1
|
Khammas ASA, Mahmud R, Hassan HA, Ibrahim I, Mohammed SS. Sonographic and clinical effects of manual physical therapy for plantar fasciitis: randomized prospective controlled trial. J Ultrasound 2024; 27:487-500. [PMID: 37917407 DOI: 10.1007/s40477-023-00833-0] [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: 06/16/2023] [Accepted: 09/06/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate the efficacy of manual physiotherapy on clinical outcomes, morphology of plantar fascia (PF), thicknesses of calcaneal fat pad (CFP) and Kager's fat pad (KFP) with ultrasound imaging in plantar fasciitis (PFS) patients. Also, to evaluate the PF thickness, pain and foot functional outcomes among PFS phases. METHODS A randomized controlled trial was conducted on 122 subjects divided into three groups: group A (40 patients with PFS) underwent manual physiotherapy, group B (42 patients with PFS) without any intervention and group C (40 healthy subjects) were matched by age, gender and BMI with each patient in group A and B. The following outcomes were evaluated at baseline and one-month of follow-ups: morphology of PF and thicknesses of CFP and KFP, pain, foot functional limitation. RESULTS PF thickness was significantly thickened in group A and B compared to group C (P < 0.001). A significant decrease in incidence of PF echogenicity and CFP thickness were found in group A and B compared to group C. Moreover, significant improvement was observed in PF thickness (P < 0.001), PF echogenicity (P < 0.001) and CFP thickness (P = 0.002) in group A at one-month after the treatment. Furthermore, pain intensity and foot functional limitation was significantly improved within group A after receiving the treatment. Significant improvement was noted in PF thickness, pain intensity and foot functional limitation among patients with acute phase. CONCLUSION The manual physiotherapy is effective in treatment of PF thickening, hypoechogenicity, pain intensity and activity limitations, particularly in patients associated with acute PFS.
Collapse
Affiliation(s)
- Abdul Sattar Arif Khammas
- Department of Radiological Techniques, College of Health and Medical Techniques/Baghdad, Middle Technical University, Bab Al-Muadham, 10047, Baghdad, Iraq.
- Department of Radiology and Imaging, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
| | - Rozi Mahmud
- Department of Radiology and Imaging, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Hasyma Abu Hassan
- Department of Radiology and Imaging, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Idris Ibrahim
- Department of Radiology and Imaging, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Safwan Saeed Mohammed
- Department of Radiological Techniques, College of Health and Medical Techniques/Baghdad, Middle Technical University, Bab Al-Muadham, 10047, Baghdad, Iraq
| |
Collapse
|
2
|
Sasun AR, Babar T, Dadgal R. Effectiveness of Ankle Proprioceptive Neuromuscular Facilitation Techniques in Restoring the Biomechanical Integrity of the Ankle Following Plantar Fasciitis: An Experimental Study. Cureus 2024; 16:e64371. [PMID: 39130914 PMCID: PMC11317122 DOI: 10.7759/cureus.64371] [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] [Received: 04/07/2024] [Accepted: 07/11/2024] [Indexed: 08/13/2024] Open
Abstract
Background Recent studies have highlighted the role of the central nervous system in modulating pain perception and the movement patterns associated with plantar fasciitis. Neurological changes, such as altered sensorimotor control and cortical reorganization, may contribute to the persistence of symptoms and the recurrence of the condition. Integrating neurorehabilitation techniques may enhance outcomes and reduce the risk of recurrence. Physiotherapy exercises such as ankle proprioceptive neuromuscular facilitation, foot doming exercises, balance exercises, towel curl exercises, and stretching exercises were given to check the impact of physiotherapy interventions on ankle muscle instability and dynamic balance following plantar fasciitis. Method An experimental investigation was carried out at the outpatient department of Acharya Vinoba Bhave Rural Hospital. A total of 71 participants were assigned arbitrarily, employing a straightforward random sampling procedure. Each participant received treatment for six weeks, with five weekly sessions. Result The results demonstrated significant findings. The pre- and post-test score results are as follows: visual analogue scale scores (t=1.619, p=0.0001), weight-bearing lunge test scores (t=24.36, p=0.0001*), and functional reach test scores (t=24.36, p=0.0001). Conclusion We conclude that physiotherapy exercises such as ankle proprioceptive neuromuscular facilitation (PNF), foot doming exercises, strengthening exercises, toe spreading exercises, towel curl exercises, and stretching exercises are effective in reducing pain and ascertaining dynamic balance in plantar fasciitis. The rehabilitation program significantly improved ankle biomechanical integrity and muscle strength, allowed functional recovery, and reduced pain. Future studies should focus on investigating the long-term effects of PNF therapies. For better patient outcomes, clinicians should consider incorporating ankle PNF exercises into their therapy regimens.
