Banca de DEFESA: ANA RAFAELLA ARAÚJO COSTA

Assessment of the effect of adapted insoles  in flip flop sandals on pain related to plantar fasciopathy: 

a study with potiguar semiarid residents.

insoles, flip flop sandals, hell pain, community, warm weather.

Introduction: Plantar fasciopathy (PF) is a painful condition of the feet, being one of the main causes of hindfoot pain that leads to work abstention and reflects the great demand for treatment in orthopedic offices. Conservative treatments account for 90% of hindfoot pain resolutions and are associated with therapies including joint mobilization, stretching, insoles, shockwave therapy, and laser therapy. However, the use of insoles is restricted to use in closed shoes such as shoes and sneakers, and this can be an obstacle to treatment in cities with hot weather. Objectives: To evaluate the effectiveness of slippers adapted to pain and function in individuals with persistent PF. Method: A double-blind, controlled, randomized clinical study of 66 male and female patients with persistent hindfoot pain, randomized into two groups: customized group (CG) (n = 34) received a custom-made slipper with foot pieces and plain beige faux leather cover. The placebo group (PL) (n = 34) received a strip slipper covered with smooth beige synthetic leather, identical to the one used by the intervention group, but without the foot pieces. Patients were instructed to wear the slipper at least 4 hours a day for 12 weeks. Two evaluations were performed: one before the intervention protocol (T0) and the second after the 12 weeks of intervention (T12). The primary outcome measure was pain that was assessed using the Visual Analog Scale (VAS). Secondary outcomes were: foot function by the Foot Function Index (FFI) questionnaire; foot and ankle functionality by the Foot and Ankle Ability Measure (FAAM) questionnaire; functional capacity by 6-minute walk test (6MWT); patient expectation and satisfaction with treatment by the likert scale; the blinding questionnaire to ensure participants were blinded and the use diary to note the hours they wore the slipper daily. Results: The CG group significantly improved morning pain through the morning VAS variable (mean difference-1.82; 95% CI -3.3 to -0.3; p = 0.016); no differences between groups for end-of-day VAS, 6MWT and FAAM. Significant improvement in foot function (FFI) was also observed in the CG group compared to the PL group, where the CG group showed significant results (mean difference -0.10; 95% -0.19 to -0.01; p = 0.023). Conclusion: The use of flip-flop insoles for 12 weeks was effective in improving pain and foot function in individuals with persistent PF.