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Burton I. Autoregulated heavy slow resistance training combined with radial shockwave therapy for plantar heel pain: Protocol for a mixed-methods pilot randomised controlled trial. Musculoskeletal Care 2021; 19:319-330. [PMID: 33629803 DOI: 10.1002/msc.1542] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 01/31/2021] [Accepted: 02/01/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Plantar heel pain (PHP) is considered a tendinopathy and it affects up to 10% of the population. Both heavy slow resistance training (HSRT) and extracorporeal shockwave therapy (ESWT) have shown effectiveness for treating PHP in isolation. However, more comprehensive exercise protocols and progression methods are needed due to poor long-term outcomes, and better standardisation of ESWT protocols are required. Autoregulation of resistance training involves self-selecting exercise dosage based on individual factors. Although autoregulation has proven effective for strength gains in athletes, it has not been investigated in tendinopathy. Recent studies recommend that PHP should not be treated by one treatment intervention in isolation. However, there is a dearth of research investigating the feasibility and effectiveness of combined treatment interventions for PHP. Currently, no studies have investigated autoregulated HSRT combined with ESWT, despite their individual efficacy. The optimal treatment protocol for PHP is unknown, and there is a need to ascertain whether the addition of ESWT to autoregulated HSRT leads to better outcomes compared to either alone. METHODS A three-arm randomised controlled trial (RCT) comparing these groups would be the ideal way to investigate this question, with a pilot RCT testing trial procedures and process evaluation required prior to a definitive RCT. Patients expectations, feasibility and acceptability of combined ESWT and exercise for PHP also remain unknown. Therefore, the addition of qualitative interviews in a mixed-methods pilot RCT would help ascertain acceptability and help explain the intervention outcomes.
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Affiliation(s)
- Ian Burton
- Angus Physiotherapy Department, NHS Tayside, Arbroath Infirmary, Arbroath, DD11 2AT, UK
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Kandil MI, Tabl EA, Elhammady AS. Prospective Randomized Evaluation of Local Injection of Allogeneic Growth Factors in Plantar Fasciitis. Foot Ankle Int 2020; 41:1335-1341. [PMID: 32755237 DOI: 10.1177/1071100720939066] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the efficacy and safety of injection of allogeneic growth factors in patients with plantar fasciitis. METHODS This study included 150 patients who were randomly divided into 2 equal groups; the patients were locally injected with allogeneic growth factors (GFs) (treatment group) or with saline 0.9% (control group). The patients were assessed using visual analog scale (VAS) and Foot Function Index-Revised short form (FFI-Rs) scores preinjection and 1, 3, 6, and 12 months postinjection. The patients were questioned about their satisfaction. Any adverse effects were recorded. RESULTS At baseline, there was no significant difference between both groups regarding the mean VAS and FFI-Rs scores. At 3-month follow-up, the reduction in mean VAS score was 87% in the treatment group and 55% in the control group (P < .001), and the reduction in mean FFI-Rs score was 62% in the treatment group and 40% in the control group (P < .001). Treatment group and study visit were significant factors affecting both VAS and FFI-Rs scores. Overall, 92% were satisfied in the treatment group, and 78.2% in the control group. Postinjection pain occurred in 5 patients in the treatment group. CONCLUSION This study provides Level I evidence regarding the efficacy and safety of allogeneic GF injection in patients with plantar fasciitis. However, additional studies are needed to evaluate their adverse effects, immunogenicity, and microbiological safety. LEVEL OF EVIDENCE Level I, prospective randomized controlled case series.
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Affiliation(s)
- Mahmoud Ibrahim Kandil
- Orthopedic Surgery, Department of Orthopaedics and Traumatology, Faculty of Medicine, Benha University, Benha, Qalyubia, Egypt
| | - Eslam Abdelshafi Tabl
- Orthopedic Surgery, Department of Orthopaedics and Traumatology, Faculty of Medicine, Benha University, Benha, Qalyubia, Egypt
| | - Adel Samy Elhammady
- Orthopedic Surgery, Department of Orthopaedics and Traumatology, Faculty of Medicine, Benha University, Benha, Qalyubia, Egypt
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Whittaker GA, Munteanu SE, Roddy E, Menz HB. Measures of Foot Pain, Foot Function, and General Foot Health. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:294-320. [PMID: 33091250 DOI: 10.1002/acr.24208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/02/2020] [Indexed: 12/26/2022]
Affiliation(s)
- Glen A Whittaker
- School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Shannon E Munteanu
- School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Edward Roddy
- Primary Care Centre Versus Arthritis, Chesterfield, UK, School of Primary, Community and Social Care, Keele University, Keele, UK, and Haywood Academic Rheumatology Centre, Midland Partnership NHS Foundation Trust, Stoke-on-Trent, UK
| | - Hylton B Menz
- School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
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Gómez-Jurado I, Juárez-Jiménez JM, Munuera-Martínez PV. Orthotic treatment for stage I and II posterior tibial tendon dysfunction (flat foot): A systematic review. Clin Rehabil 2020; 35:159-168. [PMID: 33040609 DOI: 10.1177/0269215520960121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate whether orthotic treatment is effective for the treatment of posterior tibial tendon dysfunction stages I and II (flat foot). DATA SOURCES Five databases (PubMed, Scopus, PEDro, SPORTDiscus and The Cochrane Library) were searched for potential RCTs from their inception until August 2020. REVIEW METHODS Only randomised controlled trials (RCT) that included subjects diagnosed with posterior tibial dysfunction in the initial stage and treated with orthotic treatments were selected. The outcomes assessed were whatever symptom related to posterior tibial tendon dysfunction stage I and II. Included RCTs were appraised using the Cochrane collaboration risk of bias tool. RESULTS Four RCT articles and 186 subjects were included. 75% were at high risk of bias for blinding of participants and personnel. Three different types of conservative treatment were used in the studies: foot/ankle-foot orthoses, footwear and stretching /strengthening exercises. Foot orthoses, together with exercise programmes, seemed to improve the effect of orthotic treatment. Foot orthoses with personalised internal longitudinal arch support were more effective than flat insoles or standard treatments in reducing pain. CONCLUSIONS The use of orthotic treatment may be effective in reducing pain in the early stages of posterior tibial tendon dysfunction. Further research is needed into individualised orthotic treatment and high-intensity monitored exercise programmes.
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Affiliation(s)
- Isabel Gómez-Jurado
- Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
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Bovonsunthonchai S, Thong-On S, Vachalathiti R, Intiravoranont W, Suwannarat S, Smith R. Thai version of the foot function index: a cross-cultural adaptation with reliability and validity evaluation. BMC Sports Sci Med Rehabil 2020; 12:56. [PMID: 32944253 PMCID: PMC7488097 DOI: 10.1186/s13102-020-00206-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 09/01/2020] [Indexed: 11/11/2022]
Abstract
Background The study aimed to translate the foot function index (FFI) questionnaire to Thai and to determine psychometric properties of the questionnaire among individuals with plantar foot complaints. Methods The Thai version of the FFI (FFI-Th) was adapted according to a forward and backward translation protocol by two independent translators and analyzed by a linguist and a committee. The FFI-Th was administered among 49 individuals with plantar foot complaints to determine internal consistency, reliability, and validity. Cronbach’s alpha and the Intraclass Correlation Coefficient (ICC3,1) were used to test the internal consistency and test-retest reliability. The Principal Component Analysis with varimax rotation method was used to test the factor structure and construct validity. Furthermore, the criterion validity was tested using Pearson’s correlation coefficient (rp) between the FFI-Th and the visual analogue pain scale (pain-VAS) as well as the EuroQol five-dimensional questionnaire (EQ-5D-5L). Results The FFI-Th showed good to excellent internal consistency and test-retest reliability in the total score, pain, disability, and activity limitation subscales. The Principal Component Analysis produced 4 principal factors from the FFI-Th items. Criterion validity of the FFI-Th total score showed moderate to strong correlations with pain-VAS and EQ-5D-5L, and EQ-VAS scores. Conclusion The FFI-Th was a reliable and valid questionnaire to assess the foot function in a Thai population. Trial registration NCT03161314 (08/05/2017).
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Affiliation(s)
- Sunee Bovonsunthonchai
- Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Rd., Salaya, Phuttamonthon, Nakhon Pathom, 73170 Thailand
| | - Suthasinee Thong-On
- Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Rd., Salaya, Phuttamonthon, Nakhon Pathom, 73170 Thailand
| | - Roongtiwa Vachalathiti
- Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Rd., Salaya, Phuttamonthon, Nakhon Pathom, 73170 Thailand
| | - Warinda Intiravoranont
- Physical Therapy Center, Faculty of Physical Therapy, Mahidol University, Bangkok, 10700 Thailand
| | - Sarawut Suwannarat
- Physical Therapy Center, Faculty of Physical Therapy, Mahidol University, Bangkok, 10700 Thailand
| | - Richard Smith
- Discipline of Exercise and Sport Science, School of Health Sciences, Faculty of Medicine and Health Science, The University of Sydney, Sydney, NSW 2006 Australia
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Ho LF, Guo Y, Ching JYL, Chan KL, Tsang PH, Wong MH, Chen M, Chen L, Ng BFL, Lin ZX. Efficacy of electroacupuncture plus warm needling therapy for plantar heel pain: a randomised waitlist-controlled trial. Acupunct Med 2020; 39:283-291. [PMID: 32815386 DOI: 10.1177/0964528420946048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the therapeutic effects of electroacupuncture plus warm needling (EAWN) therapy on pain and foot function in adults with plantar heel pain (PHP). METHODS This prospective, randomised, parallel-group, waitlist-controlled trial was conducted at a Chinese medicine centre in Hong Kong between May 2018 and February 2019. Eighty eligible community-dwelling subjects with PHP (mean age 59.7 years; 85% female) were equally randomised to receive EAWN therapy or remain on a waitlist. The treatment group received six 30-min sessions of standardised EAWN therapy over 4 weeks; the control group received no treatment. The outcome measures were the visual analogue scale (VAS) score for first-step pain, foot function index (FFI) scores and global rating of change (GRC) scale scores. Assessments were made at baseline, week 2 and week 4 (primary endpoint). The treatment group underwent additional assessments at week 8. Outcomes were evaluated by intention-to-treat analysis. RESULTS Patients who received EAWN therapy exhibited greater improvements in the mean first-step pain VAS and all FFI scores than did those in the control group at weeks 2 and 4, with significant between-group differences (all P < 0.001). Compared with baseline, there were significant decreases in mean first-step pain VAS scores at weeks 2 and 4, and FFI scores at week 4, in the treatment group but not in the control group. The improvements in the treatment group continued until week 8. GRC scores at week 4 indicated improvement in all treated patients and only 22.5% of the control group patients (P < 0.001). There were no study-related adverse events. CONCLUSION EAWN therapy could be an effective treatment for PHP in middle-aged and older adults. TRIAL REGISTRATION NUMBER ChiCTR1800014906 (Chinese Clinical Trials Registry).
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Affiliation(s)
- Lai Fun Ho
- Chinese Medicine Services, Pok Oi Hospital, Hong Kong, China
| | - Yuanqi Guo
- Chinese Medicine Services, Pok Oi Hospital, Hong Kong, China.,School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Jessica Yuet-Ling Ching
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,Hong Kong Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Kam Leung Chan
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,Hong Kong Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Ping Him Tsang
- Chinese Medicine Services, Pok Oi Hospital, Hong Kong, China
| | - Man Hin Wong
- Chinese Medicine Services, Pok Oi Hospital, Hong Kong, China
| | - Min Chen
- Chinese Medicine Services, Pok Oi Hospital, Hong Kong, China
| | - Liyi Chen
- Chinese Medicine Services, Pok Oi Hospital, Hong Kong, China.,School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Zhi Xiu Lin
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,Hong Kong Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Eerdekens M, Deschamps K, Wuite S, Matricali G. The Biomechanical Behavior of Distal Foot Joints in Patients with Isolated, End-Stage Tibiotalar Osteoarthritis Is Not Altered Following Tibiotalar Fusion. J Clin Med 2020; 9:E2594. [PMID: 32796511 PMCID: PMC7465493 DOI: 10.3390/jcm9082594] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 08/05/2020] [Accepted: 08/08/2020] [Indexed: 12/16/2022] Open
Abstract
Ankle arthrodesis is considered to be an optimal treatment strategy to relieve pain during walking in patients with isolated, end-stage tibiotalar osteoarthritis. The aim of this study was to investigate the post-operative effect of an arthrodesis on the ankle and foot joint biomechanics. We included both patients (n = 10) and healthy reference data (n = 17). A multi-segment foot model was used to measure the kinematics and kinetics of the ankle, Chopart, Lisfranc, and first metatarsophalangeal joints during a three-dimensional (3D) gait analysis. These data, together with patient reported outcome measures, were collected at baseline (pre-operative) and one year post-operatively. Patients experienced a decrease in pain and an increase in general well-being after surgery. Compared to the baseline measurements, patients only demonstrated a significant average post-operative increase of 0.22 W/kg of power absorption in the ankle joint. No other significant differences were observed between baseline and post-operative measurements. Current findings suggest that the biomechanical behavior of distal foot joints is not altered one year after fusion. The pain relief achieved by the arthrodesis improved the loading patterns during walking. Clinical significance of this study dictates that patients do not have to fear a loss in biomechanical functionality after an ankle arthrodesis.
