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MetatarsalgiaNCT05713175

Orthopaedic Treatment in Propulsive Metatarsalgia

A study testing EVA plantar orthosis, Polypropylene plantar orthosis and Fixtoe device in people with Metatarsalgia and Treatment, run by Universidad Complutense de Madrid at 1 site in Spain.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The goal of this clinical trial is to compare the effectiveness of two conservative orthopedic treatments in propulsive metatarsalgia. The main question it aims to answer are: To compare the effectiveness of treatments on foot pain and functionality in subjects diagnosed with propulsive metatarsalgia. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Metatarsalgia, Treatment, Foot
What is being tested?
EVA plantar orthosis, Polypropylene plantar orthosis and Fixtoe device
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
80 participants
Where
1 siteSpain
Study dates
1 Jan 2022to 1 Jan 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Mechanical pain in the 2nd or 3rd metatarsophalangeal joint (MTPJ)
  • Positive Laschman's drawer test in 2nd or 3rd MTPJ. (CITA)
  • Physical exploration revealing pain upon the palpation in plantar plate ( when cranial-caudal pressure was directly applied in the plantar aspect of the 2nd or 3rd MTPJ). (CITA)
  • Availability of dorsal-plantar and lateral wheightbearing radiography of the affected foot.

Who cannot join

  • Subjects with at least one of the following were excluded.
  • Deformity of the 2nr or 3rd metatarsal head (MTH) (Freiberg's disease)
  • Morton's neuroma and/or neuritic symptomatlogy y referred.
  • Rigid claw or hammer toe (positive Kelikian test) whithin radiographic dislocation of 2nd or 3rd MTPJ. (CITA)
  • Dermatological lesión plantar to 2nd or 3rd MTPJ (intractable plantar keratosis (IPK), foot ulcer, plantar wart, etc.)
  • Neurological, methabolical, vascular or rheumatological not-controlled systemic disease with potential manifestations in foot and ankle.
Show all 10Show fewer
  • Previous history of foot or ankle surgery entailing limitations in mobility and/or alterations of the metatarsal parabola.
  • Previous history of foot or ankle fracture
  • Morpho-functional alteration of the lower limbs: clinical asymmetry greater than 10 mm and presence of asymmetric genu varus or valgus.
  • Alterations of the cognitive state preventing to understand the objective of the study and guidelines to follow for their participation.

Trial locations and contacts

1 site in 1 country.

Spain1 site
  • Clínica Universitaria de Podología Complutense University Madrid

    Madrid, 28040

Other trials in Spain

About this study

Official title: Effectiveness of Orthopaedic Treatment in Propulsive Metatarsalgia

The goal of this clinical trial is to compare the effectiveness of two conservative orthopedic treatments in propulsive metatarsalgia.

The main question it aims to answer are:

  • To compare the effectiveness of treatments on foot pain and functionality in subjects diagnosed with propulsive metatarsalgia.
  • To determinate the influence of clinical and radiographical characteristics in pain improvement.

Participants will wear the treatment for 3 months . Researchers will compare polypropylene and EVA insoles and Fixtoe Device® to see if a foot pain improvement is achieved.

Read the detailed description

Type of Study: Randomised Clinical Trial.

Aim: To compare the effect of orthopedic treatment on foot pain and functionality in subjects diagnosed with propulsive metatarsalgia.

Study Protocol Description:

Prior to the start of the study, a calculation of the sample size will be made using the GRANMO Sample Size Calculator, version .12 April 2012, with an error of 5%, assuming a confidence level of 95% and values of ß that establish an analysis power of 80%.

The study population will be randomly divided into two treatment groups, which, in turn, will be subdivided into two groups. Said randomization will be carried out using an online tool (www.randomization.com).

Treatment groups are:

  • Group A: Treatment by custom insoles made of 4.5mm polypropylene, balanced in inversion 0-4º, MLA of the patient, 4mm-heel rise and metatarsal dome.
  • Group A1: Treatment from the date of diagnosis until the start of insoles use (3 weeks) using the Fix-Toe® device.
  • Group A2: Without orthopedic treatment from the date of diagnosis until the start of insoles use (3 weeks).
  • Group B: Treatment by custom insoles made of 45º shore A E.V.A with the patient's MLA, 4mm- heel rise and metatarsal dome.
  • Group B1: Treatment from the date of diagnosis until the start of insoles use (3 weeks) using the Fix-Toe® device.
  • Group B2: Without orthopedic treatment from the date of diagnosis until the start of insoles use (3 weeks).

