Effectiveness of Orthotic Devices in the Treatment of Achilles Tendinopathy: A Systematic Review
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SYSTEMATIC REVIEW
Effectiveness of Orthotic Devices in the Treatment of Achilles Tendinopathy: A Systematic Review Lisa A. Scott • Shannon E. Munteanu Hylton B. Menz
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Published online: 10 August 2014 Ó Springer International Publishing Switzerland 2014
Abstract Orthotic devices such as foot orthoses, splints, taping and bracing are recommended for Achilles tendinopathy (AT). This systematic review was conducted to review the current evidence for the effectiveness of orthotic devices for the treatment of mid-portion or insertional AT. Electronic bibliographic databases (MEDLINE, EMBASE, Current Contents, CINAHL and SPORTDiscus) were searched in May 2014. The methodological quality of included studies was evaluated using the Quality Index. Where possible, effects were determined using standardised mean differences. The strength of evidence for each intervention was determined according to the quality and number of studies. Twelve studies satisfied the inclusion criteria; nine studies investigated mid-portion AT, whilst three studies did not distinguish between mid-portion and insertional pathology. Weak evidence showed that foot orthoses were equivalent to physical therapy, and equivalent to no treatment. Very weak evidence supported the use of adhesive taping alone or when combined with foot orthoses. Moderate evidence showed that the AirHeelTM Electronic supplementary material The online version of this article (doi:10.1007/s40279-014-0237-z) contains supplementary material, which is available to authorized users. L. A. Scott S. E. Munteanu (&) H. B. Menz Department of Podiatry, Faculty of Health Sciences, La Trobe University, Bundoora, VIC 3086, Australia e-mail: [email protected]
brace was as effective as a calf muscle eccentric exercise programme, and weak evidence showed that this intervention was not beneficial when added to a calf muscle eccentric exercise programme. Weak evidence showed that an ankle joint dorsiflexion night splint was equally effective to a calf muscle eccentric exercise programme, and strong evidence showed that this intervention was not beneficial when added to a calf muscle eccentric exercise programme. These findings may aid clinical decision making in the context of AT, however further high-quality studies are required.
Key Points This systematic review identified 12 studies, generally of poor or moderate methodological quality, that investigated the effectiveness of orthotic devices for Achilles tendinopathy (AT) Some orthotic devices may produce equivalent positive effects to a calf muscle eccentric exercise programme, but they are not beneficial when added to a calf muscle eccentric exercise programme Further high-quality studies investigating the effectiveness of orthotic devices for mid-portion and insertional AT are required
L. A. Scott e-mail: [email protected] H. B. Menz e-mail: [email protected] L. A. Scott S. E. Munteanu H. B. Menz Lower Extremity and Gait Studies Program, Faculty of Health Sciences, La Trobe University, Bundoora, VIC 3086, A
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