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Affiliation(s)
- Maarten Eerdekens
- Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, KU Leuven, 3001 Heverlee, Belgium
- Clinical Motion Analysis Laboratorium (CMAL), UZ Leuven, 3210 Pellenberg, Belgium;
| | - Kevin Deschamps
- Clinical Motion Analysis Laboratorium (CMAL), UZ Leuven, 3210 Pellenberg, Belgium;
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, 8000 Campus Brugge, Belgium
| | - Sander Wuite
- Department of Orthopedics, UZ Leuven, 3000 Leuven, Belgium; (S.W.); (G.M.)
- Institute for Orthopaedic Research & Training, KU Leuven, 3000 Leuven, Belgium
- Department of development and regeneration, KU Leuven, 3000 Leuven, Belgium
| | - Giovanni Matricali
- Department of Orthopedics, UZ Leuven, 3000 Leuven, Belgium; (S.W.); (G.M.)
- Institute for Orthopaedic Research & Training, KU Leuven, 3000 Leuven, Belgium
- Department of development and regeneration, KU Leuven, 3000 Leuven, Belgium
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Walsh KP, Durante EC, Moser BR, Coetzee JC, Stone McGaver R. Surgical Outcomes of Os Trigonum Syndrome in Dancers: A Case Series. Orthop J Sports Med 2020; 8:2325967120938767. [PMID: 32743013 PMCID: PMC7376299 DOI: 10.1177/2325967120938767] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 03/09/2020] [Indexed: 11/17/2022] Open
Abstract
Background Management of ankle pain in dancers can be challenging because of the repetitive stress and complex demands placed on this region. Despite the prevalence of ankle injuries in this population, literature on surgical outcomes and return to dance is limited. Purpose To retrospectively evaluate the efficacy and functional outcomes after surgical excision of a symptomatic os trigonum in dancers. Study Design Case series; Level of evidence, 4. Methods Between June 2006 and June 2016, a total of 44 dancers underwent surgical excision of a symptomatic os trigonum at a single institution and by a single surgeon. All patients presented with symptoms of posterior ankle impingement syndrome and subsequently failed nonsurgical treatment. Clinical analysis was conducted using various pre- and postoperative patient-reported outcome questionnaires, including the Veterans RAND 12-Item Health Survey (VR-12), Foot Function Index-Revised (FFI-R), and visual analog scale (VAS) for pain, as well as subjective patient satisfaction. Results A total of 44 patients (54 ankles; mean age, 18.2 years) were retrospectively evaluated at a mean follow-up of 33.4 months. The VR-12 Physical Health score improved from a mean score of 37.8 ± 11.9 to 51.2 ± 10.5 (P < .001). The cumulative FFI-R score improved from 46.45 ± 13.8 to 31.2 ± 9.7 (P = .044), with the subcategory of "activity limitation" representing the highest-scoring FFI-R subcategory at 65.28 ± 13.4 preoperatively and improving to 34.47 ± 12.4 at follow-up (P < .001). The mean VAS score for subjective pain improved significantly from 5.39 ± 2.84 to 1.73 ± 2.10 (P < .00044). Conclusion Overall, the findings of the present study demonstrate that dancers of varying style and level improved significantly according to various clinical measures. Patients included in this study reported that they returned to their previous level of dance upon completion of physical therapy and maintained thriving postoperative careers, which for several meant dancing at the professional level.
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Affiliation(s)
- Keifer P Walsh
- Alabama College of Osteopathic Medicine, Dothan, Alabama, USA
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Yagci G, Erel S, Okunakol V. Validation of the Turkish version of the Revised Foot Function Index for patients with foot and ankle disorders. Foot Ankle Surg 2020; 26:624-629. [PMID: 31431327 DOI: 10.1016/j.fas.2019.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 07/09/2019] [Accepted: 08/05/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND The revised Foot Function Index (FFI-R) is a multidimensional instrument that was developed to assess a patient's self-reported health-related foot function. The FFI-R is clinically useful and easy to apply, and it has comprehensive subscales assessing the pain, stiffness, psychosocial stress, disability, and activity limitations related to foot and ankle problems. The present study was conducted to validate the Turkish version of the FFI-R, and to demonstrate its use in a Turkish population with various foot and ankle problems. METHODS The English version of the FFI-R was translated into Turkish, and then, it was administered to 124 patients (mean age of 39.9 years old) with foot and ankle problems and a mean symptom duration of 7.9 months. These patients completed two well-established foot and ankle-specific patient-reported outcome measures, the Foot and Ankle Outcome Score (FAOS) and the Manchester-Oxford Foot Questionnaire (MOX-FQ), and a general instrument, the 36-item Short Form Health Survey (SF-36). The test-retest reliability was evaluated using the intraclass correlation coefficient, and the internal consistency was measured using Cronbach's alpha. The construct validity of the FFI-R was assessed by correlating its subscales with the FAOS, MOX-FQ, and SF-36 subscales. RESULTS The test-retest reliability of the FFI-R ranged between 0.84 and 0.97. The internal consistency was 0.97 for the overall FFI-R, and it ranged between 0.85 and 0.97 for the subscales. Significant correlations were obtained between the FFI-R subscales and the FAOS, MOX-FQ, and SF-36 subscales. CONCLUSIONS The Turkish version of the FFI-R was found to be a reliable and valid instrument for measuring the foot and ankle-related functional disability and health status of Turkish patients with foot and ankle problems.
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Affiliation(s)
- Gozde Yagci
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey.
| | - Suat Erel
- Pamukkale University, School of Physical Therapy and Rehabilitation, Denizli, Turkey
| | - Vural Okunakol
- Pamukkale University, School of Physical Therapy and Rehabilitation, Denizli, Turkey
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Schaarup SO, Burgaard P, Johannsen FE. Surgical Repair of Complete Plantar Fascia Ruptures in High-Demand Power Athletes: An Alternative Treatment Option. J Foot Ankle Surg 2020; 59:195-200. [PMID: 31882140 DOI: 10.1053/j.jfas.2019.07.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 03/31/2019] [Accepted: 07/28/2019] [Indexed: 02/03/2023]
Abstract
Surgical repair of complete plantar fascia ruptures has not yet been reported in the literature. Operative technique and outcome are described in 2 gymnasts with heavy plyometric demands who received surgical repair compared with 3 athletes treated nonoperatively. Biomechanics and clinical implications are discussed. In the last 8 years, we have seen 5 high-demand athletes with total rupture of the plantar fascia. This is a retrospective clinical evaluation 1.5 to 8 years postinjury of all 5 patients using dynamic ultrasound, Foot Function Index, sports-specific questions, Foot Posture Index, and foot length. The operated gymnasts returned to the same level of performance within 12 months. None of the conservatively treated athletes returned to preinjury plyometric sports levels but reached a foot load capacity of distance running with the injured foot as limiting factor. Ultrasound with simultaneous dorsiflexion of the toes showed a normal fascia in the operated patients, but a slack fascia that tightened up only at terminal toe dorsiflexion in the conservatively treated group. According to the Foot Function Index, the operated patients reported no complaints, whereas the nonoperative group had clinical relevant impairments in activities of daily life. The Foot Posture Index in all nonoperated patients showed a relative shift toward pronation with increased foot length compared with the noninjured foot. The operated patients showed no difference in foot length but minimal shift into supination with a slightly altered arch contour. Surgical repair of plantar fascia ruptures is technically feasible to restore normal foot load capability with return to high-demand plyometric sports within 12 months.
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Affiliation(s)
| | - Peder Burgaard
- Surgeon, Rigshospitalet, Department of Orthopedic Surgery, Copenhagen, Denmark
| | - Finn Elkjær Johannsen
- Sports Physician and Scientist, Bispebjerg Hospital, Institute of Sportsmedicine Copenhagen, University of Copenhagen, Copenhagen, Denmark
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Heide M, Mørk M, Røe C, Brox JI, Fenne Hoksrud A. The effectiveness of radial extracorporeal shock wave therapy (rESWT), sham-rESWT, standardised exercise programme or usual care for patients with plantar fasciopathy: study protocol for a double-blind, randomised, sham-controlled trial. Trials 2020; 21:589. [PMID: 32600386 PMCID: PMC7325112 DOI: 10.1186/s13063-020-04510-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 06/15/2020] [Indexed: 01/20/2023] Open
Abstract
Background Plantar fasciopathy is a common cause of plantar heel pain, with a reported prevalence of up to 10%. The choice of best practice in these patients is debated. Two randomised studies reported that radial extracorporeal shock wave therapy is effective, but a meta-analysis concluded that due to methodological limitations, the evidence is questionable. There are few studies reporting the effect of exercise programs with high-load strength training, despite widespread use. The objective of this placebo-controlled, observer-blinded and partly patient blinded trial is to compare rESWT, sham-rESWT, standardised exercise programme and usual care for alleviating heel pain at 6 and 12 months follow-up. Methods/design A double-blind, randomised, sham-controlled trial is conducted at a hospital outpatient clinic of physical medicine and rehabilitation. Patients with chronic (> 3 months) pain due to plantar fasciopathy, aged 18 to 70 years old, are eligible for inclusion in the trial. Patients will be randomly allocated in 1:1 ratio to receive rESWT, sham-rESWT, standardised exercises or usual care. The sample size is estimated to 200 patients, 50 in each group. rESWT or sham-rESWT will be given once a week for 3 weeks. A physiotherapist will supervise the exercises, with a total of 8 sessions over 12 weeks. The patients in the usual care group will receive information, advice and foot orthosis only. All patients, regardless of group, will receive the same information and get an individual customised foot orthosis made by an orthopaedic technician. The primary outcome measure is heel pain intensity during activity in the last week, using a numeric rating scale (NRS, 0 to 10) at the 6 months follow-up adjusted for baseline pain intensity. The secondary outcomes are at the 6- and 12-month follow-up and include Foot Functional Index Revised Short Version (FFI-RS), Patient Global Impression of Change Scale (7-point Likert scale), RAND-12 Health Status Inventory (RAND-12), NRS during rest and NRS during activity (12 months). The patients receiving rESWT/sham-rESWT and the outcome assessor will be blinded to the group assignment. Discussion This trial is designed in order to provide results important for future clinical practice. Trial registration ClinicalTrials.gov NCT03472989. Registered on 14 March 2018
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Affiliation(s)
- Marte Heide
- Faculty of Medicine, University of Oslo, Postboks 1078, Blindern, Oslo, Norway. .,Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Postboks 4956, Ullevål, Nydalen, 0242, Oslo, Norway.
| | - Marianne Mørk
- Faculty of Medicine, University of Oslo, Postboks 1078, Blindern, Oslo, Norway.,Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Postboks 4956, Ullevål, Nydalen, 0242, Oslo, Norway
| | - Cecilie Røe
- Faculty of Medicine, University of Oslo, Postboks 1078, Blindern, Oslo, Norway.,Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Postboks 4956, Ullevål, Nydalen, 0242, Oslo, Norway
| | - Jens Ivar Brox
- Faculty of Medicine, University of Oslo, Postboks 1078, Blindern, Oslo, Norway.,Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Postboks 4956, Ullevål, Nydalen, 0242, Oslo, Norway
| | - Aasne Fenne Hoksrud
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Postboks 4956, Ullevål, Nydalen, 0242, Oslo, Norway
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Ortega-Santiago R, Ríos-León M, Martín-Casas P, Fernández-de-Las-Peñas C, Plaza-Manzano G. Active Muscle Trigger Points Are Associated with Pain and Related Disability in Patients with Plantar Heel Pain: A Case-Control Study. PAIN MEDICINE 2020; 21:1032-1038. [PMID: 30986304 DOI: 10.1093/pm/pnz086] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Pain experienced by patients with plantar heel pain has been associated with fascia thickness. It is possible that referred muscle pain may also be related to symptoms experienced by these patients. Our aim was to systematically investigate if the referred pain elicited by trigger points in the leg and foot musculature reproduces the symptoms in individuals with plantar heel pain and to determine the association of trigger points (TrPs) with pain and related disability. METHODS A case-control study was conducted. Thirty-five individuals with unilateral chronic plantar heel pain and 35 matched comparable healthy controls participated. An assessor blinded to the subject's condition explored TrPs in the flexor hallucis brevis, adductor hallucis, quadratus plantae, and internal gastrocnemius. Pain and related disability were assessed with a numerical pain rating scale (0-10), the Foot Function Index, and the Foot Health Status Questionnaire. RESULTS The number of TrPs for each patient with plantar heel pain was 4 ± 3 (2.5 ± 2 active TrPs, 1.5 ± 1.8 latent TrPs). Healthy controls only had latent TrPs (mean = 1 ± 1). Active TrPs in the quadratus plantae (N = 20, 62.5%), and flexor hallucis brevis (N = 19, 59%) were the most prevalent in patients with plantar heel pain. A greater number of active, but not latent, TrPs was associated with higher foot pain variables (0.413 < rs < 0.561, P < 0.01), higher impact of foot pain (0.350 < rs < 0.473, P < 0.05) and worse related disability (-0.447 < rs < -0.35456, P < 0.05). CONCLUSIONS The referred pain elicited by active TrPs in the foot muscles reproduced the symptoms in patients with plantar heel pain. A greater number of active TrPs was associated with higher pain and related disability in patients with plantar heel pain.
