Effectiveness of the custom-mold room temperature vulcanizing silicone toe separator on hallux valgus: A prospective, randomized single-blinded controlled trial.

BACKGROUND: Silicone toe separator is considered as a conservative treatment for hallux valgus. The prefabricated toe separator does not fit all. However, effectiveness in prescription of the custom-mold toe separator is still unknown. OBJECTIVES: To investigate the effect of using a custom-mold room temperature vulcanizing silicone toe separator to decrease hallux valgus angle and hallux pain. The compliances, complications, and satisfactions of toe separator were also explored. STUDY DESIGN: A prospective, randomized single-blinded controlled trial. METHODS: A total of 90 patients with a moderate degree of hallux valgus were enrolled in a study at the Foot Clinic, Siriraj Hospital, Thailand. Patients were randomized into two groups; the study group was prescribed a custom-mold room temperature vulcanizing silicone toe separator for 6 h per night for 12 months. Patients in both groups received proper foot care and shoes and were permitted to continue drug treatment. RESULTS: In total, 40 patients in the study group and 39 patients in the control group completed the study. The hallux valgus angle was obtained through radiographic measurement. At month 12, both groups had significant differences in mean hallux valgus angle with a decrease of 3.3° ± 2.4° for the study group and increase of 1.9° ± 1.9° for the control group. There were statistically significant differences of hallux valgus angle between the two groups ( p < 0.05) at the end of the study. Hallux pain was decreased in the study group. CONCLUSION: A custom-mold room temperature vulcanizing silicone toe separator can decrease hallux valgus angle and pain with no serious complications. Clinical relevance The custom-mold room temperature vulcanizing silicone toe separator for treatment of hallux valgus reduces deformity and hallux pain.

The use of custom-made shoes in patients with foot deformities in foot clinic, Siriraj Hospital.

OBJECTIVE: To study the frequency, result, and concomitant factors of the use of custom-made shoes in Foot Clinic, Siriraj Hospital. MATERIAL AND METHOD: Studying from patient records and interviewing the patients who had foot deformities without numbness and received custom-made shoes from the Foot Clinic, Siriraj Hospital between January 2009 and December 2011 about the latest custom-made shoes after the first three months of use. RESULTS: Sixty-seven participants were reviewed and included eight males (11.9%) and 59 females (88.1%) with an average age of 57.1 years. The majority had congenital foot deformity (19.4%). Most of them received sandal-type shoes (34.3%) and total contact orthosis (52.2%). The use of custom-made shoes that the participants had to use for more than 3 days/week and for more than or equal to 50% of daily walking and standing duration was 47.8%. Using these shoes reduced foot pain and increased walking stability (p-value = 0.007 and 0.023). Factors associated with the use of custom-made shoes were no previous callus (odds ratio = 25.30, 95% CI 2.20-290.56), decreasing callus after using the shoes (odds ratio = 23.54, 95% CI 1.65-335.23), decreasing foot pain after using the shoes (odds ratio = 5.01, 95% CI 1.20-20.95), and overall satisfaction (odd ratio = 21.47, 95% CI 3.81-121.04). CONCLUSION: The use of custom-made shoes from the Foot Clinic, Siriraj Hospital was 47.8%. Using the shoes could reduce foot pain and increase walking stability. Factors associated with the use of custom-made shoes were no previous callus, decreasing callus, decreasing foot pain, and overall satisfaction.

The efficacy of adjustable toe splint on decreasing metatarsalgia in patients with lesser toe deformity: a prospective, randomized single-blinded controlled trial.

OBJECTIVE: To study the effectiveness in application of adjustable toe splint in decreasing metatarsalgia in patients with lesser toe deformity and the complication of adjustable toe splint usage. MATERIAL AND METHOD: Thirty-six patients who had claw toes or hammer toes with metatarsalgia were enrolled in aprospective, randomized single-blinded controlled trial at the Out Patient Rehabilitation Medicine Clinic, Siriraj Hospital, Bangkok, Thailand between March and September 2011. Patients were randomized into two groups, the study group (using adjustable toe splint for 2 weeks) and the control group. Patients in both groups were advised as well to use proper shoes. RESULTS: All patients in each group completed the study. The baseline characteristics of the patients in both groups were similar The present study group reported more decrease pain at metatarsal heads and dorsum of toes than the control group (p < 0.05). Two patients reported complications from toe splint usage as toe abrasions. CONCLUSION: Using adjustable toe splint can decrease the metatarsalgia in patient with lesser toe deformity.

Exercise behavior and knowledge among the DM type II patients.

OBJECTIVE: To study the exercise behavior and knowledge about physical exercise among diabetic patients. The authors explored the correlation between the exercise behavior and knowledge of physical exercise. MATERIAL AND METHOD: DM type II patients aged more than 18 years, who attended the DM clinic, Siriraj Hospital, Bangkok between April and August 2007 were randomly interviewed by using questionnaires while they were waiting to see their doctors. RESULTS: One hundred and ninety six patients were interviewed. They were 62 males and 134 females with an average age of 60.5 years. Most of them exercised regularly at least three times a week (65.8%). Most of them exercised by walking (67%). They liked to exercise in their houses (48.7%), and in the morning (41.8%). Health care providers provided knowledge about exercise (58.2%). The benefit of exercise known the least was that it could increase endorphin release (61.2%). The aerobic exercise principle known the least was the proper frequency of exercise (50.5%). In addition, the exercise principle in DM known the least was that the DM patients should consult their doctors before starting to exercise (49%). CONCLUSION: Most of the DM patients exercised regularly, but some had insufficient knowledge. The researchers will take the results to provide the adequate knowledge to the DM patients in the future.

