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Fu Y, Chiarotto A, Enthoven W, Skou ST, Koes B. The influence of comorbidities on outcomes for older people with back pain: BACE-D cohort study. Ann Phys Rehabil Med 2023; 66:101754. [PMID: 37276834 DOI: 10.1016/j.rehab.2023.101754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 02/11/2023] [Accepted: 02/24/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND Comorbidities are common in older people with back pain but little is known about the influence of comorbidities on outcomes. OBJECTIVES To explore the influence of the most prevalent comorbidities, and the number of comorbidities, on short (at 3 months) and long-term (at 12 months) outcomes of back pain in older people. METHODS We analyzed data from the 'Back Complaints in the Elders' Dutch study cohort (BACE-D) and included participants aged >55 years. We used the modified Self-Administered Comorbidities Questionnaire (SCQ), the Numeric Rating Scale (NRS) and the Roland-Morris Disability Questionnaire (RMDQ) to assess the number of comorbidities, pain intensity and back-related physical functioning, respectively. We conducted separate linear regression models to analyze the association between comorbidities and outcomes including potential confounders of age, sex, body mass index, smoking and alcoholic drinking status, back pain history, and baseline NRS and RMDQ scores. RESULTS Our study included 669 participants with a mean age of 66.5 (SD 7.7) years of whom 394 were female. More comorbidities were positively associated with higher pain intensity (3-month regression coefficient (β) =0.27, 95% CI 0.14-0.39; 12-month β = 0.31, 95% CI 0.17-0.45) and worse physical functioning (3-month β = 0.54, 95% CI 0.31-0.77; 12-month β = 0.64, 95% CI 0.37-0.92). Four of the 5 commonest comorbidities were musculoskeletal problems. Older participants with musculoskeletal comorbidities had higher pain intensity (3-month β = 0.89 95% CI 0.41-1.37; 12-month β = 1.17, 95% CI 0.65-1.69), and worse physical functioning (3-month β = 1.61, 95% CI 0.71-2.52; 12-month β = 1.85, 95% CI 0.82-2.89, P-value < 0.001) compared to participants without musculoskeletal comorbidities. CONCLUSIONS More comorbidities are associated with worse back pain outcomes in older adults. Participants with musculoskeletal comorbidities had worse back pain outcomes than those without.
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Affiliation(s)
- Yanyan Fu
- Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - Alessandro Chiarotto
- Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | - Søren Thorgaard Skou
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
| | - Bart Koes
- Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Yozu A, Sonoda K, Hasegawa T, Kaminishi K, Osumi M, Sumitani M, Chiba R, Ota J. Effect of experimentally induced plantar pain on trunk posture during gait. J Phys Ther Sci 2023; 35:613-618. [PMID: 37670762 PMCID: PMC10475643 DOI: 10.1589/jpts.35.613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/31/2023] [Indexed: 09/07/2023] Open
Abstract
[Purpose] Plantar pain is associated with the prevalence of low back pain. Therefore, it is reasonable to assume that some kind of physical change should be occurring in the trunk due to plantar pain. However, the physical effect of plantar pain on the trunk remains unknown. We evaluated the effect of plantar pain on trunk posture during gait. [Participants and Methods] Ten healthy volunteers participated in the present study. Participants walked under two conditions: without pain and with pain. In the with pain condition, we set pain-inducing devices to the right foot to induce plantar pain during stance phase. By using 3D motion analysis system, the angles of the head, thorax, and pelvis segments, as well as the neck, trunk, bilateral hip, bilateral knee, and bilateral ankle joints, were measured. We analyzed the angle data throughout the gait cycle by using one-dimensional statistical parametric mapping. [Results] The anterior trunk tilt was observed in the right stance phase. [Conclusion] The anterior trunk tilt observed in the with pain condition may be a burden on the trunk. Our results presented one of the possible reasons for increased prevalence of low back pain in the plantar pain patients.