Collapse
Affiliation(s)
- Anam R Sasun
- Department of Neuro-Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research (DMIHER), Wardha, IND
| | - Tejal Babar
- Department of Neuro-Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research (DMIHER), Wardha, IND
| | - Ragini Dadgal
- Department of Neuro-Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research (DMIHER), Wardha, IND
| |
Collapse
|
3
|
Yilmaz R, Gül S, Yilmaz H, Karaarslan F. Comparison of the effectiveness of peloid therapy and kinesiotaping in patients with unilateral plantar fasciitis: A prospective, randomized controlled study. Turk J Phys Med Rehabil 2024; 70:221-232. [PMID: 38948638 PMCID: PMC11209338 DOI: 10.5606/tftrd.2024.13756] [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: 08/27/2023] [Accepted: 12/01/2023] [Indexed: 07/02/2024] Open
Abstract
Objectives This study aimed to compare the efficacy of peloid therapy and kinesiotaping for unilateral plantar fasciitis (PF). Patients and methods In the randomized controlled study, a total of 114 patients (89 females, 25 males; mean age: 45.1±8.3 years; range, 27 to 65 years) diagnosed with unilateral PF between January 2021 and March 2023 were randomly divided into three equal groups: the peloid group (peloid therapy and home-based exercise + heel pad), the kinesiotaping group (kinesiotaping and home-based exercise + heel pad), and the control group (home-based exercise + heel pad). Peloid therapy was performed over two weeks for a total of 10 sessions. Kinesiotaping was applied four times over two weeks. Plantar fascia, calf, and Achilles stretching exercises and foot strengthening exercises were performed, and prefabricated silicone heel insoles were used daily for six weeks. Patients were evaluated three times with clinical assessment scales for pain, the Heel Tenderness Index, and the Foot and Ankle Outcome Score before treatment, at the end of treatment, and in the first month after treatment. Results Statistically significant improvements were observed for all parameters at the end of treatment and in the first month after treatment compared to the baseline in every group (p<0.001). No superiority was found between the groups. Conclusion Peloid therapy or kinesiotaping, given as adjuncts to home-based exercise therapy and shoe insoles in patients with unilateral PF, did not result in additional benefits.
Collapse
Affiliation(s)
- Ramazan Yilmaz
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Konya Beyhekim Training and Research Hospital, Konya, Türkiye
| | - Süleyman Gül
- Department of Physical Medicine and Rehabilitation, Konya Metropolitan Hospital, Konya, Türkiye
| | - Halim Yilmaz
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Konya Beyhekim Training and Research Hospital, Konya, Türkiye
| | - Fatih Karaarslan
- Department of Medical Ecology and Hydroclimatology, University of Health Sciences, Gülhane Faculty of Medicine, Ankara, Türkiye
| |
Collapse
|
4
|
Saueressig T, Owen PJ, Pedder H, Tagliaferri S, Kaczorowski S, Altrichter A, Richard A, Miller CT, Donath L, Belavy DL. The importance of context (placebo effects) in conservative interventions for musculoskeletal pain: A systematic review and meta-analysis of randomized controlled trials. Eur J Pain 2024; 28:675-704. [PMID: 38116995 DOI: 10.1002/ejp.2222] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 10/04/2023] [Accepted: 11/25/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND AND OBJECTIVE Contextual effects (e.g. patient expectations) may play a role in treatment effectiveness. This study aimed to estimate the magnitude of contextual effects for conservative, non-pharmacological interventions for musculoskeletal pain conditions. A systematic review and meta-analysis of randomized controlled trials (RCTs) that compared placebo conservative non-pharmacological interventions to no treatment for musculoskeletal pain. The outcomes assessed included pain intensity, physical functioning, health-related quality of life, global rating of change, depression, anxiety and sleep at immediate, short-, medium- and/or long-term follow-up. DATABASES AND DATA TREATMENT MEDLINE, EMBASE, CINAHL, Web of Science Core Collection, CENTRAL and SPORTDiscus were searched from inception to September 2021. Trial registry searches, backward and forward citation tracking and searches for prior systematic reviews were completed. The Cochrane risk of bias 2 tool was implemented. RESULTS The study included 64 RCTs (N = 4314) out of 8898 records. For pain intensity, a mean difference of (MD: -5.32, 95% confidence interval (CI): -7.20, -3.44, N = 57 studies with 74 outcomes, GRADE: very low) was estimated for placebo interventions. A small effect in favour of the placebo interventions for physical function was estimated (SMD: -0.22, 95% CI: -0.35, -0.09; N = 37 with 48 outcomes, GRADE: very low). Similar results were found for a broad range of patient-reported outcomes. Meta-regression analyses did not explain heterogeneity among analyses. CONCLUSION The study found that the contextual effect of non-pharmacological conservative interventions for musculoskeletal conditions is likely to be small. However, given the known effect sizes of recommended evidence-based treatments for musculoskeletal conditions, it may still contribute an important component. SIGNIFICANCE Contextual effects of non-pharmacological conservative interventions for musculoskeletal conditions are likely to be small for a broad range of patient-reported outcomes (pain intensity, physical function, quality of life, global rating of change and depression). Contextual effects are unlikely, in isolation, to offer much clinical care. But these factors do have relevance in an overall treatment context as they provide almost 30% of the minimally clinically important difference.
