Study design: Retrospective descriptive study.
Objectives: To examine compliance in wearing heel lifts during 8 weeks of military training in cadets identified with limb length inequalities.
Background: Lack of compliance can be blamed for countless poor outcomes in the medical community. Reported compliance with intervention protocols has been reported to range from 11% to 95%. All 1100 new cadets in the class of 2005 were screened for a limb length inequality One hundred ninety-eight out of 1100 cadets were identified to have a limb length inequality on physical exam and volunteered to participate. Cadets were randomly assigned to a heel lift or control group. Cadets in the heel lift group were instructed to wear a heel lift at all times throughout cadet basic training to attempt to prevent overuse injuries. There was no difference (P > .05) between the heel lift group or the control group on injury rate or excusal days.
Methods and measures: In an attempt to discern whether the preventive intervention was ineffective by design or if noncompliance was to blame, investigators asked cadets via electronic mail survey to report compliance with heel lift wear as a percentage (0%-100%).
Results: Seventy-six out of 99 (76.8%) cadets in the heel lift group responded to the electronic mail survey. Mean reported compliance was 38%. Eighteen cadets reported between 70% and 100% compliance. The remaining 58 cadets reported less than 70% compliance.
Conclusions: Cadet compliance was poor with the use of a heel lift. Physical therapists throughout the military often prescribe heel lifts, therapeutic exercises, or medication and assume good to excellent compliance. This study reminds providers that good compliance should not be assumed in any setting.