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Affiliation(s)
- Arito Yozu
- Department of Precision Engineering, School of Engineering,
The University of Tokyo: 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
- Department of Pain and Palliative Medicine, The University
of Tokyo Hospital, Japan
| | - Kohta Sonoda
- Department of Precision Engineering, School of Engineering,
The University of Tokyo: 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Tetsuya Hasegawa
- Department of Precision Engineering, School of Engineering,
The University of Tokyo: 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Kohei Kaminishi
- Research into Artifacts, Center for Engineering (RACE),
School of Engineering, The University of Tokyo, Japan
| | - Michihiro Osumi
- Department of Pain and Palliative Medicine, The University
of Tokyo Hospital, Japan
- Department of Neurorehabilitation, Graduate School of
Health Sciences, Kio University, Japan
| | - Masahiko Sumitani
- Department of Pain and Palliative Medicine, The University
of Tokyo Hospital, Japan
| | - Ryosuke Chiba
- Division on Neuroscience, Department of Physiology,
Asahikawa Medical University, Japan
| | - Jun Ota
- Research into Artifacts, Center for Engineering (RACE),
School of Engineering, The University of Tokyo, Japan
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Muacevic A, Adler JR, Khoshhal MS, Alsaedi OF, Dwmlou BA, Alandijani HA, Aynusah HR, Aloufi MS, Omar HK, Tobaiqi MA. Prevalence of Plantar Heel Pain Among School Teachers in Medina Region, Saudi Arabia: A Cross-Sectional Study. Cureus 2022; 14:e31821. [PMID: 36579271 PMCID: PMC9784590 DOI: 10.7759/cureus.31821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2022] [Indexed: 11/24/2022] Open
Abstract
Background Plantar heel pain (PHP) can be a common medical complaint among people with both sedentary and active lifestyles due to varied causes. It can affect the quality of life and result in significant disability. Despite many studies on PHP, few have focused on a specific population, such as school teachers. School teachers represent a significant proportion of the population of Medina, and addressing such a complaint and its possible relevant factors, which are most likely to be common among them due to their comparable job duties, will aid us in determining the relationships between personal characteristics, work-related factors, and PHP, as well as in formulating management plans. This study aims to identify the prevalence of PHP and its determinants among school teachers in the Medina region of Saudi Arabia. Methodology This cross-sectional study aims to identify the prevalence of PHP in school teachers. It was conducted in the Medina region of Saudi Arabia. A self-administered, online, validated questionnaire was created and used for data collection. Consent was taken from all participants before answering the questionnaire. Participation was voluntary, and all participants could withdraw from the study at any time. Data were kept confidential and only accessible by the primary investigator, co-investigators, and the statistician; hence, secondary and tertiary blinding was not done. Results Among those who reported PHP, the highest prevalence was among those who did not exercise regularly (94.7%), followed by middle-aged women (64.3%) and those with a high body mass index (44.5%), previous foot problems (43.2%), and chronic medical diseases (41.9%). PHP was less prevalent in male teachers, those with normal body mass index, and those who spent less time standing, had no previous foot problems, and exercised regularly. Most (88.1%) participants with PHP had other musculoskeletal pain, particularly in the lower back (62.6%) and knee (40.1%). Conclusions Teachers can be apprised about the importance of consuming a well-balanced diet and exercising regularly to maintain a healthy weight. We advocate educational programs as they can assist people to understand the need to obtain medical help when they are experiencing pain.
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Mahmoud WS. Examining the efficacy of short foot exercises as an effective stand-alone treatment for mechanical low back pain associated with foot overpronation. ISOKINET EXERC SCI 2021. [DOI: 10.3233/ies-210178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Abnormal foot mechanics in foot over-pronation has an identified relationship with mechanical low back pain (MLBP). OBJECTIVE: To explore the use of short foot exercises (SFEs) as a standalone treatment for MLBP with foot over-pronation. METHODS: Forty-six patients with MLBP (PwMLBP) presenting with and foot over-pronation were analyzed. They were randomized into the SFE (short foot exercise), SFE plus traditional physical therapy treatment (SFE+TPT), and control (CG) groups. Functional disability and pain level were measured using the Oswestry Disability Index (ODI) and visual analog scale (VAS), respectively. Ultrasonography measured the cross-sectional area (CSA) of the abductor hallucis (AbdH) muscle. The foot posture and navicular drop (ND) were investigated using the foot posture index-6 (FPI) score and ND test, respectively. RESULTS: The CSA of the AbdH and VAS scores improved significantly (p< 0.001) between the groups, more in the SFE+TPT group than in the SFE group (p< 0.001). The ND, FPI, and ODI measures improved significantly among the groups (p< 0.001), with no significant difference (p> 0.002) between the SFE and SFE+TPT groups. The CG did not show significant differences in the outcome measures (p> 0.002). Based on the effect size, SFEs significantly improved all the variables of interest (d>1). CONCLUSION: SFEs, with or without TPT may offer an effective treatment for PwMLBP with foot over-pronation.
