Free Paper Australian Podiatry Conference 2019

A cross-sectional study comparing clinical and psychosocial features in tibialis posterior tendinopathy with controls: preliminary findings (#9)

Megan H Ross 1 , Michelle D Smith 1 , Bill Vicenzino 1
  1. The University of Queensland, St Lucia, QLD, Australia

 Background

Tibialis posterior tendinopathy is associated with pain during activities that load the tibialis posterior tendon and limited participation in daily and physical activities. Little is known about factors such as quality of life and psychosocial features in tibialis posterior tendinopathy. The aim of this preliminary study was to investigate clinical and psychosocial characteristics of individuals with tibialis posterior tendinopathy.

Methods

We compared individuals with tibialis posterior tendinopathy (currently n = 19, age: 42±14; BMI: 27±8) and asymptomatic controls (n = 26, age: 43±17, BMI: 23±5). Diagnosis was made clinically based on medial foot/ankle pain plus one or more of: tenderness on palpation or swelling of the tibialis posterior tendon or pain/difficulty with resisted plantarflexion inversion or single leg heel raise. Clinical measures of foot posture, function, range of motion, strength at the foot and hip, and self-reported psychosocial measures were assessed. Preliminary between group differences were explored using independent t-tests. Standardised mean differences (SMDs) were calculated to evaluate effect sizes. Interpretation of SMDs was as follows: <0.6 small, 0.61-1.2 moderate, >1.2 large.

Results

Preliminary analyses suggest large effects (SMD > 1.2) for more pain, poorer self-reported function and quality of life, in addition to more pronated foot posture, poorer single leg heel raise endurance and greater time to complete stair descent/ascent in tibialis posterior tendinopathy compared to controls (p<0.01). Data collection is still ongoing and results will be updated at the conference.

Discussion and Clinical Relevance

Altered foot posture and poorer physical function appear to be accompanied by pain, stiffness, social limitations, and lower quality of life in tibialis posterior tendinopathy. A biopsychosocial approach should be considered for assessment and management of tibialis posterior tendinopathy.