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Affiliation(s)
- Ricardo Ortega-Santiago
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine.,Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca
| | - Marta Ríos-León
- Alumna de Doctorado, Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Patricia Martín-Casas
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine.,Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
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Menz HB, Auhl M, Tan JM, Levinger P, Roddy E, Munteanu SE. Comparative Responsiveness of Outcome Measures for the Assessment of Pain and Function in Osteoarthritis of the First Metatarsophalangeal Joint. Arthritis Care Res (Hoboken) 2020; 72:679-684. [DOI: 10.1002/acr.23883] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 03/19/2019] [Indexed: 12/26/2022]
Affiliation(s)
- Hylton B. Menz
- La Trobe University, Melbourne, Victoria, Australia, and Arthritis Research UK Primary Care CentreKeele University Staffordshire UK
| | - Maria Auhl
- La Trobe University Melbourne Victoria Australia
| | - Jade M. Tan
- La Trobe University Melbourne Victoria Australia
| | - Pazit Levinger
- La Trobe University and National Ageing Research Institute Melbourne Victoria Australia
| | - Edward Roddy
- Arthritis Research UK Primary Care CentreKeele University, Staffordshire, UK, and Academic Rheumatology CentreMidlands Partnership NHS Trust Stoke‐on‐Trent UK
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Dahmen R, Konings-Pijnappels A, Kerkhof S, Verberne S, Boers M, Roorda LD, van der Leeden M. Higher body mass index is associated with lower foot health in patients with rheumatoid arthritis: baseline results of the Amsterdam-Foot cohort. Scand J Rheumatol 2020; 49:186-194. [PMID: 32154754 DOI: 10.1080/03009742.2019.1663920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objective: Obesity is highly prevalent in patients with rheumatoid arthritis (RA), with likely impact on weight-bearing foot joints. We explored the associations between body mass index (BMI) and measures of foot health in patients with RA and foot complaints.Method: We examined patients with RA presenting for their first custom-made therapeutic footwear or foot orthoses. Domains of foot health comprised: foot pain, foot-related activity limitations, forefoot plantar pressure, foot synovitis, and foot deformity. In regression analyses, BMI was the independent variable and foot health domains were the dependent variables.Results: The cohort at baseline comprised 230 patients [mean ± sd age 58 ± 13 years, 80% female, mean ± sd disease duration 10 ± 9 years, and median (interquartile range) BMI 26.7 (23.5-30.1) kg/m2]. Small to modest statistically significant associations were found in the majority of the measures studied between a higher BMI and more foot pain, more foot-related activity limitations, higher in-shoe measured forefoot plantar pressure, and the presence of foot synovitis. No relationships were found between BMI and barefoot measured forefoot plantar pressure or foot deformity.Conclusion: BMI is negatively associated with foot health in patients with RA. Although the clinical relevance of our findings for an individual patient is not immediately obvious, future research should consider BMI as a potential therapeutic target to improve foot health.
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Affiliation(s)
- R Dahmen
- Amsterdam Rehabilitation Research Center/Reade, Amsterdam, The Netherlands
| | | | - S Kerkhof
- Amsterdam Rehabilitation Research Center/Reade, Amsterdam, The Netherlands
| | - S Verberne
- Amsterdam Rehabilitation Research Center/Reade, Amsterdam, The Netherlands
| | - M Boers
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.,Rheumatology, Amsterdam Rheumatology and Immunology Centre, VU University Medical Centre, Amsterdam, The Netherlands
| | - L D Roorda
- Amsterdam Rehabilitation Research Center/Reade, Amsterdam, The Netherlands
| | - M van der Leeden
- Amsterdam Rehabilitation Research Center/Reade, Amsterdam, The Netherlands.,Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
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65
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Raeissadat SA, Nouri F, Darvish M, Esmaily H, Ghazihosseini P. Ultrasound-Guided Injection of High Molecular Weight Hyaluronic Acid versus Corticosteroid in Management of Plantar Fasciitis: A 24-Week Randomized Clinical Trial. J Pain Res 2020; 13:109-121. [PMID: 32021400 PMCID: PMC6969680 DOI: 10.2147/jpr.s217419] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 12/24/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND AND AIMS Plantar fasciitis (PF) is the leading cause of heel pain in adults. This study was designed to evaluate the effect of hyaluronic acid (HA) injection in reducing the symptoms of PF, compared with corticosteroid (CS) injection as a conventional treatment. METHODS In this triple-blind, randomized, clinical trial, 75 patients who had the symptoms of PF for at least 3 months were randomly divided into two groups of 38 and 37 individuals. Then, each patient received either a single injection of high molecular weight (>2000 kDa) HA (1 mL HA 20 mg + 1 mL lidocaine 2%) or CS (1 mL methylprednisolone 40 mg + 1 mL lidocaine 2%) under the ultrasonography (US) guidance. Visual analog scale (VAS), foot ankle ability index (FAAI), pressure pain threshold (PPT), functional foot index (FFI), and plantar fascia thickness (PFT) were measured using US at baseline, 6 weeks and 24 weeks after the injection. Eventually, at the end of the treatment period, the patients' satisfaction was measured. Intention to treat analysis was used to assess the results. RESULTS After 24 weeks of follow-up, results from 60 subjects were fully obtained; however, results of 73 patients included into intention to treat analysis in the sixth-week follow-up. In both groups, VAS, PFT and FFI decreased, while FAAI and PPT increased significantly (P <0.001). At the baseline and at the 24th-week, no significant difference between the two groups was observed in any of the variables. However, a comparison between the baseline and the sixth-week results shows a prominent decrease in PPT and PFT in the CS group compared to the HA group (P = 0.004 and P = 0.011). Finally, there were no statistical differences between the two groups in treatment satisfaction (P = 0.618). CONCLUSION Both CS and HA were effective modalities for PF and can improve pain and function with no superiority in 24th-week follow-ups, although CS seems to have a faster trend of improvement in the short term.
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Affiliation(s)
- Seyed Ahmad Raeissadat
- Clinical Research Development Center, Shahid Modarres Hospital, Tehran, Iran
- Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farshad Nouri
- Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahtab Darvish
- Clinical Research Development Center, Shahid Modarres Hospital, Tehran, Iran
- Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hadi Esmaily
- Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parsa Ghazihosseini
- Clinical Research Development Center, Shahid Modarres Hospital, Tehran, Iran
- Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Myerson CL, Myerson MS, Coetzee JC, Stone McGaver R, Giveans MR. Subtalar Arthrodesis with Use of Adipose-Derived Cellular Bone Matrix Compared with Autologous Bone Graft: A Multicenter, Randomized Controlled Trial. J Bone Joint Surg Am 2019; 101:1904-1911. [PMID: 31567665 DOI: 10.2106/jbjs.18.01300] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
UPDATE This article was updated on November 7, 2019, because of a previous error. On page 1909, in the section entitled "Discussion," the sentence that had read "Radiographic nonunion rates of 69.2% and 45.6% were observed at 6 months for ACBM and autograft, respectively, as measured on CT scans; however, these nonunion rates do account for patients who were considered to have attained fusion according to traditional methods, including absence of pain and swelling and presence of arthrodesis on radiographs" now reads "Radiographic nonunion rates of 69.2% and 45.6% were observed at 6 months for ACBM and autograft, respectively, as measured on CT scans; however, these nonunion rates do not account for patients who were considered to have attained fusion according to traditional methods, including absence of pain and swelling and presence of arthrodesis on radiographs."An erratum has been published: J Bone Joint Surg Am. 2019 XXX. BACKGROUND Subtalar arthrodesis effectively treats subtalar joint arthritis when other interventions have failed. Nonunion is a known complication of subtalar arthrodesis, with reported rates ranging from 5% to 45%. Historically, open arthrodesis has been performed with use of autologous bone graft; however, there are inherent disadvantages to autologous bone graft, including donor-site morbidity. Mesenchymal stem cells, when placed on a cellular scaffold, have shown promise as an alternative to autologous bone graft. The purpose of this multicenter, randomized controlled trial was to assess the safety and efficacy of an adipose-derived cellular bone matrix (ACBM) composite made with live cells compared with autograft in subtalar arthrodesis. METHODS A total of 140 patients were enrolled in a prospective, randomized (1:1) controlled trial performed at 6 clinical sites in the U.S. End points, including radiographic, clinical, and functional outcomes, were assessed over 2 years of follow-up. RESULTS A total of 109 patients underwent arthrodesis with ACBM (52 patients) and autograft (57 patients). At 6 months, fusion was achieved in 16 patients (30.8%) in the ACBM group and 31 patients (54.4%) in the autograft group as measured on computed tomography (p = 0.024), and in 41 patients (78.8%) in the ACBM group and 50 patients (87.7%) in the autograft group as assessed on clinical and radiographic evaluation (p = 0.213). Quality-of-life outcome measures demonstrated significant functional improvement from baseline for both groups. Fewer cases of serious adverse events occurred in the autograft group (10.5%) compared with the ACBM group (23.1%) (p = 0.078). CONCLUSIONS In patients who require subtalar arthrodesis, the use of ACBM demonstrated lower rates of radiographic fusion compared with treatment with autograft. The nonunion rate in the autologous group, as measured on computed tomography, was high. Good clinical outcomes were achieved in spite of the high non-union rates. LEVEL OF EVIDENCE Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- C Lucas Myerson
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
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67
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Shazadeh Safavi P, Janney C, Jupiter D, Kunzler D, Bui R, Panchbhavi VK. A Systematic Review of the Outcome Evaluation Tools for the Foot and Ankle. Foot Ankle Spec 2019; 12:461-470. [PMID: 30338697 DOI: 10.1177/1938640018803747] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. The goal of this systematic review is to determine the most commonly used outcome measurement tools used by foot and ankle specialists and determine their limitations, such as whether they are validated, have floor/ceiling effects, and so on. Methods. A literature search was conducted to identify primary publications between January 1, 2012 and July 1, 2017 that concern care of the foot and ankle and use any established grading criteria to evaluate patients. Results. In 669 publications, 76 scoring systems were used. The 10 most common were American Orthopaedic Foot and Ankle Score (AOFAS), visual analog scale (VAS), Short Form-36 (SF-36), Foot Function Index (FFI), Foot and Ankle Outcome Score (FAOS), Foot and Ankle Ability Measure (FAAM), SF-12, Short Musculoskeletal Function Assessment (SMFA), Ankle Osteoarthritis Scale (AOS), and Foot and Ankle Disability Index (FADI). AOFAS was used in 393 articles, VAS in 308, and SF-36 in 133 publications. AOFAS, VAS, and SF-36 were used to evaluate 23,352, 20,759, and 13,184 patients respectively. AOFAS and VAS were used simultaneously in 172 publications. Conclusion. While there are many different scoring systems available for foot and ankle specialists to use to assess or demonstrate the effectiveness of treatments, the AOFAS, while it is an unvalidated scoring system, is the most commonly used scoring system in this review. Clinical Relevance. This review presents data about commonly used patient reported outcomes systems in foot and ankle surgery. Levels of Evidence: Level III: Systematic review.
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Affiliation(s)
- Pejma Shazadeh Safavi
- University of Texas Medical Branch at Galveston, Galveston, Texas (PSS, CJ, DJ, DK, VKB).,United States Navy (CJ)
| | - Cory Janney
- University of Texas Medical Branch at Galveston, Galveston, Texas (PSS, CJ, DJ, DK, VKB).,United States Navy (CJ)
| | - Daniel Jupiter
- University of Texas Medical Branch at Galveston, Galveston, Texas (PSS, CJ, DJ, DK, VKB).,United States Navy (CJ)
| | - Daniel Kunzler
- University of Texas Medical Branch at Galveston, Galveston, Texas (PSS, CJ, DJ, DK, VKB).,United States Navy (CJ)
| | - Roger Bui
- University of Texas Medical Branch at Galveston, Galveston, Texas (PSS, CJ, DJ, DK, VKB).,United States Navy (CJ)
| | - Vinod K Panchbhavi
- University of Texas Medical Branch at Galveston, Galveston, Texas (PSS, CJ, DJ, DK, VKB).,United States Navy (CJ)
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68
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Sherman TI, Koury K, Orapin J, Schon LC. Lateral Transfer of the Flexor Digitorum Longus for Peroneal Tendinopathy. Foot Ankle Int 2019; 40:1012-1017. [PMID: 31203651 DOI: 10.1177/1071100719853297] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Few studies have reported midterm outcomes after single-stage flexor digitorum longus (FDL) tendon transfer to the lateral foot for irreparable rupture of the peroneal tendons. METHODS Over a 7-year period (2008-2015), 25 consecutive patients underwent transfer of the FDL to the fifth metatarsal for irreparable peroneal tendon tears. Of these, 15 patients were available for inclusion with a mean follow-up of 53.7 ± 23.3 months, mean age at surgery of 48.4 years, and mean body mass index (BMI) of 29.8 kg/m2. Patients completed the pain visual analog scale (VAS), Foot Function Index (FFI), Short Musculoskeletal Function Assessment (SMFA), and Foot and Ankle Ability Measure (FAAM) and participated in range of motion, peak force, and peak power testing. RESULTS All 15 patients were satisfied with their surgery and reported a reduction in their pain level with a decreased VAS of 5.6 ± 2.5. The mean FFI was 12.8 ± 9.2, the SMFA Function Index was 12.4 ± 8, and the mean SMFA Bothersome Index was 11.5 ± 11. The mean FAAM was 86.4 ± 9.7. Patients had on average 58% less eversion and 28% less inversion compared with the nonoperative side. Isometric peak torque and isotonic peak velocity were 38.4% and 28.8% less compared with the contralateral side, respectively. The average power in the operative limb was diminished by 56% compared with the nonoperative limb. CONCLUSION In this small case series with midterm follow-up, FDL transfer to the lateral foot for significant, irreparable peroneal tendinopathy was an effective and durable treatment option. LEVEL OF EVIDENCE Level IV, retrospective case series.