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Affiliation(s)
- Waleed S. Mahmoud
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Kingdom of Saudi Arabia
- Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Yin M, Yan Y, Tong Z, Xu C, Qiao J, Zhou X, Ye J, Mo W. Development and Validation of a Novel Scoring System for Severity of Plantar Fasciitis. Orthop Surg 2020; 12:1882-1889. [PMID: 33112035 PMCID: PMC7767669 DOI: 10.1111/os.12827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 09/07/2020] [Accepted: 09/16/2020] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES Plantar fasciitis (PF) is the most common cause of heel pain. Though PF is self-limited, it can develop into chronic pain and thus treatment is needed. Early and accurate prognostic assessment of patients with PF is critically important for selecting the optimal treatment pathway. Nevertheless, there is no scoring system to determine the severity of PF and no prognostic model in choosing between conservative or surgical treatment. The study aimed to develop a novel scoring system to evaluate the severity of plantar fasciitis and predict the prognosis of conservative treatment. METHODS Data of consecutive patients treated from 2014 to 2018 were retrospectively collected. One hundred and eighty patients were eligible for the study. The demographics and clinical characteristics served as independent variables. The least follow-up time was 6 months. A minimal reduction of 60% in the visual analog scale (VAS) score from baseline was considered as minimal clinically important difference (MCID). Those factors significantly associated with achieving MCID in univariate analyses were further analyzed by multivariate logistic regression. A novel scoring system was developed using the best available literature and expert-opinion consensus. Inter-observer reliability and intra-observer reproducibility were evaluated. The appropriate cut-off points for the novel score system were obtained using receiver operating characteristic (ROC) curves. RESULTS The system score = VAS (0-3 point = 1; 3.1-7 point = 3; 7.1-10 point = 5) + duration of symptoms (<6 months = 1; ≥1 6 months = 2) + ability to walk without pain (>1 h = 1; ≤1 h = 4) + heel spur in X-ray (No = 0; Yes = 2) + high intensity zone (HIZ) in MRI (No = 0; Yes = 2). The total score was divided in four categories of severity: mild (2-4 points), moderate (5-8 points), severe (9-12 points), and critical (13-15 points). Inter-observer agreement with a value of 0.84 was considered as perfect reliability. Intra-observer reproducibility with a value of 0.92 was considered as perfect reproducibility. The optimum cut-off value was 10 points. The sensitivity of predictive factors was 86.37%, 84.21%, 91.22%, 84.12%, and 89.32%, respectively; the specificity was 64.21%, 53.27%, 67.76%, 62.37%, and 79.58%, respectively; the area under curve was 0.75, 0.71, 0.72, 0.87, and 0.77, respectively. The Hosmer-Lemeshow test showed a good fitting of the score system with an overall accuracy of 90.6%. CONCLUSIONS Based on prognostic factors, the present study establishes a novel scoring system which is highly comprehensible, reliable, and reproducible. This score system can be used to identify the severity of plantar fasciitis and predict the prognosis of conservative treatment accurately. The application of this scoring system in clinical settings can significantly improve the decision-making process.