Collapse
Affiliation(s)
| | - Patrick J Owen
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Victoria, Australia
| | - Hugo Pedder
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Scott Tagliaferri
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Victoria, Australia
| | - Svenja Kaczorowski
- Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
| | - Adina Altrichter
- Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
| | - Antonia Richard
- Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
| | - Clint T Miller
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Victoria, Australia
| | - Lars Donath
- Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne, Germany
| | - Daniel L Belavy
- Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
| |
Collapse
|
5
|
Ryskalin L, Morucci G, Soldani P, Gesi M. Do the fasciae of the soleus have a role in plantar fasciitis? Clin Anat 2024; 37:413-424. [PMID: 37539773 DOI: 10.1002/ca.24102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/21/2023] [Accepted: 07/16/2023] [Indexed: 08/05/2023]
Abstract
Plantar fasciitis is a chronic, self-limiting, and painful disabling condition affecting the inferomedial aspect of the heel, usually extending toward the metatarsophalangeal joints. There is compelling evidence for a strong correlation between Achilles tendon (AT) loading and plantar aponeurosis (PA) tension. In line with this, tightness of the AT is found in almost 80% of patients affected by plantar fasciitis. A positive correlation has also been reported between gastrocnemius-soleus tightness and heel pain severity in this condition. Despite its high prevalence, the exact etiology and pathological mechanisms underlying plantar heel pain remain unclear. Therefore, the aim of the present paper is to discuss the anatomical and biomechanical substrates of plantar fasciitis with special emphasis on the emerging, though largely neglected, fascial system. In particular, the relationship between the fascia, triceps surae muscle, AT, and PA will be analyzed. We then proceed to discuss how structural and biomechanical alterations of the muscle-tendon-fascia complex due to muscle overuse or injury can create the conditions for the onset of PA pathology. A deeper knowledge of the possible molecular mechanisms underpinning changes in the mechanical properties of the fascial system in response to altered loading and/or muscle contraction could help healthcare professionals and clinicians refine nonoperative treatment strategies and rehabilitation protocols for plantar fasciitis.
Collapse
Affiliation(s)
- Larisa Ryskalin
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
- Center for Rehabilitative Medicine "Sport and Anatomy", University of Pisa, Pisa, Italy
| | - Gabriele Morucci
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
- Center for Rehabilitative Medicine "Sport and Anatomy", University of Pisa, Pisa, Italy
| | - Paola Soldani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
- Center for Rehabilitative Medicine "Sport and Anatomy", University of Pisa, Pisa, Italy
| | - Marco Gesi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
- Center for Rehabilitative Medicine "Sport and Anatomy", University of Pisa, Pisa, Italy
| |
Collapse
|
6
|
Lourenço BM, Campos MGM, Maia L, Castro B, Trede RG, Oliveira VC. Efficacy of pharmacological and non-pharmacological therapies on pain intensity and disability for plantar fasciitis: a systematic review and meta-analysis. Br J Sports Med 2023; 57:1516-1521. [PMID: 37620126 DOI: 10.1136/bjsports-2022-106403] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVE To investigate the effects of pharmacological and non-pharmacological therapies on pain intensity and disability for plantar fasciitis. DESIGN Systematic review of randomised controlled trials (RCTs). DATA SOURCES AMED, MEDLINE, PEDro, Cochrane, SPORTDiscus, CINAHL, EMBASE and PsycINFO without language or date restrictions up to 3 February 2023. ELIGIBILITY CRITERIA RCTs that evaluated the efficacy of any pharmacological and non-pharmacological therapies compared with control (placebo, sham, waiting list or no intervention) on pain intensity and disability in people with plantar fasciitis. Two reviewers independently screened eligible trials, extracted data, assessed the methodological quality of included trials and assessed the certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluations framework. Mean differences (MDs) with 95% CIs were reported. RESULTS Seventeen different therapies investigated in 28 trials were included in the quantitative analysis. For non-pharmacological therapies, moderate certainty evidence showed short-term effects of customised orthoses on pain intensity when compared with control (MD of -12.0 points (95% CI -17.1 to -7.0) on a 0-100 scale). Low certainty evidence showed short-term effects of taping on pain intensity (-21.3 (95% CI -38.6 to -4.0)). Long-term effects and effects on disability are still uncertain. For pharmacological therapies, low to very low quality evidence from few trials with small samples was inconclusive and supports that high-quality trials are needed. CONCLUSIONS Moderate-quality and low-quality evidence demonstrates customised orthoses and taping, respectively, reduce pain intensity in the short term in patients with plantar fasciitis. PROSPERO REGISTRATION NUMBER CRD42021224416.
