Characteristics and Future Direction of Tibialis Posterior Tendinopathy Research: A Scoping Review
<i>Background and Objectives</i>: Tibialis posterior tendon pathologies have been traditionally categorized into different stages of posterior tibial tendon dysfunction (PTTD), or adult acquired flatfoot deformity (AAFD), and more recently to progressive collapsing foot deformity (PCFD)....
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| Format: | Article |
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MDPI AG
2022-12-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/58/12/1858 |
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| author | Hye Chang Rhim Ravi Dhawan Ashley E. Gureck Daniel E. Lieberman David C. Nolan Ramy Elshafey Adam S. Tenforde |
| author_facet | Hye Chang Rhim Ravi Dhawan Ashley E. Gureck Daniel E. Lieberman David C. Nolan Ramy Elshafey Adam S. Tenforde |
| author_sort | Hye Chang Rhim |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Tibialis posterior tendon pathologies have been traditionally categorized into different stages of posterior tibial tendon dysfunction (PTTD), or adult acquired flatfoot deformity (AAFD), and more recently to progressive collapsing foot deformity (PCFD). The purpose of this scoping review is to synthesize and characterize literature on early stages of PTTD (previously known as Stage I and II), which we will describe as tibialis posterior tendinopathy (TPT). We aim to identify what is known about TPT, identify gaps in knowledge on the topics of TPT, and propose future research direction. <i>Materials and Methods</i>: We included 44 studies and categorized them into epidemiology, diagnosis, evaluation, biomechanics outcome measure, imaging, and nonsurgical treatment. <i>Results</i>: A majority of studies (86.4%, 38 of 44 studies) recruited patients with mean or median ages greater than 40. For studies that reported body mass index (BMI) of the patients, 81.5% had mean or median BMI meeting criteria for being overweight. All but two papers described study populations as predominantly or entirely female gender. Biomechanical studies characterized findings associated with TPT to include increased forefoot abduction and rearfoot eversion during gait cycle, weak hip and ankle performance, and poor balance. Research on non-surgical treatment focused on orthotics with evidence mostly limited to observational studies. The optimal exercise regimen for the management of TPT remains unclear due to the limited number of high-quality studies. <i>Conclusions</i>: More epidemiological studies from diverse patient populations are necessary to better understand prevalence, incidence, and risk factors for TPT. The lack of high-quality studies investigating nonsurgical treatment options is concerning because, regardless of coexisting foot deformity, the initial treatment for TPT is typically conservative. Additional studies comparing various exercise programs may help identify optimal exercise therapy, and investigation into further nonsurgical treatments is needed to optimize the management for TPT. |
| first_indexed | 2024-03-09T16:07:19Z |
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| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T16:07:19Z |
| publishDate | 2022-12-01 |
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| series | Medicina |
| spelling | doaj.art-3423ca440bab4c3a9e5f7850c61943462023-11-24T16:33:57ZengMDPI AGMedicina1010-660X1648-91442022-12-015812185810.3390/medicina58121858Characteristics and Future Direction of Tibialis Posterior Tendinopathy Research: A Scoping ReviewHye Chang Rhim0Ravi Dhawan1Ashley E. Gureck2Daniel E. Lieberman3David C. Nolan4Ramy Elshafey5Adam S. Tenforde6Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115, USADepartment of Epidemiology and Biostatistics, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USADepartment of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115, USADepartment of Human Evolutionary Biology, Harvard University, Cambridge, MA 02138, USADepartment of Physical Therapy, Movement, and Rehabilitation Science, Northeastern University, Boston, MA 02115, USADepartment of Orthopedics & Rehabilitation, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USADepartment of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115, USA<i>Background and Objectives</i>: Tibialis posterior tendon pathologies have been traditionally categorized into different stages of posterior tibial tendon dysfunction (PTTD), or adult acquired flatfoot deformity (AAFD), and more recently to progressive collapsing foot deformity (PCFD). The purpose of this scoping review is to synthesize and characterize literature on early stages of PTTD (previously known as Stage I and II), which we will describe as tibialis posterior tendinopathy (TPT). We aim to identify what is known about TPT, identify gaps in knowledge on the topics of TPT, and propose future research direction. <i>Materials and Methods</i>: We included 44 studies and categorized them into epidemiology, diagnosis, evaluation, biomechanics outcome measure, imaging, and nonsurgical treatment. <i>Results</i>: A majority of studies (86.4%, 38 of 44 studies) recruited patients with mean or median ages greater than 40. For studies that reported body mass index (BMI) of the patients, 81.5% had mean or median BMI meeting criteria for being overweight. All but two papers described study populations as predominantly or entirely female gender. Biomechanical studies characterized findings associated with TPT to include increased forefoot abduction and rearfoot eversion during gait cycle, weak hip and ankle performance, and poor balance. Research on non-surgical treatment focused on orthotics with evidence mostly limited to observational studies. The optimal exercise regimen for the management of TPT remains unclear due to the limited number of high-quality studies. <i>Conclusions</i>: More epidemiological studies from diverse patient populations are necessary to better understand prevalence, incidence, and risk factors for TPT. The lack of high-quality studies investigating nonsurgical treatment options is concerning because, regardless of coexisting foot deformity, the initial treatment for TPT is typically conservative. Additional studies comparing various exercise programs may help identify optimal exercise therapy, and investigation into further nonsurgical treatments is needed to optimize the management for TPT.https://www.mdpi.com/1648-9144/58/12/1858tibialis posterior tendinopathyposterior tibial tendon dysfunctionacquired flatfoot deformityprogressive collapsing foot deformity |
| spellingShingle | Hye Chang Rhim Ravi Dhawan Ashley E. Gureck Daniel E. Lieberman David C. Nolan Ramy Elshafey Adam S. Tenforde Characteristics and Future Direction of Tibialis Posterior Tendinopathy Research: A Scoping Review Medicina tibialis posterior tendinopathy posterior tibial tendon dysfunction acquired flatfoot deformity progressive collapsing foot deformity |
| title | Characteristics and Future Direction of Tibialis Posterior Tendinopathy Research: A Scoping Review |
| title_full | Characteristics and Future Direction of Tibialis Posterior Tendinopathy Research: A Scoping Review |
| title_fullStr | Characteristics and Future Direction of Tibialis Posterior Tendinopathy Research: A Scoping Review |
| title_full_unstemmed | Characteristics and Future Direction of Tibialis Posterior Tendinopathy Research: A Scoping Review |
| title_short | Characteristics and Future Direction of Tibialis Posterior Tendinopathy Research: A Scoping Review |
| title_sort | characteristics and future direction of tibialis posterior tendinopathy research a scoping review |
| topic | tibialis posterior tendinopathy posterior tibial tendon dysfunction acquired flatfoot deformity progressive collapsing foot deformity |
| url | https://www.mdpi.com/1648-9144/58/12/1858 |
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