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Affiliation(s)
- Meng‐chen Yin
- Department of Orthopaedics, Longhua HospitalShanghai University of Traditional Chinese MedicineShanghaiChina
| | - Yin‐jie Yan
- Department of Orthopaedics, Longhua HospitalShanghai University of Traditional Chinese MedicineShanghaiChina
| | - Zheng‐yi Tong
- Department of Orthopaedics, Longhua HospitalShanghai University of Traditional Chinese MedicineShanghaiChina
| | - Chong‐qin Xu
- Department of Orthopaedics, Longhua HospitalShanghai University of Traditional Chinese MedicineShanghaiChina
| | - Jiao‐jiao Qiao
- Department of Orthopaedics, Longhua HospitalShanghai University of Traditional Chinese MedicineShanghaiChina
| | - Xiao‐ning Zhou
- Department of Orthopaedics, Longhua HospitalShanghai University of Traditional Chinese MedicineShanghaiChina
| | - Jie Ye
- Department of Orthopaedics, Longhua HospitalShanghai University of Traditional Chinese MedicineShanghaiChina
| | - Wen Mo
- Department of Orthopaedics, Longhua HospitalShanghai University of Traditional Chinese MedicineShanghaiChina
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Yabe Y, Hagiwara Y, Sekiguchi T, Momma H, Tsuchiya M, Kanazawa K, Itaya N, Yoshida S, Sogi Y, Yano T, Onoki T, Itoi E, Nagatomi R. High prevalence of low back pain among young basketball players with lower extremity pain: a cross-sectional study. BMC Sports Sci Med Rehabil 2020; 12:40. [PMID: 32655870 PMCID: PMC7339456 DOI: 10.1186/s13102-020-00189-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 06/30/2020] [Indexed: 11/10/2022]
Abstract
Background Low back pain (LBP) is a common problem among young basketball players in addition to lower extremity injuries. However, studies that focus on LBP with lower extremity pain are limited. From the perspective of the kinematic chain, disrupted lower extremity function can lead to LBP. The association between these two symptoms in basketball players, however, has not been reported. Therefore, this study aimed to clarify the association between lower extremity pain and LBP among young basketball players. Methods This cross-sectional study was conducted on school-aged basketball players (n = 592). Information regarding their sporting activities was collected using a self-reported questionnaire. Musculoskeletal pain such as low back, knee, and ankle pain was assessed. The sports players with knee and/or ankle pain were defined as having lower extremity pain. Multivariate logistic regression analysis was used to assess the association between lower extremity pain and LBP. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated. The associations of knee or ankle pain with LBP were similarly assessed. Results School-aged basketball players had a point prevalence of 12.8% for LBP. Compared with the players without lower extremity pain, the players with lower extremity pain had higher rates of LBP, with an adjusted OR (95% CI) of 6.21 (3.57-10.80). There was also a significant association of knee and ankle pain with LBP. Compared with the players without knee or ankle pain, the adjusted ORs (95% CI) for LBP were 4.25 (2.55-7.07) in the players with knee pain and 3.79 (2.26-6.36) in the players with ankle pain. Conclusions Lower extremity pain was associated with LBP among school-aged basketball players. Further research is needed to clarify the mechanism of this association, which will provide useful information for prevention and treatment of LBP among young basketball players.