Collapse
Affiliation(s)
- Bianca Martins Lourenço
- Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Mariana Gabrich Moraes Campos
- Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Laísa Maia
- Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Brenda Castro
- Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Renato Guilherme Trede
- Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Vinícius Cunha Oliveira
- Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| |
Collapse
|
7
|
Khammas ASA, Mahmud R, Hassan HA, Ibrahim I, Mohammed SS. An assessment of plantar fascia with ultrasound findings in patients with plantar fasciitis: a systematic review. J Ultrasound 2023; 26:13-38. [PMID: 36040577 PMCID: PMC10063743 DOI: 10.1007/s40477-022-00712-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/14/2022] [Indexed: 10/14/2022] Open
Abstract
INTRODUCTION Plantar fasciitis (PFS) is described by an intense pain over medial tubercle of calcaneus, increased with the first step after waking up, after rest and during weightbearing activity. It is the most common cause of plantar heel pain in adults with the prevalence estimated 10% of the general population. Ultrasound imaging is commonly being used to measure the PF thickness, evaluate the efficacy of different treatments and a guide therapeutic technique in patients with PFS. The objective of this study was to systematically review the studies that were previously published to evaluate the role of ultrasound in the assessment of PF in patients with PFS. METHODS A systematic search was carried out over the last 5 years from 2017 to 2022 on basis the following electronic databases: Science Direct, Scopus, Web of Science, Springer and PubMed. The keywords that used in the searching were: ultrasound, sonography, ultrasonography, plantar fasciitis, imaging of plantar fascia, physiotherapy of plantar fasciitis, interventional treatment of plantar fasciitis, randomized controlled trial of plantar fasciitis and interventional ultrasound. The review focused on the assessment of PF in patients with PFS underwent different interventions using B-mode, shear wave elastography (SWE) and color Doppler ultrasound. RESULTS During the search process, 1661 were recorded using the proper keywords from 2017 to 2022 in which 666 original articles were found after removing the review and duplicated articles. Of these, thirty articles met the inclusion criteria and included in this review. The articles have assessed the PF in patients with PFS under different conditions using different ultrasound modes. Twenty-six articles evaluated the effectiveness of different treatment on PF in patients with PFS using different ultrasound modes. In 8 of 26 articles, the ultrasound was used as both an assessment tool of PF and guide therapeutic technique in patients with PFS. In 18 articles, the ultrasound was used as only assessment tool to identify the PF thickness and its observation changes in patients with PFS. Four articles compared the PF thickness and its intrafascial changes between patients with PFS and healthy subjects. CONCLUSION The ultrasound can be a reliable tool in assessment the effect of different interventions on PF by evaluating its thickness, echogenicity and stiffness changes in patients with PFS. There were different methods and treatments were used among the studies.
Collapse
Affiliation(s)
- Abdul Sattar Arif Khammas
- Department of Radiological Techniques, College of Health and Medical Techniques/Baghdad, Middle Technical University, 10047, Bab Al Muadham, Baghdad, Iraq.
- Department of Radiology and Imaging, Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
| | - Rozi Mahmud
- Department of Radiology and Imaging, Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Hasyma Abu Hassan
- Department of Radiology and Imaging, Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Idris Ibrahim
- Department of Radiology and Imaging, Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Safwan Saeed Mohammed
- Department of Radiological Techniques, College of Health and Medical Techniques/Baghdad, Middle Technical University, 10047, Bab Al Muadham, Baghdad, Iraq
| |
Collapse
|
8
|
Guimarães JDS, Arcanjo FL, Leporace G, Metsavaht LF, Conceição CS, Moreno MVMG, Vieira TEM, Moraes CC, Gomes Neto M. Effects of therapeutic interventions on pain due to plantar fasciitis: A systematic review and meta-analysis. Clin Rehabil 2022; 37:727-746. [PMID: 36571559 DOI: 10.1177/02692155221143865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To determine the effects of different therapeutic interventions that have ever been evaluated in randomized controlled trials on pain due to plantar fasciitis. METHODS We searched different electronic databases until September 2022. Mean differences (MDs) and 95% confidence intervals (CIs) were calculated. The Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the overall certainty evidence. RESULTS A total of 236 studies met the study criteria, including 15,401 patients. Botulinum toxin MD -2.14 (CI: -4.15, -0.14), micronized dehydrated human amnion/chorion membrane injection MD -3.31 (CI: -5.54, -1.08), dry needling MD -2.34 (CI: -4.64, -0.04), low-dye taping MD -3.60 (CI: -4.16, -3.03), low-level laser therapy MD -2.09 (CI: -2.28, -1.90), myofascial releases MD -1.79 (CI: -2.63, -0.94), platelet-rich plasma MD -2.40 (CI: -4.16, -0.63), radiofrequency MD -2.47 (CI: -4.65, -0.29), and stretching MD -1.14 (CI: -2.02, -0.26) resulted in being effective treatments for pain when compared to the control in the short term. In the medium and long term, only extracorporeal shock wave therapy MD -0.97 (CI: -1.13, -0.81)/MD -2.49 (CI: -3.17, -1.82) was effective for improving pain when compared to the control. CONCLUSIONS Considering the available studies, this systematic review and meta-analysis showed that different therapeutic interventions seem to be useful strategies for improving pain in patients with plantar fasciitis. In the medium and long term, only extracorporeal shock wave therapy was effective in improving pain when compared to the control.