The effect of calf stretching box on stretching calf muscle compliance: a prospective, randomized single-blinded controlled trial.

PRIMARY OBJECTIVE: To study the effect of calf stretching box usage in increasing the compliance of performing calf stretching exercise as compared to the conventional exercise method. SECONDARY OBJECTIVE: To study the effect of calf stretching box usage in decreasing the calf muscle tightness and complications as compared to the conventional exercise method. MATERIAL AND METHOD: Eighty patients older than 45 years old with calf muscles tightness were enrolled in a prospective, randomized single-blinded controlled trial at the out-patient Rehabilitation medicine clinic, Siriraj Hospital, Bangkok Thailand between April and August 2009. Patients were randomized into two groups, the study group (stretching by using calf stretching box) and the control group (stretching by the conventional exercise method). Patients in both groups were asked to hold the stretch for at least 1 minute and to perform the stretching program at least two times per day, every day for two weeks. Furthermore, they were asked to record the real frequency and duration of their exercise and complications in a logbook every day. RESULTS: Thirty-eight patients in each group completed the study. The baseline characteristics of the patients in both groups were similar. The study group had higher frequency and longer duration of performing calf stretching exercise than the control group. They also reported more decrease of calf muscle tightness with less pain complication (shoulder pain, knee pain, low back pain, and calf muscle pain) than the control group (p < 0.05). However, there were no significant differences in the (between before and after) numbers of taut bands, trigger points, and tender points of calf muscle and degree of ankle range of motion between the two groups. CONCLUSION: Stretching calf muscle with calf stretching box can increase compliance, decrease calf muscle tightness and decrease complications when compared with the conventional exercise method.

Knowledge and practice of physical exercise among the inhabitants of Bangkok.

OBJECTIVE: To study the knowledge and practice of physical exercise among the inhabitants of Bangkok. The factors correlated with knowledge and the practice of physical exercise, were also explored. MATERIAL AND METHOD: A self-administered questionnaire was designed to survey 1200 inhabitants in Bangkok and the vicinity aged more than 18 years old. RESULTS: One thousand one hundred and seven people aged ranging from 18-81 years old completed the questionnaires (response rate 92.25%). Six hundred and forty people (58.4%) exercised regularly. The exercise was performed 1-2 days per week with varied duration. They performed exercises alone, in their homes, in the evening. They did not report any expenditure on the exercises. Common types of exercise reported were walking, jogging, attending an aerobic exercise class, using an exercise machine, and callisthenic exercise. Two hundred and seven people (18.9%) did not perform exercise at all because of the lack of time. The factors correlated with regular exercise were the increasing age, the high level of education, the amount of free time per day, and the enjoyment of exercise. With relation to knowledge of exercise, most people lacked knowledge of the benefits of exercise rather than how to do exercise and when to stop exercising. People who had a higher educational level than secondary school and a high income, practiced exercise everyday. They acquired their knowledge of exercise from attending an exercise course. CONCLUSION: People living in Bangkok usually performed regular exercises of 1-2 days per week with varied duration. The majority lacked knowledge of the benefits of exercise. Educational level of the samples was the only factor correlated with both regular exercise and knowledge of exercise.

Effectiveness of physical therapy for patients with adhesive capsulitis: a randomized controlled trial.

OBJECTIVE: To compare the effectiveness of a combined technique of physical and ibuprofen for the treatment of adhesive capsulitis with ibuprofen alone. MATERIAL AND METHOD: 122 subjects were randomly allocated to have 3 weeks treatment either with ibuprofen (n=61) or ibuprofen and a combined technique of physical therapy (n=61). Outcome measures were carried out 3 weeks and 12 weeks after randomization. Primary outcome measures were the success of treatment measured by improvement in the Shoulder Pain and Disability Index, and global rating. RESULTS: At 3 weeks, 21 (35.0%) of 60 patients in the study group were considered to have had successful treatment compared with 11 (18.6%) of 59 in the control group (difference between groups 16.4%, 95% CI: 4.0-31.3, p=0.044). There was no significant difference in the success rate between the two groups at the 12th week follow-up. CONCLUSION: The results of this study support the use of physical therapy for patients with adhesive capsulitis.

Effectiveness of an elastic knee sleeve for patients with knee osteoarthritis: a randomized single-blinded controlled trial.

OBJECTIVES: To study the effectiveness of elastic sleeves in patients with knee osteoarthritis (knee OA). METHOD: Patients with knee OA attending the outpatient clinic of Siriraj Hospital, who met the eligibility criteria, were randomly allocated to receive an 8-week treatment protocol. The control group received acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs) and education. The study group received the same treatment, in combination with a daytime elastic knee sleeve. Primary outcome variable included change in aggregated functional performance time (AFPT). RESULTS: In the immediate period after treatment, the study group had a mean improvement in AFPT of 1.63 seconds more than the control group (95% CI: 0.21-3.05, p = 0.025). At the end of the 8th week, the changes of AFPT were not statistically different between the two groups. CONCLUSION: This study shows small short-term beneficial effects of an elastic sleeve in patients with knee OA in cases with acute exacerbation.