Visits protocol is as follows:

  • Day 1: inclusion, clinical and radiographical evaluation. Pain questionnaires fulfillment.Treatment group allocation.
  • Day 2 (3 weeks after Day 1): Pain questionnaires fulfillment. Starts insoles treatment.
  • Day 3 (6 weeks after Day 2): Pain questionnaires fulfillment (telephone).
  • Day 4 (6 weeks after Day 3): Pain questionnaires fulfillment. Clinical evaluation. End of study.
Being tested
EVA plantar orthosis, Polypropylene plantar orthosis, Fixtoe device
Keywords
Metatarsalgia, Forefoot, Foot Diseases, Treatment
Medical subject headings
Metatarsalgia, Foot Diseases, Musculoskeletal Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • EVA plantar orthosisDevice

    Treatment consisting of a personalized plantar orthosis fabricated in 45º shore A hardness Ethyl Vinyl Acetate (EVA), which incorporates a 4mm heel rise and metatarsal dome placed proximal to the 2nd-3rd-4th metatarsal heads. No modifications applied to the patients' medial longitudinal arch.

  • Polypropylene plantar orthosisDevice

    Treatment consisting of a personalized plantar orthosis fabricated in 4mm polypropylene, which incorporates a 4mm heel rise and metatarsal dome placed proximal to the 2nd-3rd-4th metatarsal heads. No modifications applied to the patients' medial longitudinal arch.Orthosis fabricated following the inverted orthotic technique.

  • Fixtoe deviceDevice

    Fixtoe Device, simulating the metatarsophalangeal stabilization tape technique is worn for one month, prior to definitive treatment consisting of a personalized plantar orthosis.

Study groups in NCT05713175
Study groupRoleWhat they receive
EVA plantar orthosisActive comparatorTreatment consisting of a personalized plantar orthosis fabricated in 45º shore A hardness Ethyl Vinyl Acetate (EVA), which incorporates a 4mm heel rise and metatarsal dome placed proximal to the 2nd-3rd-4th metatarsal heads. No modifications applied to the patients' medial longitudinal arch.
Receives: Device: EVA plantar orthosis
Polypropylene plantar orthosisActive comparatorTreatment consisting of a personalized plantar orthosis fabricated in 4mm polypropylene, which incorporates a 4mm heel rise and metatarsal dome placed proximal to the 2nd-3rd-4th metatarsal heads. No modifications applied to the patients' medial longitudinal arch.Orthosis fabricated following the inverted orthotic technique.
Receives: Device: Polypropylene plantar orthosis
Fixtoe deviceActive comparatorFixtoe device, simulating the metatarsophalangeal joint stabilization tape technique . Worn for one month, prior to definitive treatment.
Receives: Device: EVA plantar orthosis; Device: Polypropylene plantar orthosis; Device: Fixtoe device

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Foot Pain

    Foot Pain measured using a 11-point VAS score. 0 is the lower (better) value and 10 is the higher (worst) value.

    Measured: Up to 20 weeks.

  2. Foot Pain and Disability

    Measured using the Foot Function Index (FFI-Sp) questionnaire (Spanish version). Higher values mean worse outcome and lower values mean better outcome.

    Measured: Up to 20 weeks.

Secondary outcomes (35)
  1. Demographic data: Age.

    Expressed in years

    Measured: Day 1.

  2. Demographic data: Gender

    Women or Men

    Measured: Day 1.

  3. Demographic data: Wheight

    Expressed in kilograms.

    Measured: Day 1.

  4. Demographic data: Height

    Expressed in centimetres.

    Measured: Day 1.

  5. Demographic data: Body Mass Index (BMI)

    Weight and Height will be combined to report BMI in kg/m^2

    Measured: Day 1.

  6. Demographic data: Adherence to treatment

    Good / Bad. Measured using a own questionnaire.

    Measured: Day 2, Day 3, Day 4.

  7. Demographic data: Time with symptoms.

    >12 months / 6-12 months / > 6 months / > 3 months

    Measured: Day 1.