Collapse
Affiliation(s)
- Janice de S Guimarães
- Postgraduate Program in Medicine and Health at the Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Foot and Ankle Medicine and Surgery Department, 534569Cardiopulmonar Hospital, Salvador, Bahia, Brazil
| | - Fabio L Arcanjo
- Postgraduate Program in Medicine and Health at the Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, 28111Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Gustavo Leporace
- Physiotherapy Research Group, 28111Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Biocinética, Rua Visconde de Pirajá, Rio de Janeiro, Brazil
| | | | - Cristiano Sena Conceição
- Postgraduate Program in Medicine and Health at the Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, 28111Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Marcus V M G Moreno
- Foot and Ankle Medicine and Surgery Department, 534569Cardiopulmonar Hospital, Salvador, Bahia, Brazil
| | - Tulio E Marçal Vieira
- Foot and Ankle Medicine and Surgery Department, 534569Cardiopulmonar Hospital, Salvador, Bahia, Brazil
| | - Carolina Cunha Moraes
- Foot and Ankle Medicine and Surgery Department, Portuguese Hospital of Bahia, Salvador, Bahia, Brazil
| | - Mansueto Gomes Neto
- Postgraduate Program in Medicine and Health at the Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, 28111Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Department, Physiotherapy course, 28111Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| |
Collapse
|
9
|
Kim Y, Bhatia D, Lee Y, Ryu Y, Park HS. Development and Clinical Evaluation of a Novel Foot Stretching Robot that Simultaneously Stretches Plantar Fascia and Achilles Tendon for Treatment of Plantar Fasciitis. IEEE Trans Biomed Eng 2022; 69:2628-2637. [PMID: 35171762 DOI: 10.1109/tbme.2022.3151871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This paper presents the development and clinical evaluation of a foot stretching robot that simultaneously stretches the plantar fascia and Achilles tendon for the treatment of plantar fasciitis. The therapeutic effectiveness of the robot and feasibility of using metatarsophalangeal joint stiffness as an indicator of recovery were identified through the clinical evaluations. METHODS The robot implements an effective foot stretching protocol through a novel mechanism design that simultaneously stretches the plantar fascia and Achilles tendon using a single motor. Thirty patients with plantar fasciitis and fifteen healthy participants volunteered in the cross-sectional clinical evaluation, and nine patients from the patients group participated in the one-month clinical trial. Four main outcomes (Foot Function Index, Visual Analogue Scale-Foot and Ankle, plantar fascia thickness, and metatarsophalangeal joint stiffness) were used for the clinical evaluations. RESULTS In the cross-sectional clinical evaluation, the symptomatic feet of patients showed moderate negative correlation between normalized metatarsophalangeal joint stiffness and plantar fascia thickness with statistical significance. In the one-month clinical trial, all the main outcomes showed significant improvement after using the developed robot. Comparing our results with previous studies also indicated a therapeutic superiority of our robot for treating plantar fasciitis. CONCLUSION Our foot stretching robot had significant therapeutic effect on plantar fasciitis, and normalized metatarsophalangeal joint stiffness measured by our robot could be used as a monitoring indicator for recovery from plantar fasciitis. SIGNIFICANCE This study contributed to practical issues related to treatment of plantar fasciitis, and our results could be applied to effective treatment of plantar fasciitis and progressive monitoring of recovery.
Collapse
|
10
|
Feyzioğlu Ö, Öztürk Ö, Muğrabi S. Effects of custom-made insoles on foot pressure redistribution, gait parameters, and pain in calcaneal apophysitis-a pretest and posttest study. Prosthet Orthot Int 2021; 45:532-537. [PMID: 34561380 DOI: 10.1097/pxr.0000000000000039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 07/27/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Calcaneal apophysitis is a self-limiting disorder that often affects adolescents with a high level of activity and leads to increased pain severity, impairments in gait parameters, and poor health-related quality of life. OBJECTIVE To investigate the combination of custom-made insoles and exercise on foot pressure distribution, spatial-temporal gait parameters, and pain intensity in patients with calcaneal apophysitis. STUDY DESIGN A one-group pretest-posttest design. METHODS Forty patients, aged between 8 and 15 years, diagnosed with calcaneal apophysitis, were included in this study. Patients were asked to use the custom-made insoles and to perform a home exercise program for 3 days a week. The duration of treatment was 4 weeks. The pain severity was evaluated with the Visual Analog Scale. The spatial-temporal gait parameters and foot pressure distribution were assessed with the Zebris FDM-THM-S treadmill system before and after the treatment. RESULTS At posttreatment assessment, there were significant changes in step length, stance phase percentage, swing phase percentage, and gait speed (P < 0.05), except step width and cadence (P > 0.05). Moreover, significant differences were found in forefoot, midfoot, and rearfoot pressure distribution (P < 0.05). There was also a significant decrease in pain intensity during activity compared to the pretreatment (P < 0.05). CONCLUSION Our study results suggest that the combination of the custom-made insoles and exercise program created improvements in spatial-temporal gait parameters and foot pressure distribution by reducing the pain severity.