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Affiliation(s)
- Thomas I Sherman
- 1 Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Kimberly Koury
- 1 Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Jakrapong Orapin
- 1 Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Lew C Schon
- 1 Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
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Ho LF, Guo Y, Ching JYL, Chan KL, Tsang PH, Wong MH, Chen L, Ng BFL, Lin ZX. Efficacy and safety of electroacupuncture plus warm needling therapy for heel pain: study protocol for a randomized controlled trial. Trials 2019; 20:480. [PMID: 31391104 PMCID: PMC6686470 DOI: 10.1186/s13063-019-3572-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 07/11/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Heel pain is a common foot disorder that causes pain and functional limitations. The prevalence of disabling foot pain will increase as the population ages. Previous studies have reported the positive therapeutic effects of electroacupuncture, warm needling, or the combination of both for heel pain but with limitations in the study methodologies. The current study is a rigorously designed randomized controlled trial that aims to evaluate the clinical efficacy and safety of electroacupuncture plus warm needling therapy in patients with heel pain. METHODS/DESIGN The study protocol describes a prospective, open-label, parallel-group, randomized controlled trial to be conducted in Hong Kong. Eighty patients aged 50-80 years who have reported heel pain and first-step pain equal to or exceeding 50 mm on the 100-mm visual analog scale (VAS) will be recruited. They will be randomly assigned (1:1 ratio) to the electroacupuncture plus warm needling therapy (i.e., treatment) group or the waitlist (i.e., control) group. The treatment group will undergo six treatment sessions in 4 weeks. The control group will receive no treatment during the study period. The primary outcome measure is a mean change in the first-step pain VAS score from the baseline to week 4. Secondary outcome measures include a mean change in first-step pain VAS score from the baseline to week 2, a mean change in Foot Function Index (FFI) subscale scores and the total score from the baseline to week 2 and week 4, and patients' self-reported level of improvement at week 4. Additional week 8 follow-up assessments with first-step pain VAS and FFI measurements will be arranged for the treatment group. Any adverse events will be recorded throughout the study to evaluate safety. An intention-to-treat approach will be used to analyze the study results. DISCUSSION This study will provide evidence on the efficacy and safety of electroacupuncture plus warm needling therapy as an alternative treatment method for heel pain. The findings will determine whether the treatment protocol is efficacious in relieving pain and improving foot function among older adults with heel pain. The study will also provide information for subsequent large-scale randomized controlled trials in the future. TRIAL REGISTRATION Chinese Clinical Trial Registry, ChiCTR1800014906 . Registered on 12 February 2018.
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Affiliation(s)
- Lai Fun Ho
- Chinese Medicine Services, Pok Oi Hospital, Hong Kong SAR, China
| | - Yuanqi Guo
- Chinese Medicine Services, Pok Oi Hospital, Hong Kong SAR, China
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jessica Yuet-Ling Ching
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kam Leung Chan
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ping Him Tsang
- Chinese Medicine Services, Pok Oi Hospital, Hong Kong SAR, China
| | - Man Hin Wong
- Chinese Medicine Services, Pok Oi Hospital, Hong Kong SAR, China
| | - Liyi Chen
- Chinese Medicine Services, Pok Oi Hospital, Hong Kong SAR, China
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - Zhi-Xiu Lin
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Klaue K, Wichelhaus A, Maik P, Mittlmeier T. The circular arc shaped nail for fixing the tibiotalocalcaneal arthrodesis. After clinical results. Injury 2019; 50 Suppl 3:23-31. [PMID: 31378544 DOI: 10.1016/j.injury.2019.07.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/09/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Tibiotalocalcaneal arthrodesis is commonly considered a salvage option for a variety of hindfoot disorders involving the ankle and subtalar joint mostly with concomitant deformity. Retrograde interlocking nailing represents one of the biomechanically most stable fixation modes after reduction of hindfoot geometry. The considerable complications, non-union and revision rates at a moderate outcome reported even with modern retrograde nails underscore the idea that the development of an optimized retrograde nail may be warranted. METHODS A novel circular shaped nail was designed with a perfect fit to the reamed canal and the implant geometry which respects physiologic hindfoot anatomy and alignment. The present clinical series reports the experience and the clinical and radiographic outcomes after application of the implant in the first 30 consecutive patients. Assessments included validated versions of the AOFAS Ankle/Hindfoot Score and the Foot Function Index. RESULTS Anatomical alignment was achieved and maintained in 29/30 cases with a single case of later loss of reduction due to a technical error which led to surgical reintervention two months after the index procedure. The overall union rate reached 93%. Two non-unions (one ankle, one subtalar joint) were observed without necessitating further surgery. Three superficial surgical site infections were registered which made a local flap coverage necessary in two patients due to local skin break-down. No deep infection occurred. There were 2 implant removals, one was not related to hindfoot nailing. At the time of follow-up, the AOFAS Ankle/Hindfoot Score was 57 (median) from a maximum of 86 points. The self-assessment via the Foot Function Index improved from preoperative 155 points to 62.5 postoperatively (median values, p<0.001, Wilcoxon test). CONCLUSION On the basis of our results, which saw a high rate of successful fusion and patient satisfaction and where the hindfoot reduction was maintained until definite healing in the vast majority of cases, the novel circular arc nail represents a viable and safe option for tibiotalocalcaneal arthrodesis with a low complication rate.
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Affiliation(s)
- Kaj Klaue
- Reparto di Chirurgia Ortopedica, Clinica Luganese, sede Moncucco, CH-6900, Lugano, Switzerland
| | - Alice Wichelhaus
- Rostock University Medical Center, Dept. of Trauma, Hand and Reconstructive Surgery, Schillingallee 35, D-18057, Rostock, Germany
| | - Paulina Maik
- Rostock University Medical Center, Dept. of Trauma, Hand and Reconstructive Surgery, Schillingallee 35, D-18057, Rostock, Germany
| | - Thomas Mittlmeier
- Rostock University Medical Center, Dept. of Trauma, Hand and Reconstructive Surgery, Schillingallee 35, D-18057, Rostock, Germany.
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Cole W, Samsell B, Moore MA. Achilles Tendon Augmented Repair Using Human Acellular Dermal Matrix: A Case Series. J Foot Ankle Surg 2019; 57:1225-1229. [PMID: 29779989 DOI: 10.1053/j.jfas.2018.03.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Indexed: 02/03/2023]
Abstract
Achilles tendon ruptures are common in the general population, especially among members of the older demographic occasionally active in sports. Operative treatments provide a lower incidence of rerupture than do nonoperative treatments, although surgical complications remain a concern. The use of a human acellular dermal matrix to augment Achilles tendon repair might reduce the incidence of complications. In the present case series, we describe the outcomes of 9 patients who underwent Achilles tendon repair with acellular dermal matrix augmentation. Functional outcomes were evaluated using the Foot Function Index-Revised long form, and the clinical results were recorded. After a mean average follow-up period of 14.4 (range 12.0 to 20.0) months, the mean Foot Function Index-Revised long form score was 33.0% ± 4.2%. No cases of rerupture or complications that required additional treatment occurred during the observation period. The outcomes we have presented support further evaluation beyond this case series for using a human acellular dermal matrix to augment Achilles tendon repairs.
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Affiliation(s)
- Windy Cole
- Adjunct Faculty and Director, Wound Care Research, Kent State University College of Podiatric Medicine, Independence, OH; Medical Director, Wound Care Center, University Hospitals Ahuja Medical Center, Beachwood, OH.
| | - Brian Samsell
- Scientific Writer, Scientific Affairs, LifeNet Health, Virginia Beach, VA
| | - Mark A Moore
- Global Senior Director, Scientific Affairs, LifeNet Health, Virginia Beach, VA
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Rushing CJ, Rathnayake VR, Oxios AJ, Galan GP, Ramil M, Spinner SM, Hardigan P. Patient-Perceived Recovery and Outcomes After Silastic Implant Arthroplasty. J Foot Ankle Surg 2019; 57:1080-1086. [PMID: 30172719 DOI: 10.1053/j.jfas.2018.03.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Indexed: 02/03/2023]
Abstract
In some chronic musculoskeletal conditions, patients with persistent pain and disability have still achieved recovery through behavioral adaptations (readjustment) or cognitive coping (redefinition). Although the pendulum shift from physician-reported clinical indicators to patient-reported outcomes measures (PROMs) has recently focused on quantifying residual pain and disability to determine recovery (resolution), whether patients are capable of coping with any ongoing deficits and achieving other forms of recovery has not been considered. We performed a retrospective case series to assess patient-perceived recovery and outcomes after silastic implant arthroplasty for hallux rigidus. From July 2006 to July 2016, 28 patients at a single institution were enrolled. PROMs were prospectively obtained and compared between patients considering themselves recovered without or with residual deficits (recovered-resolved, recovered-not resolved) and those not recovered. Holistic satisfaction, procedure-specific satisfaction, complications, reoperations, and failure rates were recorded. Overall, 50.0% perceived themselves as recovered-resolved, 43% as recovered-not resolved, and 7% as not recovered. The mean modified Foot Function Index was 17.26, the verbal analog scale for pain score was 2.03, and implant survivorship 100% at a median of 67 (interquartile range 28.4 to 103.5) months. Although only 50% of patients reported complete symptom resolution, satisfaction was high, and most perceived themselves as recovered, suggesting recovery in hallux rigidus might not always be predicated by the complete resolution of all symptomatology. Although PROMs relying on pain inference and functional disability will continue to be utilized with increasing frequency, foot and ankle surgeons should be cognizant of their inherent limitations in assessing other forms of recovery.
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Affiliation(s)
| | | | - Adam J Oxios
- Resident, Westside Regional Medical Center, Plantation, FL
| | | | - Madelin Ramil
- Research Director, Westside Regional Medical Center, Plantation, FL
| | - Steven M Spinner
- Residency Director, Westside Regional Medical Center, Plantation, FL
| | - Patrick Hardigan
- Director, Statistical Consulting Center, Nova Southeastern University, Fort Lauderdale, FL
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73
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Morris R, Pallister I, Trickett RW. Measuring outcomes following tibial fracture. Injury 2019; 50:521-533. [PMID: 30482409 DOI: 10.1016/j.injury.2018.11.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 10/31/2018] [Accepted: 11/08/2018] [Indexed: 02/02/2023]
Abstract
AIM The aim of this study was to determine how outcome is measured following adult tibial fracture in the modern era of functional outcome measurement and patient reported outcomes. METHODS A systematic review of publications since 2009 was performed, looking specifically at acute, adult tibial shaft fractures. Ovid Medline, Embase, PubMed and PsycINFO databases were searched for relevant titles which were then screened by two authors with adjudication where necessary by a third. Relevant articles were reviewed in full and data was extracted concerning the study participants, study design and any measures that were used to quantify the results following fracture. The results were collated and patient reported outcome measures were assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) standards. RESULTS A total of 943 titles and articles were reviewed, with 117 included for full analysis. A wide range of clinical and radiological "outcomes" were described, along with named clinician- and patient-reported outcome measures. There was considerable heterogeneity and lack of detail in the description of the simplest outcomes, such as union, infection or reoperation. Reported clinician and patient reported outcome measures are variably used. None of the identified patient reported outcome measures have been validated for use following tibial fracture. CONCLUSION We recommend definition of a core outcome set for use following tibial fracture. This will standardise outcome reporting following these injuries. Furthermore, there is need for a validated patient reported outcome measure to better assess patient important outcomes in this patient group.
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Affiliation(s)
- R Morris
- Department of Trauma & Orthopaedics, Abertawe Bro Morgannwg University Health Board, Morriston Hospital, Swansea, SA6 6NL, UK
| | - I Pallister
- Department of Trauma & Orthopaedics, Abertawe Bro Morgannwg University Health Board, Morriston Hospital, Swansea, SA6 6NL, UK
| | - R W Trickett
- Department of Trauma & Orthopaedics, Abertawe Bro Morgannwg University Health Board, Morriston Hospital, Swansea, SA6 6NL, UK.
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Konings-Pijnappels APM, Tenten-Diepenmaat M, Dahmen R, Verberne SK, Dekker J, Twisk JWR, Roorda LD, van der Leeden M. Forefoot pathology in relation to plantar pressure distribution in patients with rheumatoid arthritis: A cross-sectional study in the Amsterdam Foot cohort. Gait Posture 2019; 68:317-322. [PMID: 30566899 DOI: 10.1016/j.gaitpost.2018.12.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 10/27/2018] [Accepted: 12/10/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND In patients with rheumatoid arthritis (RA), both high and low forefoot plantar pressures have been reported. Better understanding of pathology in the forefoot associated with altered pressure distribution in patients with RA could help to better formulate and specify goals for treatment with foot orthoses or therapeutic footwear. OBJECTIVES To investigate the association of plantar pressure with disease activity and deformity in the forefoot in patients with rheumatoid arthritis and forefoot symptoms. METHODS A cross sectional study, using data of 172 patients with rheumatoid arthritis and forefoot symptoms, was conducted. Peak pressure (PP) and pressure time integral (PTI) in the forefoot were measured with a pressure platform. Forefoot deformity was assessed using the Platto score. Forefoot disease activity was defined as swelling and/or pain assessed by palpation of the metatarsophalangeal joints. The forefoot was divided in a medial, central and lateral region, in which the following conditions could be present: 1) no pathology, 2) disease activity, 3) deformity or 4) disease activity and deformity. A multilevel analysis was performed using condition per forefoot region as independent variable and PP or PTI in the corresponding region as dependent variable. RESULTS Statistically significant higher plantar pressures were found in forefoot regions with deformities (RR 1.2, CI 1.1-1.3, P<0.0001), compared to forefoot regions without forefoot pathology. No significant differences in plantar pressures were found when solely forefoot disease activity was present in forefoot regions. SIGNIFICANCE Forefoot deformities are related to higher plantar pressures measured in the corresponding forefoot regions. The absence of an association between local disease activity and plantar pressure might be explained by the low prevalence of metatarsophalangeal joint pain or swelling. Future research with sensitive imaging measures to detect disease activity is recommended to reveal the effect of forefoot disease activity on plantar pressure.