  8. Foot clinical evaluation data: Toes deformity

    No deformity / Sagittal plane deformity / V sign

    Measured: Day 1.

  9. Foot clinical evaluation data: Paper pull-out test

    No resistence / Medium resistence / Resistence

    Measured: Day 1, Day 2.

  10. Foot clinical evaluation data: 1st metatarsophalangeal joint range of movement

    Expressed in degrees.

    Measured: Day 1, Day 4

  11. Foot clinical evaluation data: Medial column of the foot stiffness

    Low / Moderate/ High

    Measured: Day 1.

  12. Foot clinical evaluation data: Functional Hallux Limitus

    Yes / No. According to Functional Hallux Limitus test.

    Measured: Day 1.

  13. Foot clinical evaluation data: First ray mobility

    Dorsal > Plantar / Similar / Dorsal < Plantar

    Measured: Day 1.

  14. Foot clinical evaluation data: Lunge test

    Positive / Negative

    Measured: Day 1.

  15. Foot clinical evaluation data: Arch index

    Expressed in degrees.

    Measured: Day 1, Day 4.

  16. Foot clinical evaluation data: Navicular Drop Test

    Expressed in centimetres.

    Measured: Day 1, Day 4.

  17. Foot clinical evaluation data: Calcaneus relaxed standing position.

    Expressed in degrees.

    Measured: Day 1, Day 4.

  18. Foot clinical evaluation data: Subtalar joint axis orientation

    Medial / Neutral / Lateral

    Measured: Day 1.

  19. Radiographical data: HAV angle

    Expressed in degrees.

    Measured: Day 1.

  20. Radiographical data: 1st metatarsophalangeal joint osteoarthritis

    0/ 1/ 2/ 3/ 4

    Measured: Day 1.

  21. Metatarsal formula

    According to the length of the metatarsal bones.

    Measured: Day 1.

  22. Radiographical data: 2nd metatarsophalangeal joint angle

    Expressed in degrees.

    Measured: Day 1.

  23. Radiographical data: 3rd metatarsophalangeal joint angle

    Expressed in degrees.

    Measured: Day 1.

  24. Radiographical data: M1-M2 intermetatarsal angle

    Expressed in degrees.

    Measured: Day 1.

  25. Radiographical data: 2nd- 3rd metatarsophalangeal joint impingement

    Yes / No

    Measured: Day 1.

  26. Radiographical data: 2nd - 3rd metatatsophalangeal joint radiolucency.

    Yes / No

    Measured: Day 1.

  27. Radiographical data: Metatarsus primus elevatus

    Yes / No

    Measured: Day 1.

  28. Radiographical data: 1st cuneiform - 2nd metatarsal gap

    Expressed in centimetres.

    Measured: Day 1.

  29. Radiographical data: talar coverage angle

    Expressed in degrees.

    Measured: Day 1.

  30. Radiographical data: 1st cuneiform - 5th metatarsal distance

    Expressed in centimetres.

    Measured: Day 1.

  31. Radiographical data: Meary's line

    Dorsal / Plantar

    Measured: Day 1.

  32. Foot orthosis data: Metatarsal dome location in relation to central metatarsal heads

    Similar / Distal / Proximal

    Measured: Day 4.

  33. Foot orthosis data: Metatarsal dome location in relation to 1st metatarsal head

    Similar / Distal / Proximal

    Measured: Day 4.

  34. Foot orthosis data: Stability

    Yes / No

    Measured: Day 4.

  35. Foot orthosis data: Orthotic deformity test

    Yes / No

    Measured: Day 4.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Feb 2023
  2. Study start1 Jan 2022
  3. Primary completion1 Jan 2023
  4. Study completion1 Jan 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Parallel Groups Open Randomised Clinical Trial
Masking
Single blind
Who is masked
Participant
Enrolment
80 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05713175
Sponsor's protocol ID
Tesis Doc Maria Ruiz-Ramos
Status last verified
Jan 2023
First submitted
5 Oct 2022
Last updated
6 Feb 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing EVA plantar orthosis, Polypropylene plantar orthosis and Fixtoe device in people with Metatarsalgia and Treatment, run by Universidad Complutense de Madrid at 1 site in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 6 Feb 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Foot Pain (time frame: Up to 20 weeks.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Feb 2023.

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