Collapse
Affiliation(s)
- Özlem Feyzioğlu
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Özgül Öztürk
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | | |
Collapse
|
11
|
Plantar Fasciitis: Distal Tarsal Tunnel (Baxter's Nerve) in the Athlete. OPER TECHN SPORT MED 2021. [DOI: 10.1016/j.otsm.2021.150854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
12
|
Hafliðadóttir SH, Juhl CB, Nielsen SM, Henriksen M, Harris IA, Bliddal H, Christensen R. Placebo response and effect in randomized clinical trials: meta-research with focus on contextual effects. Trials 2021; 22:493. [PMID: 34311793 PMCID: PMC8314506 DOI: 10.1186/s13063-021-05454-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 07/13/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Contextual effects (i.e., placebo response) refer to all health changes resulting from administering an apparently inactive treatment. In a randomized clinical trial (RCT), the overall treatment effect (i.e., the post-treatment effect in the intervention group) can be regarded as the true effect of the intervention plus the impact of contextual effects. This meta-research was conducted to examine the average proportion of the overall treatment effect attributable to contextual effects in RCTs across clinical conditions and treatments and explore whether it varies with trial contextual factors. METHODS Data was extracted from trials included in the main meta-analysis from the latest update of the Cochrane review on "Placebo interventions for all clinical conditions" (searched from 1966 to March 2008). Only RCTs reported in English having an experimental intervention group, a placebo comparator group, and a no-treatment control group were eligible. RESULTS In total, 186 trials (16,655 patients) were included. On average, 54% (0.54, 95%CI 0.46 to 0.64) of the overall treatment effect was attributable to contextual effects. The contextual effects were higher for trials with blinded outcome assessor and concealed allocation. The contextual effects appeared to increase proportional to the placebo effect, lower mean age, and proportion of females. CONCLUSION Approximately half of the overall treatment effect in RCTs seems attributable to contextual effects rather than to the specific effect of treatments. As the study did not include all important contextual factors (e.g., patient-provider interaction), the true proportion of contextual effects could differ from the study's results. However, contextual effects should be considered when assessing treatment effects in clinical practice. TRIAL REGISTRATION PROSPERO CRD42019130257 . Registered on April 19, 2019.
Collapse
Affiliation(s)
- Sigurlaug H Hafliðadóttir
- Section for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, DK-2000, Copenhagen F, Denmark.,SEARCH Research Group, Research Unit of Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Carsten B Juhl
- SEARCH Research Group, Research Unit of Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,Department of Physiotherapy and Occupational Therapy, University Hospital of Copenhagen, Herlev, Gentofte, Denmark
| | - Sabrina M Nielsen
- Section for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, DK-2000, Copenhagen F, Denmark.,Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense, Denmark
| | - Marius Henriksen
- The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Ian A Harris
- Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,Faculty of Medicine, South Western Sydney Clinical School, The University of New South Wales, Sydney, New South Wales, Australia.,Institute of Musculoskeletal Health, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Henning Bliddal
- The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Robin Christensen
- Section for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, DK-2000, Copenhagen F, Denmark. .,Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense, Denmark.
| |
Collapse
|
13
|
Bahar-Ozdemir Y, Atan T. Effects of adjuvant low-dye Kinesio taping, adjuvant sham taping, or extracorporeal shockwave therapy alone in plantar fasciitis: A randomised double-blind controlled trial. Int J Clin Pract 2021; 75:e13993. [PMID: 33410228 DOI: 10.1111/ijcp.13993] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/09/2020] [Accepted: 01/03/2021] [Indexed: 01/18/2023] Open
Abstract
AIM Extracorporeal shockwave therapy (ESWT) is known as one of the most effective treatment methods in plantar fasciitis (PF). Low-dye taping, which is the most preferred method of banding treatments, provides an analgesic effect by correcting biomechanics. It was aimed to compare the efficacy of adjuvant low-dye kinesio-taping (KT), sham-taping, or ESWT alone in PF. METHODS In this double-blind, sham-controlled study, 45 patients with PF were randomised into Group 3 (Group 1: ESWT plus low-dye KT, n = 15; Group 2: ESWT plus Sham-taping, n = 15; and Group 3: ESWT only, n = 15) five-session ESWT were administrated. KT was performed and changed every 1-week for the ESWT sessions in Groups 1 and 2. The main outcome measures were the visual analogue scale (VAS) change, the heel tenderness index (HTI), foot function index (FFI). The patients were evaluated at the beginning and end of the treatment and at the 4-week follow-up. RESULTS The demographic characteristics and baseline outcomes between groups were similar (P > .05). No significant difference was found between Groups 1 and 2, Groups 1 and 3 and Groups 2 and 3 with respect to VAS, HTI changes during the 4-week follow-up. VAS and HTI changes were observed in all three groups, there were no differences between groups. Repeated-measures ANOVA showed a significant interaction between the time and the groups in FFI-total (F3.919 = 2.607; P = .043). For the FFI total, there was only a significant difference in favour of Group 1 when compared with Group 2 (P = .027). CONCLUSIONS Although low-dye KT in addition to ESWT was more effective on foot function improvement than additive sham-taping and ESWT alone, it did not provide a significant benefit on pain and heel tenderness because of PF. CLINICAL TRIAL REGISTRATION NUMBER The study was registered at the U.S. National Institutes of Health (ClinicalTrials.gov) (NCT03904966).
Collapse
Affiliation(s)
- Yeliz Bahar-Ozdemir
- Department of Physical Medicine and Rehabilitation, Health Sciences University Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Tugba Atan
- Department of Physical Medicine and Rehabilitation, Gaziler Physical Therapy and Rehabilitation Education and Research Hospital, Ankara, Turkey
| |
Collapse
|
14
|
Mohammed W, Farah S, Nassiri M, McKenna J. Therapeutic efficacy of platelet-rich plasma injection compared to corticosteroid injection in plantar fasciitis: A systematic review and meta-analysis. J Orthop 2020; 22:124-134. [PMID: 32336895 PMCID: PMC7177161 DOI: 10.1016/j.jor.2020.03.053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 03/26/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND This study summarizes all literature assessing the long term effects of platelet-rich plasma (PRP) injection compared to corticosteroid injection to relieve pain and improve function in Plantar Fasciitis patients. MATERIALS AND METHODS This is a PRISMA compliant systematic review of 5 databases and include a meta-analysis of Randomized Controlled Trial data comparing the two injections. RESULTS Ten prospective trials were included with total number of 543 participants. The PRP group had significantly better pain scores at 3 months and 6 months follow-up. CONCLUSION PRP injections provide better pain relief, compared to corticosteroids, in patients with plantar fasciitis.
