#Mtp foot series
Furthermore, a case series has shown they may have beneficial effects on pain in a small group of people with mechanically induced first MTP joint pain, suggesting these biomechanical devices may improve clinical symptoms associated with first MTP joint OA. Foot orthoses with a cut-out under the first MTP joint have been shown to reduce hallux plantar pressures in people with first MTP joint OA and improve the first metatarsal angle and MTP joint range of motion in people with limited first MTP joint movement. People with first MTP joint OA walk with altered foot biomechanics, displaying reduced joint range of motion and greater maximum force and peak plantar pressures under the hallux, which may contribute to symptom severity. Accordingly, foot OA has been highlighted as an under-researched problem and identified as a research priority by OA experts and all leading international OA clinical bodies. Non-drug, non-surgical strategies are recommended as first line treatments in international OA clinical guidelines, however there have only ever been two randomised controlled trials (RCTs) of these treatments for first MTP joint OA, and one randomized clinical feasibility study. The condition causes dorsal osteophytes and joint space narrowing which impair range of motion, and in turn, lead to substantial problems performing functional weight bearing activities and impaired quality of life. First MTP joint OA is highly debilitating with most (72%) of those affected reporting the symptoms as disabling. Osteoarthritis (OA) of the foot affects 16.7% of people aged 50 years and older, making it as prevalent as knee OA, and the most commonly affected foot site is the first metatarsophalangeal (MTP) joint. Prospectively registered with the Australian New Zealand Clinical Trials Registry (reference: ACTRN12619000926134) on. Outcomes will help to inform clinical guidelines and practice about the use of foot orthoses for managing symptoms in this under-researched group of people with OA. This study will provide novel evidence about whether contoured foot orthoses improve pain and other symptoms compared to sham insoles in people with first MTP joint OA. Secondary outcomes include additional measures of first MTP joint and foot pain, physical function, quality of life, participant-perceived global ratings of change (pain and function), and level of physical activity. The primary outcome is self-reported first MTP joint pain on walking (numerical rating scale), assessed at baseline and 12 weeks. Participants have two visits with a study podiatrist where they are provided with their allocated insoles, to be worn daily for 12 weeks at all times when wearing shoes. Following baseline assessment, participants are randomized to receive either: i) contoured foot orthoses or ii) sham flat insoles following baseline assessment. We are recruiting 88 community-dwelling people with symptomatic radiographic first MTP joint OA.
#Mtp foot trial
The FORT trial (Foot ORthoses for big Toe joint osteoarthritis) is a two-arm participant- and assessor-blinded, multi-site RCT conducted in Melbourne, Sydney, Brisbane and the Gold Coast, Australia. This clinical trial aimed to determine whether contoured foot orthoses lead to greater reductions in first MTP joint pain on walking compared to sham flat insoles in people with first MTP joint OA. Foot orthoses are a common non-drug, non-surgical strategy used by allied health professionals for people with first MTP joint OA, however, it is unknown whether these devices are effective in improving the symptoms associated with the condition. Non-drug, non-surgical treatments are recommended by OA clinical guidelines, yet there have only ever been two randomised controlled trials (RCTs) evaluating such strategies in people with first MTP joint OA. First metatarsophalangeal (MTP) joint osteoarthritis (OA) is a painful and debilitating condition affecting nearly one in 10 people aged over 50 years.
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