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Affiliation(s)
- Yutaka Yabe
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan
| | - Yoshihiro Hagiwara
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan.,Department of Medicine and Science in Sports and Exercise, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575 Japan
| | - Takuya Sekiguchi
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan
| | - Haruki Momma
- Department of Medicine and Science in Sports and Exercise, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575 Japan
| | - Masahiro Tsuchiya
- Department of Nursing, Faculty of Health Science, Tohoku Fukushi University, 1-8-1 Kunimi, Aoba-ku, Sendai, 981-8522 Japan
| | - Kenji Kanazawa
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan
| | - Nobuyuki Itaya
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan
| | - Shinichirou Yoshida
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan
| | - Yasuhito Sogi
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan
| | - Toshihisa Yano
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan
| | - Takahiro Onoki
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan
| | - Eiji Itoi
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan
| | - Ryoichi Nagatomi
- Department of Medicine and Science in Sports and Exercise, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575 Japan.,Division of Biomedical Engineering for Health and Welfare, Tohoku University Graduate School of Biomedical Engineering, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575 Japan
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McClinton SM, Heiderscheit BC, McPoil TG, Flynn TW. Effectiveness of physical therapy treatment in addition to usual podiatry management of plantar heel pain: a randomized clinical trial. BMC Musculoskelet Disord 2019; 20:630. [PMID: 31883516 PMCID: PMC6935140 DOI: 10.1186/s12891-019-3009-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 12/17/2019] [Indexed: 12/19/2022] Open
Abstract
Background Many patients will seek care from a podiatrist for plantar heel pain (PHP), while few of these patients will also be seen by a physical therapist. Physical therapists can provide treatment that is not a part of routine podiatric care for PHP and may provide additional improvement. Therefore, the purpose of this study was to examine the effects of interdisciplinary care for PHP that incorporated physical therapy treatment after initiating podiatric treatment. Methods Eligible individuals with PHP that presented to a podiatrist were randomized to receive usual podiatric care (uPOD) or usual podiatric care plus physical therapy treatment (uPOD+PT). The primary outcome was change in foot and ankle ability measure (FAAM) at 6-months. Secondary outcomes included change in numeric pain rating scale (NPRS), patient-reported success, and 6-week and 1-year endpoints. Patient-reported success was defined as the top two global rating of change scale rankings. Primary analysis was intention-to-treat (ITT) using analysis by covariance adjusted to baseline scores, and a secondary per-protocol (PP) analysis was performed analyzing only those who completed treatment. Results Ninety-five individuals participated and were included in the ITT analysis, and 79 were included in the PP analysis. For the primary outcome of FAAM change from baseline to 6-months, both groups improved significantly (uPOD+PT: 26.8 [95% CI 21.6, 31.9]; uPOD: (20 [15.6, 24.4]), but there was no between-group difference (4.3 [− 1, 9.6]). For secondary outcomes, the uPOD+PT group demonstrated greater improvement in NPRS at 6 weeks (0.9 [0.3, 1.4]) and 1 year (1.5 [0.6, 2.5]) in the ITT analysis. In the PP analysis, the uPOD+PT group demonstrated greater improvement in FAAM at 6 months (7.7 [2.1, 13.3]) and 1 year (5.5 [0.1, 10.8]), NPRS at 6 weeks (0.9 [0.2, 1.6]), 6 months (1.3 [0.6, 2.1]) and 1 year (1.3 [0.6, 2.1]), and in patient-reported success (relative risk [95% CI]) at 6 weeks (2.8 [1.1, 7.1]), 6 months (1.5 [1.1, 2.1]), and 1 year (1.5 [1.1, 1.9]). Conclusions There was no significant benefit of uPOD+PT in the primary outcome of FAAM change at 6 months. Secondary outcomes and PP analysis indicated additional benefit of uPOD+PT, mostly observed in individuals who completed treatment. Trial registration Prospectively registered May 24, 2013 at www.clinicaltrials.gov (NCT01865734).
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Affiliation(s)
- Shane M McClinton
- Doctor of Physical Therapy Program, Des Moines University, 3200 Grand Avenue, Des Moines, IA, USA.
| | - Bryan C Heiderscheit
- Departments of Orthopedics & Rehabilitation and Biomedical Engineering, and Doctor of Physical Therapy Program, University of Wisconsin-Madison, 1636 Highland Ave, Madison, WI, USA
| | - Thomas G McPoil
- School of Physical Therapy, Regis University, Denver, CO, USA
| | - Timothy W Flynn
- School of Physical Therapy, South College, Knoxville, TN, USA
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Grim C, Kramer R, Engelhardt M, John SM, Hotfiel T, Hoppe MW. Effectiveness of Manual Therapy, Customised Foot Orthoses and Combined Therapy in the Management of Plantar Fasciitis-a RCT. Sports (Basel) 2019; 7:sports7060128. [PMID: 31141994 PMCID: PMC6628384 DOI: 10.3390/sports7060128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 05/24/2019] [Accepted: 05/26/2019] [Indexed: 01/12/2023] Open
Abstract
Background: Plantar fasciitis (PF) is one of the most common causes of plantar heel pain. Objective: To evaluate the effectiveness of three different treatment approaches in the management of PF. Methods: Sixty-three patients (44 female, 19 men; 48.4 ± 9.8 years) were randomly assigned into a manual therapy (MT), customised foot orthosis (FO) and a combined therapy (combined) group. The primary outcomes of pain and function were evaluated using the American Orthopaedic Foot and Ankle Society-Ankle Hindfoot Scale (AOFAS-AHS) and the patient reported outcome measure (PROM) Foot Pain and Function Scale (FPFS). Data were evaluated at baseline (T0) and at follow-up sessions after 1 month, 2 months and 3 months (T1–T3). Results: All three treatments showed statistically significant (p < 0.01) improvements in both scales from T0 to T1. However, the MT group showed greater improvements than both other groups (p < 0.01). Conclusion: Manual therapy, customised foot orthoses and combined treatments of PF all reduced pain and function, with the greatest benefits shown by isolated manual therapy.
