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Effects of insoles adapted in flip-flop sandals in patients with persistent plantar heel pain: a sham-controlled randomised trial [with consumer summary]
Fagundes MG, Mendes AAMT, Bezerra VF, de Freitas WRMS, Scattone Silva R, Pontes-Silva A, de Medeiros Barbosa G, Cardoso de Souza M
Clinical Rehabilitation 2024 Nov;38(11):1466-1480
clinical trial
9/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: Yes; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To evaluate the use of custom-made insoles adapted to flip-flops on pain intensity, foot function, and functional walking ability in individuals with persistent plantar heel pain in the short and medium term. DESIGN: Randomised controlled trial. SETTING: Flip-flop sandals in patients with persistent plantar heel pain. MAIN MEASURES: Participants (n = 80) were assessed at baseline, six and 12 weeks after the intervention, and 4 weeks post-intervention. RESULTS: For the primary outcomes, after 6 weeks of intervention, no between-group difference was observed in the intensity of morning pain or pain with walking, mean difference -0.4 (95% confidence intervals -1.5 to 0.8). Similarly, after 12 weeks of intervention, no between-group difference was observed in the intensity of morning pain or pain with walking, mean difference -0.7 (95% confidence intervals -1.9 to 0.6). Finally, at 4 weeks after the end of the intervention, there was no between-group difference in morning pain or pain on walking, mean difference = 0.01 (95% confidence intervals -1.4 to 1.4). All differences and confidence intervals were smaller than the minimum clinically important difference for pain (2 points). There were no differences between the groups for the secondary outcomes. In addition, the mean differences were smaller than the minimum clinically important differences for pain intensity, foot function and functional walking ability. CONCLUSION: Custom-made insoles fitted to flip-flops did not differ from flip-flops with sham insoles in improving pain intensity, foot function and functional walking ability in people with persistent heel pain. TRIAL REGISTRATION: ClinicalTrials.gov (Identifier: NCT04784598).

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