Influence of strengthening exercises on outcomes associated with Posterior Tibial Tendon Dysfunction

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I learned a tremendous amount about PTTD performing this study. Although strengthening exercises in general were not significantly more effective many benefits we did not measure seemed evident. 1) A subset of patients experienced significant recovery of foot function in the strengthening group. Identifying this subset may be beneficial for clinical practice and future research. 2) Patients became much more aggressive in managing their foot problem as a result of the "active" approach. Self efficacy may be another positive outcome we did not measure. And, 3) Another, reason for the lack of effect of strengthening may be that the control brace did NOT limit ankle dorsiflexion/plantarflexion. This may have maintained some strength in the control group without prescribing exercise. It is likely important that clinicians avoid bracing for the patients with PTTD that restricts ankle movement if function of the foot and ankle are to maintained long term.

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