Journal of the American Podiatric Medical Association
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J Am Podiatr Med Assoc · Jul 2015
Randomized Controlled Trial Multicenter StudyA randomized controlled trial of custom foot orthoses for the treatment of plantar heel pain.
Up to 10% of people will experience heel pain. The purpose of this prospective, double-blind, randomized clinical trial was to compare custom foot orthoses (CFO), prefabricated foot orthoses (PFO), and sham insole treatment for plantar fasciitis. ⋯ The CFO group demonstrated 5.6-fold greater improvements in spontaneous physical activity versus the PFO and sham groups. All three groups improved in morning pain after treatment that included standardized athletic shoes, stretching, and ice. The CFO changes may have been moderated by decreased stretching and ice use after 3 months. These findings suggest that more objective measures, such as spontaneous physical activity improvement, may be more sensitive and specific for detecting improved weightbearing function than traditional clinical outcome measures, such as pain and disease-specific quality of life.
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J Am Podiatr Med Assoc · Sep 2006
Randomized Controlled Trial Multicenter StudyAnalgesic efficacy of valdecoxib for acute postoperative pain after bunionectomy.
Two randomized, double-blind, placebo-controlled studies assessed the analgesic efficacy of valdecoxib in patients with moderate-to-severe pain after bunionectomy. Study 1 (N = 374) assessed the efficacy of two regimens of valdecoxib on the day after surgery (valdecoxib, 40 mg, with a 20-mg redose [n = 127]; valdecoxib, 40 mg, with a placebo redose [n = 122]; and placebo/placebo [n = 125]), and study 2 (N = 478) examined the efficacy of two different multiple-dose regimens on postoperative days 2 through 5 (valdecoxib, 20 mg, twice daily [n = 160]; valdecoxib, 20 mg, once daily [n = 159]; and placebo [n = 159]). Valdecoxib provided significant pain relief and reduced the use of opioid rescue medication. This efficacy was accompanied by improved global scores, decreased pain interference with function, and increased patient satisfaction.
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J Am Podiatr Med Assoc · Mar 2006
Multicenter StudyThe physician's attire and its influence on patient confidence.
Although physician appearance has been a topic of discussion in the medical literature for many years, no objective research has been performed on this topic in the field of podiatric medicine. Our primary objective was to examine patient confidence in physicians as it relates to professional clinic attire versus casual or scrub outfits. We also assessed the influence of other variables, such as white coat, name tag, age, and sex, on patient confidence. ⋯ The results indicate that 68% of patients surveyed felt that professional attire inspired the most confidence. Ninety-six percent of all patients either preferred white coats or were indifferent to their presence. We conclude that professionally dressed podiatric physicians may inspire more confidence in a significant percentage of their patients.
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J Am Podiatr Med Assoc · May 2004
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialAnalgesic efficacy of preoperative parecoxib sodium in an orthopedic pain model.
The efficacy and safety of preoperative intravenous administration of parecoxib sodium, a novel parenteral prodrug of a cyclooxygenase-2 selective inhibitor, in treating postoperative pain resulting from bunionectomy were evaluated in 50 patients who were part of a larger cohort of orthopedic and podiatric patients. Following bunionectomy, the median time to rescue medication (survival analysis) was 4 hours 18 min (95% confidence interval, 3 hours 4 min to 4 hours 37 min) in the placebo group, 7 hours 5 min (95% confidence interval, 3 hours 20 min to >24 hours) in the 20-mg parecoxib sodium group, and 10 hours 43 min (95% confidence interval, 4 hours 42 min to 14 hours 7 min) in the 40-mg parecoxib sodium group (significant for 40-mg parecoxib sodium versus placebo). Four or more hours after surgery, the mean pain-intensity (categorical) score was significantly lower in both parecoxib sodium groups than in the placebo group. Preoperative administration of parecoxib sodium was well tolerated and significantly reduced postoperative pain in patients who had undergone bunionectomy.