An investigation on the effect of custom-made orthoses in combination with physiotherapy management in the treatment of non-specific mechanical low back pain

Abstract

Aim The aim of this study was to investigate whether there would be significant effect on pain, disability, as well as on kinematic and spatiotemporal data during gait at heel strike, midstance, and toe-off when prescribing custom-made foot orthoses in combination with 6-week physiotherapy intervention in individuals diagnosed with Non-Specific Mechanical Low Back Pain. Research Design and Method This research project was a Quantitative, Postpositivist, and Quasi-experimental study which investigated the effects of custom-made foot orthoses in combination with physiotherapy management in the treatment of Non-Specific Mechanical low back pain. 20 participants were recruited and divided into two equal groups; quantitative data was collected from Comparison Group A, who underwent 6-weeks physiotherapeutic intervention, and Experimental Group B, who were provided with custom-made foot orthoses in addition to the physiotherapeutic intervention. Data collected at baseline and following a six-week intervention period included the Oswestry Disability Index Questionnaire score, the Visual Analog scale score, lower limb, pelvic kinematics, and spatiotemporal data obtained from Gait Analysis testing using Vicon Optoelectronic Motion Capture System. Statistical analyses were consequently carried out to evaluate the effects of combining custom-made foot orthoses with six-weeks physiotherapy intervention in the treatment of Non-Specific Mechanical low back pain. Results In both Group A and Group B, there was a statistically significant improvement in pain and disability (p=<0.05), but the improvement was not statistically significantly different between the two groups. Significant Kinematic changes were noted in both groups, with changes in the pelvis noted only in Group B, and Spatiotemporal data were noted. An increase in Walking Speed was noted in Group A and a decrease in Cadence, a decrease in single support and stride time in Group B. It was also noted that Group B became closer to Normative Data post-intervention. Conclusion The findings in the present study indicate that both 6-week physiotherapy intervention only and 6-week physiotherapy intervention combined with custom-made foot orthoses are effective in reducing pain and disability in the management of Non-Specific Mechanical Low Back Pain. However, the orthoses group exhibited a trend towards more normalization of the gait pattern, which, in the long term, could translate into an added benefit for the patient. However, this will need to be investigated further. Both types of interventions should be considered in the management of Low Back Pain patients who also present with altered foot biomechanics