Collapse
Affiliation(s)
- Wafi Mohammed
- Tallaght University Hospital, Tallaght, Dublin 24, Ireland
| | - Salma Farah
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | | | - Johnny McKenna
- Tallaght University Hospital, Tallaght, Dublin 24, Ireland
| |
Collapse
|
15
|
Gatz M, Betsch M, Quack V, Bejder L, Schrading S, Tingart M, Dirrichs T. Shear wave elastography for treatment monitoring of plantar fasciitis. J Sports Med Phys Fitness 2020; 60:1137-1147. [PMID: 32955840 DOI: 10.23736/s0022-4707.20.10702-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Plantar fasciitis is a common cause of heel pain. Monitoring therapy effects is challenging with conventional B-mode ultrasound. Shear wave elastography (SWE) provides important diagnostic information beyond B-mode, with typically lower tissue stiffness in symptomatic plantar fascia. Up to now little is known about SWE features for therapy monitoring in plantar fasciitis. We evaluated the clinical effects of a 3-month physical therapy based treatment and its influence on B-mode and SWE ultrasound findings in patients suffering from plantar fasciitis, correlating ultrasound findings to score-based symptom development. METHODS Prospective, IRB-approved clinical study in plantar fasciitis patients undergoing a 3-month physical therapy based treatment. Measurement time points were before (T0), after 1 (T1) and 3 (T2) months of treatment, consisting of clinical orthopedic (FFI, AOFAS-Score) and multimodal radiologic sonographic examinations (B-mode/SWE) using a high-resolution linear 18-MHz probe. RESULTS A total of 33 patients with 43 symptomatic plantar fascia were included. We found a significant (P<0.001) clinical score improvement (AOFAS +14, FFI-Pain -21, FFI-Function -18) between T0 and T2. Mean initial thickness (T0) of symptomatic plantar fascia was 4.2 (±1.2) mm, compared to 3.2 (±0.7) mm at the asymptomatic contralateral side (P<0.001). No significant thickness changes were seen at T1 (4.2±1.1 mm) and T2 (4.5±1.3 mm), even though clinical scores improved significantly. Mean initial stiffness (T0) of symptomatic plantar fascia was 59.57 (±43.3) kPa, compared to 83.23 (±47.3) kPa at the asymptomatic contralateral side (P<0.001). In contrast to B-mode ultrasound, SWE values increased significantly between T0 (59.6±43.3 kPa), T1 (82.6±47.3 kPa) and T2 (102.5±47.2 kPa) (P<0.001-0.009), with positive correlations for AOFAS/FFI-Pain/Function scores (r=0.285-0.473, P<0.001-0.002). CONCLUSIONS A physical therapy based treatment relieves plantar fasciitis symptoms during a 3-month period. In line with symptom reduction, stiffness (Young's-moduli) of plantar fascia increased significantly, while B-mode ultrasound revealed no measurable changes during the healing process. Shear wave elastography was able to quantify plantar fascia pathologies and their recovery under therapy.
Collapse
Affiliation(s)
- Matthias Gatz
- Department of Orthopedics, University Hospital RWTH Aachen, Aachen, Germany
| | - Marcel Betsch
- Department of Orthopedics, University Hospital RWTH Aachen, Aachen, Germany
| | - Valentin Quack
- Department of Orthopedics, University Hospital RWTH Aachen, Aachen, Germany
| | - Ljudmila Bejder
- Department of Orthopedics, University Hospital RWTH Aachen, Aachen, Germany
| | - Simone Schrading
- Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany
| | - Markus Tingart
- Department of Orthopedics, University Hospital RWTH Aachen, Aachen, Germany
| | - Timm Dirrichs
- Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany -
| |
Collapse
|
16
|
Ranbhor AR, Prabhakar AJ, Eapen C. Immediate effect of foam roller on pain and ankle range of motion in patients with plantar fasciitis: A randomized controlled trial. Hong Kong Physiother J 2020; 41:25-33. [PMID: 34054254 PMCID: PMC8158403 DOI: 10.1142/s1013702521500025] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 08/24/2020] [Indexed: 11/18/2022] Open
Abstract
Background: Stretching has been proven to be effective on pain and range of motion (ROM) in patients with plantar fasciitis. Despite recent gain in popularity and the proposed theories of effectiveness of foam roller, there is a lack of literature on the effect of foam rolling on plantar fasciitis. Objective: The objective of this study was to compare the effects of foam rolling and stretching on pain and ankle ROM in patients with plantar fasciitis. Methods: A total of 50 participants were included and randomly allocated to the stretching and foam roller groups. Visual analog scale (VAS), pressure pain thresholds (PPTs) for gastrocnemius, soleus and plantar fascia and weight-bearing lunge test (WBLT) measurements were recorded at baseline and immediately after treatment. Results: Within-group analysis has shown there is a statistically significant difference (p<0.001) in all the outcome measures in both foam roller and self-stretching groups. The between-groups analysis showed no statistical significance difference in VAS, plantar fascia PPT and WBLT parameters (with p-values of 0.171, 0.372 and 0.861, respectively); however, significant differences were found in gastrocnemius PPT (p=0.029) and soleus PPT (p=0.013). Conclusion: It was seen that both stretching and foam rolling techniques helped in reducing pain and increasing the ROM. However, the effectiveness of foam roller was superior to stretching in terms of increase in PPTs at gastrocnemius and soleus. Clinical Trial Registration No: CTRI/2018/01/011398. Name of registry: The Clinical Trials Registry — India (CTRI); https://ctri.nic.in.