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Affiliation(s)
- A P M Konings-Pijnappels
- Amsterdam Rehabilitation Research Center, Reade, Dr. Jan van Breemenstraat 2, PO 58271, 1040 HG, Amsterdam, the Netherlands.
| | - M Tenten-Diepenmaat
- Amsterdam Rehabilitation Research Center, Reade, Dr. Jan van Breemenstraat 2, PO 58271, 1040 HG, Amsterdam, the Netherlands.
| | - R Dahmen
- Amsterdam Rehabilitation Research Center, Reade, Dr. Jan van Breemenstraat 2, PO 58271, 1040 HG, Amsterdam, the Netherlands.
| | - S K Verberne
- Amsterdam Rehabilitation Research Center, Reade, Dr. Jan van Breemenstraat 2, PO 58271, 1040 HG, Amsterdam, the Netherlands.
| | - J Dekker
- VU University Medical Center, Department of Rehabilitation Medicine, PO 7057, 1007 MB, Amsterdam, the Netherlands; Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
| | - J W R Twisk
- Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, De Boelelaan 1089a, 1081 HV Amsterdam, the Netherlands.
| | - L D Roorda
- Amsterdam Rehabilitation Research Center, Reade, Dr. Jan van Breemenstraat 2, PO 58271, 1040 HG, Amsterdam, the Netherlands.
| | - M van der Leeden
- Amsterdam Rehabilitation Research Center, Reade, Dr. Jan van Breemenstraat 2, PO 58271, 1040 HG, Amsterdam, the Netherlands; VU University Medical Center, Department of Rehabilitation Medicine, PO 7057, 1007 MB, Amsterdam, the Netherlands; Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
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75
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Al-Boloushi Z, Gómez-Trullén EM, Bellosta-López P, López-Royo MP, Fernández D, Herrero P. Comparing two dry needling interventions for plantar heel pain: a protocol for a randomized controlled trial. J Orthop Surg Res 2019; 14:31. [PMID: 30683124 PMCID: PMC6347763 DOI: 10.1186/s13018-019-1066-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 01/10/2019] [Indexed: 12/18/2022] Open
Abstract
Background Both manual therapy techniques and dry needling have shown to be effective treatment options for the treatment of plantar heel pain; however, in recent years, other techniques based on dry needling (DN), such as percutaneous needle electrolysis (PNE), have also emerged. Currently, PNE is being used in clinical practice to manage myofascial trigger points, despite the lack of studies comparing the effects of this technique over dry needling. Therefore, the aim of this randomized controlled study is to compare the effectiveness of DN versus PNE for improving the level of pain experienced by patients suffering from plantar heel pain provoked by myofascial trigger points. Methods A randomized controlled trial will be conducted with blinded participants and outcome assessors. A sample of 94 patients with a medical diagnosis of plantar heel pain will be recruited and divided into two treatment groups. Eligible participants will be randomly allocated to either (a) treatment group with DN and a self-stretching home program or (b) treatment group with PNE and a self-stretching home program. Each group will receive one treatment session per week over a period of 4 weeks. The primary outcome measure will be the pain subscale of the Foot Health Status Questionnaire. The secondary outcome measures will be a visual analogue scale for pain (average and highest level of pain experienced during the previous 48 h; level of pain immediately after the treatment session) and health-related quality of life (assessed using the EuroQoL-5 dimensions). Cost-effectiveness data will be extracted based on the EuroQoL-5 dimensions. Follow-up measurements will take place at baseline and at 4, 8, 12, 26, and 52 weeks. Discussion The justification for this trial is the need to improve current understanding regarding the effectiveness of treatments targeting the rehabilitation of plantar heel pain. This study will be the first randomized controlled trial to directly compare the effectiveness of DN and PNE combined with a specific stretching program for the treatment of plantar heel pain provoked by myofascial trigger points. Trial registration Clinical Trials NCT03236779. Registered at clinicaltrials.gov 2 August 2017.
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Affiliation(s)
- Zaid Al-Boloushi
- Department of Physical Medicine and Rehabilitation and Nursing, Health Sciences Faculty, University of Zaragoza, C/ Domingo Miral s/n, 50009, Zaragoza, Spain.,iPhysio Research Group, Universidad San Jorge, Campus Universitario, Autov. A23 km 299, 50830. Villanueva de Gállego, Zaragoza, Spain.,Ministry of Health, State of Kuwait, Jamal Abdulnasser Street, Al Solaibeykhat Area Safat, 13001, Kuwait City, Kuwait
| | - Eva María Gómez-Trullén
- Department of Physical Medicine and Rehabilitation and Nursing, Health Sciences Faculty, University of Zaragoza, C/ Domingo Miral s/n, 50009, Zaragoza, Spain
| | - Pablo Bellosta-López
- iPhysio Research Group, Universidad San Jorge, Campus Universitario, Autov. A23 km 299, 50830. Villanueva de Gállego, Zaragoza, Spain
| | - María Pilar López-Royo
- Department of Physical Medicine and Rehabilitation and Nursing, Health Sciences Faculty, University of Zaragoza, C/ Domingo Miral s/n, 50009, Zaragoza, Spain.,iPhysio Research Group, Universidad San Jorge, Campus Universitario, Autov. A23 km 299, 50830. Villanueva de Gállego, Zaragoza, Spain
| | - Daniel Fernández
- iPhysio Research Group, Universidad San Jorge, Campus Universitario, Autov. A23 km 299, 50830. Villanueva de Gállego, Zaragoza, Spain
| | - Pablo Herrero
- iPhysio Research Group, Universidad San Jorge, Campus Universitario, Autov. A23 km 299, 50830. Villanueva de Gállego, Zaragoza, Spain.
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Freed L, Ellis MB, Johnson K, Haddon TB. Fasciotomy and Surgical Tenotomy for Chronic Achilles Insertional Tendinopathy A Retrospective Study Using Ultrasound-Guided Percutaneous Microresection. J Am Podiatr Med Assoc 2019; 109:1-8. [PMID: 30964321 DOI: 10.7547/15-168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Achilles insertional tendon pathology is a common condition affecting a broad range of patients. When conservative treatments are unsuccessful, the traditional open resection, debridement, and reattachment of the Achilles tendon is a variably reliable procedure with significant risk of morbidity. Fasciotomy and surgical tenotomy using ultrasound-guided percutaneous microresection is used on various tendons in the body, but the efficacy has not been examined specifically for the Achilles tendon. METHODS A retrospective review evaluated 26 procedures in 25 patients who underwent Achilles fasciotomy and surgical tenotomy. The Foot Function Index was used to quantify pain, disability, activity limitation, and overall scores. RESULTS Mean Foot Function Index scores were as follows: pain, 8.53%; disability, 7.91%; activity limitation, 2.50%; and overall, 6.97%. Twenty index procedures were successful, and two patients repeated the procedure successfully for an overall 84.6% success rate in patients with chronic insertional pathology with mean surveillance of 16 months. There were no infections or systemic complications. CONCLUSIONS Ultrasound-guided percutaneous microresection is a safe and minimally invasive percutaneous alternative that can be used before proceeding to a more invasive open procedure.
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Affiliation(s)
- Lewis Freed
- East Valley Foot and Ankle Specialists, Mesa, AZ
| | - Mark B. Ellis
- Department of Podiatry, George E. Wahlen VA Medical Center, Salt Lake City, UT
| | - Kate Johnson
- A Step Ahead Foot and Ankle Center, Fort Collins, CO
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Dunning J, Butts R, Henry N, Mourad F, Brannon A, Rodriguez H, Young I, Arias-Buría JL, Fernández-de-las-Peñas C. Electrical dry needling as an adjunct to exercise, manual therapy and ultrasound for plantar fasciitis: A multi-center randomized clinical trial. PLoS One 2018; 13:e0205405. [PMID: 30379937 PMCID: PMC6209187 DOI: 10.1371/journal.pone.0205405] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 09/25/2018] [Indexed: 12/31/2022] Open
Abstract
Study Design Randomized, single-blinded, multi-center, parallel-group trial. Objectives To compare the effects of adding electrical dry needling into a program of manual therapy, exercise and ultrasound on pain, function and related-disability in individuals with plantar fasciitis (PF). Background The isolated application of electrical dry needling, manual therapy, exercise, and ultrasound has been found to be effective for PF. However, no previous study has investigated the combined effect of these interventions in this population. Methods One hundred and eleven participants (n = 111) with plantar fasciitis were randomized to receive electrical dry needling, manual therapy, exercise and ultrasound (n = 58) or manual therapy, exercise and ultrasound (n = 53). The primary outcome was first-step pain in the morning as measured by the Numeric Pain Rating Scale (NPRS). Secondary outcomes included resting foot pain (NPRS), pain during activity (NPRS), the Lower Extremity Functional Scale (LEFS), the Foot Functional Index (FFI), medication intake, and the Global Rating of Change (GROC). The treatment period was 4 weeks with follow-up assessments at 1 week, 4 weeks, and 3 months after the first treatment session. Both groups received 6 sessions of impairment-based manual therapy directed to the lower limb, self-stretching of the plantar fascia and the Achilles tendon, strengthening exercises for the intrinsic muscles of the foot, and therapeutic ultrasound. In addition, the dry needling group also received 6 sessions of electrical dry needling using a standardized 8-point protocol for 20 minutes. The primary aim was examined with a 2-way mixed-model analysis of covariance (ANCOVA) with treatment group as the between-subjects variable and time as the within-subjects variable after adjusting for baseline outcomes. Results The 2X4 ANCOVA revealed that individuals with PF who received electrical dry needling, manual therapy, exercise and ultrasound experienced significantly greater improvements in first-step morning pain (F = 22.021; P<0.001), resting foot pain (F = 23.931; P<0.001), pain during activity (F = 7.629; P = 0.007), LEFS (F = 13.081; P<0.001), FFI Pain Subscale (F = 13.547; P<0.001), FFI Disability Subscale (F = 8.746; P = 0.004), and FFI Total Score (F = 10.65; P<0.001) than those who received manual therapy, exercise and ultrasound at 3 months. No differences in FFI Activity Limitation Subscale (F = 2.687; P = 0.104) were observed. Significantly (X2 = 9.512; P = 0.023) more patients in the electrical dry needling group completely stopped taking medication for their pain compared to the manual therapy, exercise and ultrasound group at 3 months. Based on the cutoff score of ≥+5 on the GROC, significantly (X2 = 45.582; P<0.001) more patients within the electrical dry needling group (n = 45, 78%) achieved a successful outcome compared to the manual therapy, exercise and ultrasound group (n = 11, 21%). Effect sizes ranged from medium to large (0.53<SMD<0.85) at 3 months in favor of the electrical dry needling group. Conclusion The inclusion of electrical dry needling into a program of manual therapy, exercise and ultrasound was more effective for improving pain, function and related-disability than the application of manual therapy, exercise and ultrasound alone in individuals with PF at mid-term (3 months). Level of evidence Therapy, Level 1b.
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Affiliation(s)
- James Dunning
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, Alabama, United States of America
- * E-mail:
| | - Raymond Butts
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, Alabama, United States of America
- Research Physical Therapy Specialists, Columbia, South Carolina, United States of America
| | - Nathan Henry
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, Alabama, United States of America
- Troop Medical Clinic, Eglin Air Force Base, Florida, United States of America
| | - Firas Mourad
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
- Universita di Roma Tor Vergata, Italy
| | - Amy Brannon
- TOPS Physical Therapy and Orthopaedics, Phoenix, Arizona, United States of America
| | - Hector Rodriguez
- Manual Physical Therapy Specialists, El Paso, Texas, United States of America
| | - Ian Young
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, Alabama, United States of America
- CORA Physical Therapy, Savannah, Georgia, United States of America
| | - Jose L Arias-Buría
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
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Comparison of effects of low-level laser therapy and extracorporeal shock wave therapy in plantar fasciitis treatment: A randomized, prospective, single-blind clinical study. Turk J Phys Med Rehabil 2018; 65:184-190. [PMID: 31453560 DOI: 10.5606/tftrd.2019.3528] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 08/27/2018] [Indexed: 12/26/2022] Open
Abstract
Objectives The aim of this study is to compare the efficacy of extracorporeal shock wave therapy (ESWT) and low-level laser therapy (LLLT) in terms of fascia thickness, heel pain, and foot functions in patients with plantar fasciitis (PF). Patients and methods Between April 2015 and October 2015, a total of 34 patients (5 males, 29 females; mean age 51.5±10.8 years; range, 18 to 65 years) with PF were randomized into two treatment groups to receive either ESWT or LLLT using closed envelope method. The patients were evaluated before and after treatment and one month after treatment using the visual analog scale (VAS)-pain, Foot Function Index (FFI), and plantar fascia thickness measured by ultrasonography. Results A significant improvement in the VAS-pain and FFI scores and plantar fascia thickness was observed in both groups after treatment and one month after treatment, compared to pre-treatment values (p<0.05). Changes over time in these outcome parameters were not different between study groups (p>0.05). Conclusion Our study results suggest that both ESWT and LLLT seem to be effective on pain, foot functions, and fascia thickness in the treatment of PF.Presented at the 26th National Congress of Physical Medicine and Rehabilitation, April 25-29, 2017 Antalya, Turkey.
