The use of total contact orthoses in patients with foot problems in foot clinic, Siriraj hospital

Abstract

To study the use rate, result and concomitant factors of the use of total contact orthoses in Foot Clinic, Siriraj Hospital which has not been studied before. Studying from patient records and interviews with patients who had foot problems without impairment of foot sensation and received TCO from Foot Clinic between July, 2015 and April, 2016. First interview, patients were asked information before use and latter about the latest TCO after use in first 1 month. One hundred and fifteen participants were recruited but eight lost to follow up. The majority had chronic plantar fasciitis (26.2%), posterior tibial tendon dysfunction (25.2%), hallux valgus (21.5%) and metatarsalgia (21.5%). The use of TCO defined as the participants had to use for more than 3 days/week and for more or equal to 50% of daily walking and standing duration was 67.3%. Using TCO can provide walking stability ( P -value = 0.008). For patients with metatarsalgia, using TCO can significantly reduce pain ( P -value = 0.002). Many factors found associated with the use of TCO including receiving TCO for more than first pair (Odds ratio = 4.09, 95% CI 1.51–11.05), ability to find proper shoes that fit with TCO (Odds ratio = 0.36, 95% CI 0.15–0.89), level of convenience of putting on/taking off shoes with TCO ≥ 9 (Odds ratio = 2.66, 95% CI 1.16–6.12), level of comfort satisfaction during TCO use ≥ 9 (Odds ratio = 3.61, 95% CI 1.55–8.40). The latter two factors are found to be associated with the use of TCO from stepwise logistic regression analysis (adjusted Odds ratio = 3.39, 95% CI 1.18–9.71, 3.02, 95% CI 1.07–8.47 respectively). The use of TCO in Foot Clinic was 67.3%. Using TCO could result in walking stability. Patients who received more than first pair of TCO and had comfort satisfaction level ≥ 9, were more likely to use TCO.