were eligible if they were published in the English language and contained data on clinical impairments, pain or disability compared between participants diagnosed with PTTD and pain-free individuals. Standardised mean differences (SMDs) were calculated where possible and meta-analysis was performed when homogeneity of outcomes allowed. Ten eligible studies were identified and pooled in the meta-analyses. Strong effects were revealed for poor heel rise endurance (SMD -1.52, 95% CI -2.05 to - 0.99), less forefoot adduction-inversion strength (SMD -1.19, 95% CI -1.68 to - 0.71) and lower arch height (SMD -1.76, 95% CI -2.29 to - 1.23). Compared to controls, individuals with PTTD also had more self-reported stiffness (SMD 1.45, 95% CI 0.91 to 1.99), difficulties caused by foot problems (SMD 1.42, 95% CI 0.52 to 2.33) and social restrictions (SMD1.26, 95% CI 0.25 to 2.27). There is evidence of impaired tibialis posterior capacity and lowered arch height in individuals with PTTD compared to controls. Further to addressing the expected impairments in local tendon function and foot posture, pain, stiffness, functional limitations and social participation restrictions should be considered when managing PTTD.

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Geographical breakdown

Country Count As %
Unknown 113 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 13 12%
Other 10 9%
Student > Ph. D. Student 10 9%
Student > Bachelor 10 9%
Researcher 9 8%
Other 23 20%
Unknown 38 34%
Readers by discipline Count As %
Nursing and Health Professions 28 25%
Medicine and Dentistry 27 24%
Sports and Recreations 7 6%
Social Sciences 4 4%
Biochemistry, Genetics and Molecular Biology 2 2%
Other 4 4%
Unknown 41 36%