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Cazzell S, Stewart J, Agnew PS, Senatore J, Walters J, Murdoch D, Reyzelman A, Miller SD. Randomized Controlled Trial of Micronized Dehydrated Human Amnion/Chorion Membrane (dHACM) Injection Compared to Placebo for the Treatment of Plantar Fasciitis. Foot Ankle Int 2018; 39:1151-1161. [PMID: 30058377 DOI: 10.1177/1071100718788549] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Failure of conservative management to reduce/eliminate symptoms of plantar fasciitis (PF) may indicate need for advanced treatments. This study reports Level 1 evidence supporting 3-month safety and efficacy of micronized dehydrated human amnion/chorion membrane (dHACM) injection as a treatment for PF. METHODS A prospective, single-blind, randomized controlled trial was conducted at 14 sites in the United States. Subjects were randomized to receive 1 injection, in the affected area, of micronized dHACM (n=73) or 0.9% sodium chloride placebo (n=72). Safety/efficacy assessments were conducted at 4 weeks, 8 weeks, 3 months, 6 months, and 12 months postinjection, using visual analog scale (VAS) for pain, Foot Function Index-Revised (FFI-R) score, and presence/absence of adverse events. Primary outcome was mean change in VAS score between baseline and 3 months expressed as difference in means for treatment versus control subjects. Secondary outcome was mean change in FFI-R score between baseline and 3 months expressed as difference in means for treatment versus control subjects. RESULTS Baseline VAS scores were similar between groups. At the 3-month follow-up, mean VAS scores in the treatment group were 76% lower compared with a 45% reduction for controls ( P < .0001), FFI-R scores for treatment subjects had mean reduction of 60% versus baseline, whereas control subjects had mean reduction of 40% versus baseline ( P = .0004). Of 4 serious adverse events, none were related to study procedures. CONCLUSION Pain reduction and functional improvement outcomes were statistically significant and clinically relevant, supporting use of micronized dHACM injection as a safe and effective treatment for PF. LEVEL OF EVIDENCE Level I, prospective randomized trial.
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Affiliation(s)
| | | | | | | | - Jodi Walters
- 5 Southern Arizona VA Health Care System, Tuscon, AZ, USA
| | | | - Alex Reyzelman
- 7 Center for Clinical Research, Inc, Castro Valley, CA, USA
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Clinical effectiveness of multi-wavelength photobiomodulation therapy as an adjunct to extracorporeal shock wave therapy in the management of plantar fasciitis: a randomized controlled trial. Lasers Med Sci 2018; 34:583-593. [PMID: 30194553 DOI: 10.1007/s10103-018-2632-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Accepted: 08/30/2018] [Indexed: 01/21/2023]
Abstract
The goal of our study was to investigate the cumulative effect of combining medium-energy extracorporeal shock wave therapy (ESWT) and photobiomodulation therapy (PBMT), as well as to compare between their relative effectiveness in the management of plantar fasciitis (PF). One hundred twenty participants with chronic PF, more than 6 months with failure to respond to conservative treatment, were randomly assigned into four equal groups. Participants received either ESWT with PBMT, ESWT (once a week), PBMT (three times a week), or sham-PBMT (three times a week) for three consecutive weeks. A home exercise program was also included for all four groups. Outcome measures included pressure pain threshold (PPT), visual analogue scale (VAS), and functional foot index disability subscale (FFI-d) that were collected prior to the first treatment session and at the end of the 3-week treatment period, as well as at a follow-up session, 12 weeks after the final treatment session. There were statistically significant improvements in post-intervention and follow-up PPT, VAS, and FFI-d values in all treatment groups (P < 0.0001). As for the sham-PBMT, no significant difference was found between the pre-, post-intervention and follow-up values (P > 0.05). Bonferroni correction test revealed that there was a significant difference between all the four groups in PPT, VAS, and FFI-d values (P < 0.0001). All active treatment groups maintained the treatment effect at the 12-week follow-up. Both ESWT and PBMT were effective in increasing PPT values, decreasing pain and increasing functional ability. Additionally, application of PBMT after ESWT was shown to be superior over ESWT and PBMT alone, and ESWT was superior over PBMT in terms of reducing pain sensitivity and increasing function.Level of Evidence II.
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Plaza-Manzano G, Ríos-León M, Martín-Casas P, Arendt-Nielsen L, Fernández-de-Las-Peñas C, Ortega-Santiago R. Widespread Pressure Pain Hypersensitivity in Musculoskeletal and Nerve Trunk Areas as a Sign of Altered Nociceptive Processing in Unilateral Plantar Heel Pain. THE JOURNAL OF PAIN 2018; 20:60-67. [PMID: 30121357 DOI: 10.1016/j.jpain.2018.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 07/28/2018] [Accepted: 08/12/2018] [Indexed: 02/03/2023]
Abstract
Our aim was to investigate the differences in pressure sensitivity over musculoskeletal and nerve symptomatic and distant areas between individuals with plantar heel pain and healthy subjects and to determine the relationship between sensitivity to pressure pain, foot pain, and fascia thickness. Thirty-five patients with unilateral chronic plantar heel pain and 35 matched healthy controls participated. Pressure pain thresholds (PPTs) were assessed bilaterally over several nerve trunks (median, radial, ulnar, common peroneal, tibial, and sural nerve trunks) and musculoskeletal structures (calcaneus, medial gastrocnemius, tibialis anterior, and second metacarpal) by an assessor blinded to the subject's condition. Pain was assessed with a numerical pain rating scale (0-10), impact of foot pain was assessed with the Foot Function Index, and plantar fascia thickness was measured via ultrasound imaging. Analysis of covariance revealed lower widespread and bilateral PPTs over both nerve trunks and musculoskeletal structures in individuals with plantar heel pain (P < .001). Female patients showed lower PPT than male patients in almost all points (P < .001). PPT over the peripheral nerve trunks of the lower extremity were significantly associated with the intensity of pain at first step in the morning and with the foot function disability scale of the Foot Function Index (P < .05). This study found widespread pressure pain hypersensitivity over both nerve trunks and musculoskeletal structures in individuals with unilateral chronic plantar heel pain, suggesting the presence of a central altered central nociceptive pain processing. Pressure hypersensitivity over nerve trunks on the lower extremity was associated with higher pain intensity and related disability. PERSPECTIVES: This study found widespread pressure hypersensitivity over both nerve trunks and musculoskeletal structures in individuals with unilateral chronic plantar heel pain, as a manifestation of a centrally altered central nociceptive pain processing.
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Affiliation(s)
- Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - Marta Ríos-León
- Alumna de Doctorado, Escuela Internacional de Doctorado Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Patricia Martín-Casas
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - Lars Arendt-Nielsen
- Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, School of Medicine, Aalborg University, Aalborg, Denmark
| | - César Fernández-de-Las-Peñas
- Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, School of Medicine, Aalborg University, Aalborg, Denmark; Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain; Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
| | - Ricardo Ortega-Santiago
- Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, School of Medicine, Aalborg University, Aalborg, Denmark; Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
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Park SY, Bang HS, Park DJ. Potential for foot dysfunction and plantar fasciitis according to the shape of the foot arch in young adults. J Exerc Rehabil 2018; 14:497-502. [PMID: 30018939 PMCID: PMC6028224 DOI: 10.12965/jer.1836172.086] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 04/16/2018] [Indexed: 11/22/2022] Open
Abstract
This study investigated potential for foot dysfunction and plantar fasciitis according to the shape of the foot arch in young adults. Fifty-two participants were required for the present study design to achieve 80% power, 0.8 effect size (η2), and an alpha level of 0.05. This study recruited 52 young adults (30 men and 22 women). All participants voluntarily agreed to participate in the study after hearing explanations about the purpose and process of the study. They were divided into two groups of 26 according to the shape of foot with and without flat foot using the navicular drop test. The participants were measured the foot function index (FFI), range of motion (ROM) of ankle, and four-way ankle strength. Additionally, the thickness of the plantar fascia was measured using ultrasonography. Intraclass correlation coefficient (ICC) was used to verify the inter- and intrarater reliability of ultrasonography. The inter- and intrarater reliability was excellent (ICC2,1=0.88, ICC3,1=0.93). There were significant differences in dorsi-flexion of ankle ROM, FFI, dorsi-flexion and eversion of ankle strength, and the thickness of the plantar fascia between the two groups (P<0.05). Based on the results, the group with flat foot may gradually generate potential of the foot dysfunction and plantar fasciitis. Therefore, the interventions are necessary to improve the foot dysfunction and plantar fasciitis in people with flat foot.
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Affiliation(s)
- Se-Yeon Park
- Department of Physical Therapy, College of Health Medicine, Kaya University, Gimhae, Korea
| | - Hyun-Seok Bang
- Department of Physical Education, College of Health, Social Welfare and Education, Tongmyong University, Busan, Korea
| | - Du-Jin Park
- Department of Physical Therapy, College of Health Medicine, Kaya University, Gimhae, Korea
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83
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Validity of the Hispanic version of the American Academy of Orthopaedic Surgeons Foot and Ankle Outcomes Questionnaire in patients with traumatic foot and ankle injuries. OTA Int 2018; 1:e001. [PMID: 33937639 PMCID: PMC7953699 DOI: 10.1097/oi9.0000000000000001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 03/12/2018] [Indexed: 12/02/2022]
Abstract
Background: Hispanics represent the largest minority group in the United States and are projected to represent 29% of the US population by 2060. Enrolling Hispanic patients in clinical outcome trials is critical to study a representative sample of the general population. Lack of translated and validated survey tools has been identified as a major barrier to enrolling Spanish speaking patients. The purpose of this validation study was to study the correlation between the Spanish translation of the American Academy of Orthopaedic Surgeons Foot and Ankle Outcomes questionnaire (AAOS-FAOQ) and the Spanish versions of the Foot Function Index (FFI) and the Foot Health Status Questionnaire (FHSQ) in Hispanics from Mexican lineage with traumatic foot and ankle injuries. Methods: A cross-sectional validation study in 36 Hispanic patients from Mexican lineage with foot and ankle injuries was performed. The Hispanic version of the AAOS-FAOQ and the Spanish translations of the FAOQ, FHSQ, FFI, and the Short-Form 36 questionnaire (SF-36) were distributed among all patients. Subsequent statistical analysis correlating the Hispanic version of the AAOS-FAOQ to the FFI, FHSQ, and SF-36 was performed. Additional analysis on the Hispanic AAOS-FAOQ included test–retest reliability and internal consistency. Results: The Hispanic AAOS-FAOQ Global Foot and Ankle subscale showed statistically significant (P < .05) correlations with 5 of 8 subscales of the FHSQ, the FFI, and the Physical Component Summary subscale of the SF-36. The AAOS-FAOQ Global Foot & Ankle Scale also demonstrated a test–retest reliability of 0.736 and a strong internal consistency. Conclusions: This study further validates AAOS-FAOQ in Mexican Hispanics by showing strong correlations with the validated Spanish versions of the FFI and FHSQ.
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84
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Reliability and validity of the Turkish version of the foot function index in patients with calcaneal heel spur. JOURNAL OF SURGERY AND MEDICINE 2018. [DOI: 10.28982/josam.408694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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85
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Gatt A, Grech M, Chockalingam N, Formosa C. A Preliminary Study on the Effect of Computer-Aided Designed and Manufactured Orthoses on Chronic Plantar Heel Pain. Foot Ankle Spec 2018; 11:112-116. [PMID: 28513217 DOI: 10.1177/1938640017709906] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Chronic plantar heel pain (CPHP) is a significant, painful condition referring to a range of undifferentiated foot conditions that affect the heel of the foot. METHOD Participants presenting with CPHP of more than 6 months' duration were recruited on a first through the door basis. Computer-Aided Design and Computer-Aided Manufactured (CAD-CAM) orthoses were designed and constructed for each participant, then dispensed as per normal practice. Pre- and postintervention assessment of pain was performed at baseline and after 6 weeks of use, utilizing the pain subset of the Foot Function Index (FFI). RESULTS There was a significant reduction in the mean pain scores for all participants in all constructs of the FFI. Total FFI score was also significant ( P = .003). CONCLUSION CAD-CAM orthoses have the potential to become a treatment modality of choice in CPHP since they have resulted in a significant improvement in heel pain after only 6 weeks' use. LEVELS OF EVIDENCE Therapeutic, Level IV: Prospective, comparative trial.
