Comparison among Three Different Rehabilitation Programs on Outcomes of Patients with Posterior Tibial Tendon Dysfunction

Abdelmowla, Rasha Ali Ahmed; Abdelmowla, Hanan Ali Ahmed; Abd-Elmageed, Asmaa Sayed

doi:10.21608/tsnj.2022.243357

Comparison among Three Different Rehabilitation Programs on Outcomes of Patients with Posterior Tibial Tendon Dysfunction

Document Type : Original Article

Authors

¹ Assistant Professor of Medical-Surgical Nursing, Faculty of Nursing, Assiut University, Assiut, Egypt

² Lecturer of Medical-Surgical Nursing, Faculty of Nursing, Assiut University, Assiut, Egypt

10.21608/tsnj.2022.243357

Abstract

^{Background: Posterior tibial tendon dysfunction is a chronic, progressive, disabling condition of tendon that adversely affects ankle, foot and lower limb function.Aim: Was to compare among three different rehabilitation programs on outcomes of patients with posterior tibial tendon dysfunction. Subjects and methods: Research design: Quasi-experimental design was used with a comparative study using parallel-randomized groups (three intervention groups) with absence of control group. Subjects and setting: The study included 60 patients with stage I posterior tibial tendon dysfunction attended to orthopedic department and orthopedic outpatients clinic at Assiut University Hospitals. They randomly assigned into 3 equal groups (20 for each) by using a computer based selection program; group (A) muscle strengthening exercises and cold application, group (B) muscle strengthening exercises, medial arch support insoles and contrast bath, and group (C) muscle strengthening exercises, medial arch support insoles, ankle strengthening exercises and contrast bath. Tools: Patients assessment sheet, visual analog scale, revised foot function index, short musculoskeletal functional assessment questionnaire and exercises adherence logbook. Results: Pain level, revised foot function index scores, and short musculoskeletal functional assessment questionnaire scores significantly decreased in all groups after rehabilitation (p. value < 0.01). Group (C) demonstrated most improvement in each category followed by group (B) while group (A) demonstrated least improvement. Conclusion: Muscle strengthening exercises, medial arch support insoles, ankle strengthening exercises and contrast bath considered more effective rehabilitation program in reducing pain and improving perceptions of function than other rehabilitation programs. Recommendation: Rehabilitation should be considered within the first line of managing patients with stage I posterior tibial tendon dysfunction}