Efetividade do uso de palmilhas em pacientes com neuroma de morton.

• Ano de defesa: 2019
• Autor(a) principal: Harada, Hilda Alcantara Veiga de Oliveira [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Neuroma De Morton; Doenças Do Pé; Aparelhos Ortopédicos; Marcha; Dor; Pressão
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=7014159; https://repositorio.unifesp.br/handle/11600/59965

Objective: The aim of the present study was to assess the effectiveness of a customized insole with metatarsal and arch support on pain in patients with Morton’s neuroma and the impact of this insole on function, load distribution in the plantar region, gait, quality of life and satisfaction with insole use. Methods: A randomized, controlled, double-blind, clinical trial was carried out with intent-to-treat analysis. Seventy-two patients with NM were randomly allocated into a study group (n=36) and control group (n=36). One week following the baseline evaluation, the study group received a customized insole with metatarsal and arch support made of ethyl vinyl acetate and the control group received a flat insole of the same material, color and density. The groups were evaluated after 6, 12 and 24 weeks of insole use. The following assessment parameters were employed: pain when walking, on palpation and at rest (END); paresthesia (ENP); quality of life (SF- 36); foot function (FFI and FHSQ); six-minute walk test (6MWT) and foot pressure analysis using the AM Cube FootWalk Pro program. Results: The groups were homogeneous regarding the majority of variables at baseline. In the comparisons over time, statistically significant differences between groups were found for pain when walking (p=0.048), in the general health domain (p <0.001) and physical activity (p = 0.025) in the FHSQ questionnaire, in the general FFI questionnaire score (p = 0.012) and in the functional capacity domain of the SF- 36 questionnaire (p = 0.046). For pain at rest and palpation, in the domains of the FFI, some parameters of the FHSQ (vigor, pain, function and general health of the foot) and quality of life (limitation by physical aspects, bodily pain and vitality), we observed improvement in both groups with no statistically significant difference between them. No change was observed in the baropodometry parameters with the use of the insole. Conclusions: A customized insole with metatarsal and arch support reduce pain when walking and improve function of patients with NM.