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Affiliation(s)
- Alfred Gatt
- Faculty of Health Sciences, University of Malta, Msida, Malta (AG, MG, CF).,Faculty of Health Sciences, Staffordshire University, Stoke on Trent, UK (NC)
| | - Mark Grech
- Faculty of Health Sciences, University of Malta, Msida, Malta (AG, MG, CF).,Faculty of Health Sciences, Staffordshire University, Stoke on Trent, UK (NC)
| | - Nachiappan Chockalingam
- Faculty of Health Sciences, University of Malta, Msida, Malta (AG, MG, CF).,Faculty of Health Sciences, Staffordshire University, Stoke on Trent, UK (NC)
| | - Cynthia Formosa
- Faculty of Health Sciences, University of Malta, Msida, Malta (AG, MG, CF).,Faculty of Health Sciences, Staffordshire University, Stoke on Trent, UK (NC)
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86
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Cinar E, Saxena S, Uygur F. Combination Therapy Versus Exercise and Orthotic Support in the Management of Pain in Plantar Fasciitis: A Randomized Controlled Trial. Foot Ankle Int 2018; 39:406-414. [PMID: 29327602 DOI: 10.1177/1071100717747590] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND This study aimed at estimating the effectiveness of two commonly used modalities-extracorporeal shock wave therapy (ESWT) and low-level laser therapy (LLLT)-each combined with usual care (exercises and orthotic supports) in comparison to only usual care to relieve pain in patients with plantar fasciitis (PF). METHODS Participants with PF were randomly allocated into 3 groups: ESWT (n = 25), LLLT (n = 24), and control (n = 17). All participants received a home exercise program with orthotic support. The ESWT group received 2000 shock waves with 0.02 mJ/mm2 for 3 sessions, once a week; LLLT group received gallium-aluminum-arsenide laser with 850 nm wavelength for 10 sessions, 3 times a week. Pain was measured by Foot Function Index-pain subscale (FFI-p) and Numerical Rating Scale for pain (NRS-p). The scores were recorded at baseline, third week, and third month after the treatment. Analysis was performed using repeated measures ANOVA. RESULTS There was a significant improvement in pain over the 3 months in all groups on both FFI-p ( P < .001) and NRS-p ( P < .001). In NRS-p, LLLT group had significantly lower pain than ESWT ( P = .002) at the third week and control ( P = .043) and ESWT ( P = .003) at third month. In FFI-p total score, ESWT group had higher pain than LLLT ( P = .003) and control ( P = .035) groups at third week and LLLT ( P = .010) group at third month. CONCLUSION When LLLT and ESWT were combined with usual care, LLLT was found to be more effective than ESWT in reducing pain in PF at short-term follow-up. LEVEL OF EVIDENCE Level II, comparative study.
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Affiliation(s)
- Eda Cinar
- 1 School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Shikha Saxena
- 1 School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Fatma Uygur
- 2 Department of Physical Therapy and Rehabilitation, Faculty of Health Science Cyprus International University, Cyprus, Turkey
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87
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Adaptation and Validation of the Foot Function Index-Revised Short Form into Polish. BIOMED RESEARCH INTERNATIONAL 2017; 2017:6051698. [PMID: 29333446 PMCID: PMC5733175 DOI: 10.1155/2017/6051698] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 10/06/2017] [Accepted: 11/05/2017] [Indexed: 12/12/2022]
Abstract
Purpose The aim of the present study was to adapt the Foot Function Index-Revised Short Form (FFI-RS) questionnaire into Polish and verify its reliability and validity in a group of patients with rheumatoid arthritis (RA). Methods The study included 211 patients suffering from RA. The FFI-RS questionnaire underwent standard linguistic adaptation and its psychometric parameters were investigated. The enrolled participants had been recruited for seven months as a convenient sample from the rheumatological hospital in Śrem (Poland). They represented different sociodemographic characteristics and were characterized as rural and city environments residents. Results The mean age of the patients was 58.9 ± 10.2 years. The majority of patients (85%) were female. The average final FFI-RS score was 62.9 ± 15.3. The internal consistency was achieved at a high level of 0.95 in Cronbach's alpha test, with an interclass correlation coefficient ranging between 0.78 and 0.84. A strong correlation was observed between the FFI-RS and Health Assessment Questionnaire-Disability Index (HAQ-DI) questionnaires. Conclusion The Polish version of FFI-RS-PL indicator is an important tool for evaluating the functional condition of patients' feet and can be applied in the diagnosis and treatment of Polish-speaking patients suffering from RA.
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88
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Younis AS, Michael F, Reda Y, Hamdy M. Jahss type one posterior first metatarsophalangeal dislocation treated with open reduction without fixation: A case report. Trauma Case Rep 2017; 12:54-58. [PMID: 29644286 PMCID: PMC5887096 DOI: 10.1016/j.tcr.2017.10.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2017] [Indexed: 11/27/2022] Open
Affiliation(s)
- Ahmed Saeed Younis
- Department of Orthopaedic Surgery, Ain Shams University Hospitals, Ramses St., Abbasiya sq., Cairo 11566, Egypt
| | - Fady Michael
- Department of Orthopaedic Surgery, Ain Shams University Hospitals, Ramses St., Abbasiya sq., Cairo 11566, Egypt
| | - Yasser Reda
- Department of Orthopaedic Surgery, Ain Shams University Hospitals, Ramses St., Abbasiya sq., Cairo 11566, Egypt
| | - Moheeb Hamdy
- Department of Orthopaedic Surgery, Ain Shams University Hospitals, Ramses St., Abbasiya sq., Cairo 11566, Egypt
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89
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Yi LC, Cabral ACC, Kamonseki DH, Budiman-Mak E, Vidotto MC. Translation and cultural adaptation of the revised foot function index for the Portuguese language: FFI-R Brazil. SAO PAULO MED J 2017; 135:573-577. [PMID: 29236935 PMCID: PMC10016017 DOI: 10.1590/1516-3180.2017.0183030817] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 08/03/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The revised foot function index (FFI-R) is used to evaluate the functionality of patients with conditions that affect the feet. The objective here was to produce the Brazilian Portuguese version of this index. DESIGN AND SETTING Translation and validation study conducted at the Federal University of São Paulo, Brazil. METHODS The translation and cultural adaptation process involved translation by two independent translators, analysis by an expert committee, back translation into the original language, analysis by the expert committee again and a pretest. The Portuguese-language version was administered to 35 individuals with plantar fasciitis and metatarsalgia to determine their level of understanding of the assessment tool. RESULTS Changes were made to the terms and expressions of some original items to achieve cultural equivalence. Terms not understood by more than 10% of the sample were altered based on the suggestions of the patients themselves. CONCLUSION The translation and cultural adaptation of the FFI-R for the Portuguese language were completed and the Brazilian version was obtained.
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Affiliation(s)
- Liu Chiao Yi
- PhD. Professor, Department of Human Movement Sciences, Universidade Federal de São Paulo (UNIFESP), Campus Baixada Santista, Santos (SP), Brazil.
| | - Ana Carolina Camacho Cabral
- Undergraduate Student, Physiotherapy Course, Universidade Federal de São Paulo (UNIFESP), Campus Baixada Santista, Santos (SP), Brazil.
| | - Danilo Harudy Kamonseki
- Postgraduate Student, Universidade Federal de São Paulo (UNIFESP), Campus Baixada Santista, Santos (SP), Brazil.
| | - Elly Budiman-Mak
- PhD. Professor, Medicine Department, Loyola University of Chicago, Chicago, United States.
| | - Milena Carlos Vidotto
- PhD. Professor, Department of Human Movement Sciences, Universidade Federal de São Paulo (UNIFESP), Campus Baixada Santista, Santos (SP), Brazil.
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90
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STÉFANI KELLYCRISTINA, PEREIRA FILHO MIGUELVIANA, OLIVEIRA PEDRORIZZI, Wun PYL. TRANSLATION, CULTURAL ADAPTATION AND VALIDATION OF THE FOOT FUNCTION INDEX - REVISED (FFI-R). ACTA ORTOPEDICA BRASILEIRA 2017; 25:188-193. [PMID: 29081702 PMCID: PMC5608736 DOI: 10.1590/1413-785220172505172107] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective: The aim of this study was to translate, culturally adapt, and validate the “Foot Function Index - Revised” (FFI-R) for use in Brazilian Portuguese. Methods: The scale was translated and administered (as recommended by Guillemin, 2000) to 52 patients in the postoperative period after foot and ankle surgery. Seven days after the initial assessment, the scale was readministered by a different interviewer. The data were entered into an Excel spreadsheet and analyzed using SPSS version 23.0 software for Mac. Reproducibility was assessed using intraclass correlation analysis. Results were considered statistically significant at a type I error rate of 5%. Results: The following random-effects intraclass correlation coefficients (ICC) were obtained for each score on the FFI-R: 0.625 for pain, 0.558 for stiffness, 0.757 for difficulty, 0.718 for activity restrictions, 0.854 for personal concerns, and 0.753 for the total score. Conclusion: The FFI-R was successfully translated to Portuguese and culturally adapted for use in Brazilian patients, demonstrating satisfactory validity and reliability. Level of Evidence I, Testing of Previously Developed Diagnostic Criteria on Consecutive Patients (with universally applied reference “golg” standard).
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91
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Mischke JJ, Jayaseelan DJ, Sault JD, Emerson Kavchak AJ. The symptomatic and functional effects of manual physical therapy on plantar heel pain: a systematic review. J Man Manip Ther 2017; 25:3-10. [PMID: 28855787 DOI: 10.1080/10669817.2015.1106818] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Plantar heel pain is common and can be severely disabling. Unfortunately, a gap in the literature exists regarding the optimal intervention for this painful condition. Consequently, a systematic review of the current literature regarding manual therapy for the treatment of plantar heel pain was performed. METHODS A computer-assisted literature search for randomized controlled trials in MEDLINE, EMBASE, Cochrane, CINAHL, and Rehabilitation & Sports Medicine Source, was concluded on 7 January 2014. After identification of titles, three independent reviewers selected abstracts and then full-text articles for review. RESULTS Eight articles were selected for the final review and underwent PEDro scale assessment for quality. Heterogeneity of the articles did not allow for quantitative analysis. Only two studies scored ≥7/10 on the PEDro scale and included joint, soft tissue, and neural mobilization techniques. These two studies showed statistically greater symptomatic and functional outcomes in the manual therapy group. DISCUSSION This review suggests that manual therapy is effective in the treatment of plantar heel pain; however, further research is needed to validate these findings given the preponderance of low quality studies.
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Affiliation(s)
- John J Mischke
- Department of Physical Therapy, University of Montana, Missoula, MT, USA
| | - Dhinu J Jayaseelan
- Department of Physical Therapy and Health Care Sciences, The George Washington University, Washington, DC, USA
| | - Josiah D Sault
- Department of Physical Therapy, University of Illinois at Chicago, Chicago IL, USA
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92
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Uğurlar M, Sönmez MM, Armağan R, Eren OT. Comparison of two different vacuum-assisted closure (VAC) treatments of multiple chronic diabetic foot wounds in the same extremity. Foot Ankle Surg 2017; 23:173-178. [PMID: 28865586 DOI: 10.1016/j.fas.2016.05.314] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Revised: 03/01/2016] [Accepted: 05/03/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND The aim of the present study is to compare the clinical efficacy and safety of two different vacuum-assisted closure (VAC) applications in one center between two groups of patients with Wagner Grade 3-4 multiple chronic diabetic foot wounds. METHODS The study was a randomized-controlled, prospective investigation between two groups of patients with Wagner Grade 3-4 multiple chronic diabetic foot wounds at single extremity. There were 10 patients in the first group receiving VAC treatment by means of Y-connector and 11 patients in the second group receiving bridge-VAC treatment. RESULTS There were no significant difference in Revised Foot Function Index scores and total treatment costs between the both groups. The cost of the VAC dressing supplies in one session of the dressings was lower in the bridge-VAC group. CONCLUSIONS In conclusion, although bridge-VAC treatment seems to be an alternative method to the VAC treatment by means of Y-connector, we found no superiority of one over the other VAC application for chronic diabetic foot wounds.
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Affiliation(s)
- Meriç Uğurlar
- Department of Orthopaedics and Traumatology, Sisli Hamidiye Etfal Education and Research Hospital, Turkey.
| | - Mesut Mehmet Sönmez
- Department of Orthopaedics and Traumatology, Sisli Hamidiye Etfal Education and Research Hospital, Turkey.
| | - Raffi Armağan
- Department of Orthopaedics and Traumatology, Sisli Hamidiye Etfal Education and Research Hospital, Turkey.
| | - Osman Tuğrul Eren
- Department of Orthopaedics and Traumatology, Sisli Hamidiye Etfal Education and Research Hospital, Turkey.
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93
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Menz HB, Auhl M, Tan JM, Levinger P, Roddy E, Munteanu SE. Predictors of response to prefabricated foot orthoses or rocker-sole footwear in individuals with first metatarsophalangeal joint osteoarthritis. BMC Musculoskelet Disord 2017; 18:185. [PMID: 28499363 PMCID: PMC5427603 DOI: 10.1186/s12891-017-1558-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 05/06/2017] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Osteoarthritis of the first metatarsophalangeal joint (1st MTPJ OA) is a common and disabling condition commonly managed with footwear and orthotic interventions. The objective of this study was to identify factors associated with a successful treatment response in people with 1st MTPJ OA provided with prefabricated orthoses or rocker-sole footwear as part of a randomised clinical trial. METHODS People with 1st MTPJ OA (n = 88) who participated in a randomised trial were allocated to receive prefabricated foot orthoses (n = 47) or rocker-sole footwear (n = 41) and completed a baseline questionnaire including information on demographics, anthropometrics, general health, pain characteristics (including the Foot Health Status Questionnaire [FHSQ] and Foot Function Index [FFI]) and perceptions of the interventions, and a clinical assessment of foot posture, range of motion, radiographic severity and in-shoe plantar pressures. Adherence was documented using diaries. At 12 weeks, participants documented their perception of improvement on a 15-point scale. Those reporting at least moderate improvement on this scale were classified as 'responders'. RESULTS There were 29 responders (62%) in the orthoses group and 16 responders (39%) in the rocker-sole group. In the orthoses group, responders had greater baseline pain severity while walking, a higher FFI difficulty score, and wore their orthoses more frequently. In the rocker-sole group, responders had a higher FFI stiffness score and greater radiographic severity. However, the accuracy of these variables in identifying responders in each group was modest (62 and 53%, respectively). CONCLUSION The response to prefabricated orthoses or rocker-sole footwear in people with 1st MTPJ OA is related to measures of increased pain and disease severity. However, the overall classification accuracy associated with these factors is not sufficient for identifying individuals who are most likely to benefit from these interventions. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12613001245785.
