105 Loop Taping for Heel Fat Pad Syndrome: A Randomized Controlled Crossover Clinical Trial

Introduction Heel fat pad syndrome (HFPS) is the second leading cause of plantar heel pain. Clinical practice guidelines recommend conservative treatments for HFPS (activity modification, arch taping, and viscoelastic heel-cups). Alarmingly, the evidence for managing HFPS is scant and no well-executed randomised trials exist to support specific treatments. We aim to examine the effect of a novel heel fat pad loop taping on pain and function for HFPS. Materials and Methods In this two-arm crossover, participant-blinded RCT, participants with HFPS are block-randomized into either AB or BA interventions (A=loop taping that encircles/bunches the fat pad to centralize it and enhance its fullness and resilience to compression, B=control taping that mimic the loop taping without any force/pressure or attempt to bunch/centralize the fat pad) with a 4-to-7-day between-intervention washout period. The primary outcome is pain during the most pain-aggravating activity selected by participants (30-sec single-leg standing or 20-meter barefoot walking). Secondary outcomes are worst pain in the past 24 hours, foot health/function using the Foot Health Status Questionnaire, and global rating of change. We also assessed mechanistic outcomes of ultrasound-measured heel fat pad thickness and pressure-algometer-measured pressure pain thresholds. Results This pre-registered RCT will be completed in December 2022. 19 participates are needed to detect a 2-point greater pain reduction for loop vs. control taping. We have eligibility-screened 17 participants, enrolled and completed data collection in 2. Conclusion Findings of this first RCT examining clinical and mechanistic effects of loop taping will provide much-needed evidence on effective non-pharmacological managements of HFPS.