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Affiliation(s)
- Casper Grim
- Department of Orthopaedic, Trauma, Hand and Neuro Surgery, Klinikum Osnabrueck GmbH, 49076 Osnabrueck, Germany.
| | - Ruth Kramer
- Physiopraxis Kramer, 49492 Westerkappeln , Germany.
| | - Martin Engelhardt
- Department of Orthopaedic, Trauma, Hand and Neuro Surgery, Klinikum Osnabrueck GmbH, 49076 Osnabrueck, Germany.
| | - Swen Malte John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrueck, 49076 Osnabrueck, Germany.
| | - Thilo Hotfiel
- Department of Orthopaedic, Trauma, Hand and Neuro Surgery, Klinikum Osnabrueck GmbH, 49076 Osnabrueck, Germany.
- Department of Orthopedic Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, 91054 Erlangen, Germany.
| | - Matthias Wilhelm Hoppe
- Department of Orthopaedic, Trauma, Hand and Neuro Surgery, Klinikum Osnabrueck GmbH, 49076 Osnabrueck, Germany.
- Department of Movement and Training Science, University of Wuppertal, 42119 Wuppertal, Germany.
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McClinton S, Heiderscheit B, McPoil TG, Flynn TW. Physical therapist decision-making in managing plantar heel pain: cases from a pragmatic randomized clinical trial. Physiother Theory Pract 2018; 36:638-662. [PMID: 29979912 DOI: 10.1080/09593985.2018.1490941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Plantar heel pain (PHP) is a common condition managed by physical therapists that can, at times, be difficult to treat. Management of PHP is complicated by a variety of pathoanatomic features associated with PHP in addition to several treatment approaches with varying efficacy. Although clinical guidelines and clinical trial data support a general approach to management, the current literature is limited in case-specific descriptions of PHP management that addresses unique combinations of pathoanatomical, physical, and psychosocial factors that are associated with PHP. Purpose: The purpose of this case series is to describe physical therapist decision-making of individualized multimodal treatment for PHP cases presenting with varied clinical presentations. Treatment incorporated clinical guidelines and recent evidence including a combination of manual therapy, patient education, stretching, resistance training, and neurodynamic interventions. A common clinical decision-making framework was used to progress individualized treatment from a focus on symptom modulation initially to increased load tolerance of involved tissues and graded activity. In each case, patients met their individual goals and demonstrated clinically meaningful improvements in pain, function, and global rating of change that were maintained at the 1-2-year follow-up. Implications: This case series provides details of physical therapist management of a variety of PHP clinical presentations that can be used to complement clinical practice guidelines in the management of PHP.
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Affiliation(s)
- Shane McClinton
- Doctor of Physical Therapy Program, Des Moines University , Des Moines, IA, USA
| | - Bryan Heiderscheit
- Departments of Orthopedics & Rehabilitation and Biomedical Engineering, and Doctor of Physical Therapy Program, University of Wisconsin-Madison , Madison, WI, USA
| | - Thomas G McPoil
- School of Physical Therapy, Regis University , Denver, CO, USA
| | - Timothy W Flynn
- School of Physical Therapy, South College , Knoxville, TN, USA
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