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Affiliation(s)
- Hylton B Menz
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, 3086, VIC, Australia. .,Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, 3086, VIC, Australia. .,Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, ST5 5BG, UK.
| | - Maria Auhl
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, 3086, VIC, Australia.,Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, 3086, VIC, Australia
| | - Jade M Tan
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, 3086, VIC, Australia.,Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, 3086, VIC, Australia
| | - Pazit Levinger
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, 3086, VIC, Australia.,Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, 8001, VIC, Australia
| | - Edward Roddy
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, ST5 5BG, UK
| | - Shannon E Munteanu
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, 3086, VIC, Australia.,Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, 3086, VIC, Australia
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94
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González-Sánchez M, Ruiz-Muñoz M, Li GZ, Cuesta-Vargas AI. Chinese cross-cultural adaptation and validation of the Foot Function Index as tool to measure patients with foot and ankle functional limitations. Disabil Rehabil 2017; 40:2056-2061. [DOI: 10.1080/09638288.2017.1325944] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Manuel González-Sánchez
- Departamento de fisioterapia, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
- Cátedra de Fisioterapia y Discapacidad, Universidad de Málaga, Málaga, Spain
| | - Maria Ruiz-Muñoz
- Departamento de Enfermería y Podología, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - Guang Zhi Li
- Department of Traditional Chinese Medicine, Inner Mongolia Medical University, Hohhot, China
| | - Antonio I. Cuesta-Vargas
- Departamento de fisioterapia, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
- Cátedra de Fisioterapia y Discapacidad, Universidad de Málaga, Málaga, Spain
- School of Clinical Sciences at Queensland University, Brisbane, Australia
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95
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Hunt MA, Takacs J, Krowchuk NM, Hatfield GL, Hinman RS, Chang R. Lateral wedges with and without custom arch support for people with medial knee osteoarthritis and pronated feet: an exploratory randomized crossover study. J Foot Ankle Res 2017; 10:20. [PMID: 28473871 PMCID: PMC5414382 DOI: 10.1186/s13047-017-0201-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 04/22/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pronated foot posture is associated with many clinical and biomechanical outcomes unique to medial compartment knee osteoarthritis (OA). Though shoe-worn insole treatment, including lateral wedges, is commonly studied in this patient population, their effects on the specific subgroup of people with medial knee OA and concomitant pronated feet are unknown. The purpose of this study was to evaluate whether lateral wedge insoles with custom arch support are more beneficial than lateral wedge insoles alone for knee and foot symptoms in people with medial tibiofemoral knee osteoarthritis (OA) and pronated feet. METHODS Twenty-six people with pronated feet and symptomatic medial knee OA participated in a randomized crossover study comparing five degree lateral wedge foot insoles with and without custom foot arch support. Each intervention was worn for two months, separated by a two-month washout period of no insoles wear. Main outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and physical function subscales, the revised short-form Foot Function Index (FFI-R) pain and stiffness subscales, and the timed stair climb test. Regression modeling was conducted to examine treatment, period, and interaction effects. RESULTS Twenty-two participants completed the study, and no carryover or interaction effects were observed for any outcome. Significant treatment effects were observed for the timed stair climb, with greater improvements seen with the lateral wedges with arch support. Within-condition significant improvements were observed for WOMAC pain and physical function, as well as FFI-R pain and stiffness with lateral wedges with arch support use. More adverse effects were reported with the lateral wedges alone, while more people preferred the lateral wedges with arch support overall. CONCLUSIONS Addition of custom arch support to a standard lateral wedge insole may improve foot and knee symptoms in people with knee OA and concomitant pronated feet. These preliminary findings suggest further research evaluating the role of shoe-worn insoles for treatment of this specific sub-group of people with knee OA is warranted. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT02234895.
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Affiliation(s)
- Michael A Hunt
- Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Judit Takacs
- Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Natasha M Krowchuk
- Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Gillian L Hatfield
- Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Rana S Hinman
- Department of Physiotherapy, University of Melbourne, Melbourne, VIC Australia
| | - Ryan Chang
- Human Performance Engineering Laboratory, Reebok International, Canton, MA USA
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96
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In TS, Jung JH, Kim K, Jung KS, Cho HY. The reliability and validity of the Korean version of the foot function index for patients with foot complaints. J Phys Ther Sci 2017; 29:53-56. [PMID: 28210038 PMCID: PMC5300804 DOI: 10.1589/jpts.29.53] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Accepted: 09/26/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to establish the reliability and validity of the
Foot Function Index translated into Korean for use in patients with plantar fasciitis and
foot/ankle fracture. [Subjects and Methods] Thirty-six subjects with foot complaints, 14
males and 22 females, participated in the study. Reliability was determined by using the
intra-class correlation coefficient and Cronbach’s alpha for internal consistency.
Validity was examined by correlating Foot Function Index scores with the Short Form-36 and
the Visual Analog Scale scores. [Results] Test-retest reliability was 0.90 for the pain
subscale, and 0.94 and 0.91 for the disability and activity limitation subscales,
respectively. The criterion-related validity was established by comparison with the Korean
version of the Short Form-36 and Visual Analog Scale. [Conclusion] The Korean version of
the Foot Function Index was shown to be a reliable and valid instrument for assessing foot
complaints.
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Affiliation(s)
- Tae-Sung In
- Department of Physical Therapy, Gimcheon University, Republic of Korea
| | - Jin-Hwa Jung
- Department of Occupational Therapy, Semyung University, Republic of Korea
| | - Keunjo Kim
- Department of Physical Therapy, Gimcheon University, Republic of Korea
| | - Kyoung-Sim Jung
- Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine: 88 Olympic-ro, 43 gil, Songpa-gu, Seoul 05505, Republic of Korea
| | - Hwi-Young Cho
- Department of Physical Therapy, College of Health Science, Gachon University: 191 Hambangmoe-ro, Yeonsu-gu, Incheon 406-799, Republic of Korea
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97
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Gu JX, Huan AS, Zhang NC, Liu HJ, Xia SC, Regmi S, Yang L. Reconstruction of Heel Soft Tissue Defects Using Medial Plantar Artery Island Pedicle Flap: Clinical Experience and Outcomes Analysis. J Foot Ankle Surg 2017; 56:226-229. [PMID: 28126375 DOI: 10.1053/j.jfas.2016.11.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Indexed: 02/03/2023]
Abstract
We report our clinical experience with 11 cases of heel soft tissue defects treated with a medial plantar artery island pedicle flap. We also evaluated the functional outcomes of reconstruction. We enrolled 11 patients (10 [90.9%] males and 1 [9.1%] female), who received a medial plantar artery island pedicle flap for heel soft tissue defects from August 2010 to July 2014. The cause of the defects included trauma (post-traumatic heel skin necrosis) in 2 (18.2%) patients, infection (calcaneal osteomyelitis with overlying soft tissue infection) in 2 (18.2%) patients, and tumor (stage IA melanoma) in 7 (63.6%) patients. The mean average size of the defect was 3.7 cm × 4.4 cm (range 3.1 cm × 4.0 cm to 4.5 cm × 5.5 cm). The mean follow-up period was 19.6 (range 8 to 35) months, and all flaps survived within that period. The mean static 2-point discrimination was 34.4 (range 29 to 40) mm at the heel and 17.2 mm at the distal sole. The mean visual analog scale score for the aesthetic appearance of the reconstructed heel was 9 (range 8 to 9.5). The average revised Foot Function Index score was 25.8 (range 21 to 37). The medial plantar artery island pedicle flap is a versatile and effective method for reconstructing heel soft tissue defects.
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Affiliation(s)
- Jia-Xiang Gu
- Surgeon, Department of Hand and Foot Surgery, Subei People's Hospital, Clinical Medical College, Yangzhou University, Yangzhou, People's Republic of China.
| | - An-Shi Huan
- Postgraduate Student, College of Medicine, Yangzhou University, Yangzhou, People's Republic of China
| | - Nai-Chen Zhang
- Surgeon, Department of Hand and Foot Surgery, Subei People's Hospital, Clinical Medical College, Yangzhou University, Yangzhou, People's Republic of China
| | - Hong-Jun Liu
- Surgeon, Department of Hand and Foot Surgery, Subei People's Hospital, Clinical Medical College, Yangzhou University, Yangzhou, People's Republic of China
| | - Shi-Cong Xia
- Surgeon, Department of Hand and Foot Surgery, Subei People's Hospital, Clinical Medical College, Yangzhou University, Yangzhou, People's Republic of China
| | - Subhash Regmi
- Surgeon, Department of Hand and Foot Surgery, Subei People's Hospital, Clinical Medical College, Yangzhou University, Yangzhou, People's Republic of China
| | - Lin Yang
- Surgeon, Department of Hand and Foot Surgery, Subei People's Hospital, Clinical Medical College, Yangzhou University, Yangzhou, People's Republic of China
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98
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Autologous whole blood versus corticosteroid local injection in treatment of plantar fasciitis: A randomized, controlled multicenter clinical trial. Clin Rheumatol 2016; 36:661-669. [DOI: 10.1007/s10067-016-3484-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 10/08/2016] [Accepted: 11/11/2016] [Indexed: 12/20/2022]
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99
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Assad S, Ahmad A, Kiani I, Ghani U, Wadhera V, Tom TN. Novel and Conservative Approaches Towards Effective Management of Plantar Fasciitis. Cureus 2016; 8:e913. [PMID: 28083457 PMCID: PMC5215813 DOI: 10.7759/cureus.913] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
We assessed the effectiveness of the different treatments for plantar fasciitis (PF) based on the changes in functional outcomes. A systematic literature search was carried out and studies from 2010 to 2016 were included in this review. The databases from Google Scholar, PubMed and Cochrane were used for the various treatment modalities of plantar fasciitis. The objectives measured included visual analog scale (VAS), Roles and Maudsley scale, foot function index (FFI), plantar fascia thickness and American Orthopedic Foot and Ankle Society (AOFAS) ankle-hind foot scale as the tools to predict the improvement in symptoms of pain and discomfort. Eight randomized controlled trails that met the selection criteria were included in this review. Extracorporeal shock wave lithotripsy (ESWL) with botulinum toxin type A, corticosteroid injections, autologous whole blood and plasma treatment, novel treatments like cryopreserved human amniotic membrane, effect of placebo, platelet rich plasma injections and corticosteroid injections, physiotherapy and high strength training were analyzed. All the treatment modalities applied did lead to the reduction in pain scores, but for long term management autologous condition plasma and platelet rich plasma are the preferred treatment options. Impact of physiotherapy and high strength training is equivalent to corticosteroid injections and hence is suited for patients avoiding invasive forms of treatment.
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Affiliation(s)
- Salman Assad
- Department of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Awaiz Ahmad
- Neurosurgery, Shifa International Hospital, Islamabad, Pakistan
| | - Immad Kiani
- Internal Medicine, Shifa International Hospital, Islamabad, Pakistan
| | - Usman Ghani
- Department of Medicine, Shifa International Hospital, Islamabad, Pakistan
| | | | - Todd N Tom
- Surgery, ARH Regional Healthcare Center/University of Kentucky College of Medicine
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100
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Schneider W, Jurenitsch S. Age- and Sex-Related Normative Data for the Foot Function Index in a German-Speaking Cohort. Foot Ankle Int 2016; 37:1238-1242. [PMID: 27435183 DOI: 10.1177/1071100716659747] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Despite increasing popularity of the Foot Function Index (FFI), normative values are still unavailable for this self-administered score. This study was designed to generate age- and sex-related normative values for the FFI-total and for both subscales FFI-pain and FFI-disability. METHODS We used the cross-cultural adapted and validated German version of the FFI to generate a data pool using the results of 625 individuals, including staff and visitors to our hospital and excluding persons scheduled for foot surgery or in after-treatment. RESULTS Mean values for FFI-total were calculated: 15.3 points (95% confidence interval [CI], 13.3-16.9), 14.9 points for FFI-pain (CI, 13.3-16.5), and 15.6 for FFI-disability (CI, 13.8-17.4). Results showed higher values for FFI-total, FFI-pain, and FFI-disability for individuals older than 40 years. In general, normative values showed a tendency for higher values with age. A slightly inconsistent distribution over different age groups with a peak for individuals in their 40s and 50s was observed, especially for FFI-pain. Men had better scores than women. Individuals with previous surgery showed lower scores in their respective score. CONCLUSIONS Our data calculated normative values for a German-speaking cohort for FFI-total as well as for both subscales FFI-pain and FFI-disability. Our data quantified the increase of FFI-total, FFI-pain, and FFI-disability normative values with age but also showed a slightly inconsistent distribution of normative values over all age groups. We demonstrated higher normative values for women and slightly higher normative values for individuals with previous foot or ankle surgery. LEVEL OF EVIDENCE II, prospective comparative study.
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