Collapse
Affiliation(s)
- Aishwarya R Ranbhor
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Karnataka, India
| | - Ashish J Prabhakar
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Karnataka, India
| | - Charu Eapen
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Karnataka, India
| |
Collapse
|
17
|
Mitham K, Mallows A, Debenham J, Seneviratne G, Malliaras P. Conservative management of acute lower limb tendinopathies: A systematic review. Musculoskeletal Care 2020; 19:110-126. [PMID: 32979021 DOI: 10.1002/msc.1506] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 08/18/2020] [Accepted: 08/21/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Most knowledge regarding conservative management for lower limb tendinopathy (LLT) is for persistent symptoms, with less known about conservative management of acute LLT. Sub-optimal management of acute LLT is detrimental in many regards, not least the likely conversion to persistent symptoms. OBJECTIVES To synthesise existing literature on conservative management of acute LLTs. DESIGN Systematic review of relevant literature (PROSPERO [ID: CRD42018117882]). METHOD A search was made of multiple databases (MEDLINE, CINAHL and EMBASE) using relevant search terms. Titles, abstracts and then full texts were filtered to find articles that met the strict inclusion/exclusion criteria. Searching, data extraction and quality assessment, using the Grading of Recommendations Assessment, Development and Evaluation, were done independently by two authors. To understand how the interventions impacted the duration of reported symptoms, results were split into three time points: short-term (<4 weeks), medium-term (4-12 weeks) and long-term (>12 weeks). RESULTS Thirteen studies (n = 534) met the criteria for inclusion. There was very low level of certainty for the effectiveness of interventions at short-term, medium-term and long-term follow ups. However, there were large effects seen across a number of different treatments on pain intensity and disability in LLTs. CONCLUSIONS This review demonstrates that limited evidence currently exists to guide the management of acute LLT, and the quality of the existing evidence is collectively low. These findings inform the discussion of different treatment options with patients in a shared decision-making process to empower and enable the patient.
Collapse
Affiliation(s)
| | - Adrian Mallows
- School of Sport, Rehabilitation & Exercise Sciences, University of Essex, Colchester, UK
| | - James Debenham
- School of Physiotherapy, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | | | - Peter Malliaras
- Physiotherapy Department, School of Primary and Allied Health Care, Monash University, Clayton, Victoria, Australia
| |
Collapse
|
18
|
Cupler ZA, Alrwaily M, Polakowski E, Mathers KS, Schneider MJ. Taping for conditions of the musculoskeletal system: an evidence map review. Chiropr Man Therap 2020; 28:52. [PMID: 32928244 PMCID: PMC7491123 DOI: 10.1186/s12998-020-00337-2] [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: 02/20/2020] [Accepted: 07/12/2020] [Indexed: 12/14/2022] Open
Abstract
Background Taping is a common treatment modality used by many rehabilitation providers. Several types of tapes and taping methods are used in the treatment of musculoskeletal dysfunction and pain. Purpose To summarize and map the evidence related to taping methods used for various joints and conditions of the musculoskeletal system, and to provide clinicians and researchers with a user-friendly reference with organized evidence tables. Data sources The PEDro, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Central Register for Controlled Trials, PubMed, and PROSPERO databases were searched from inception through October 31, 2019. Study selection Eligible studies were selected by two independent reviewers and included either systematic reviews (SRs) or randomized controlled trials (RCTs) and included a musculoskeletal complaint using a clinical outcome measure. Data extraction Data was extracted by two investigators independently. Risk of bias and quality were assessed using A MeaSurement Tool to Assess systematic Reviews (AMSTAR) for SRs or the Physiotherapy Evidence Database (PEDro) scale for RCTs. The protocol was registered with PROSPERO (CRD42019122857). Data synthesis Twenty-five musculoskeletal conditions were summarized from forty-one SRs and 127 RCTs. There were 6 SRs and 49 RCTs for spinal conditions. Kinesio tape was the most common type of tape considered. Four evidence tables representing the synthesized SRs and RCTs were produced and organized by body region per condition. Limitations Inclusion of only English language studies. Also, the heterogeneous nature of the included studies prevented a meta-analysis. Conclusions There is mixed quality evidence of effectiveness for the different types of taping methods for different body regions and conditions. All of the SRs and RCTs found during our search of the taping literature have been organized into a series of appendices. A synthesis of the results have been placed in evidence tables that may serve as a useful guide to clinicians and researchers.
Collapse
Affiliation(s)
- Zachary A Cupler
- Physical Medicine & Rehabilitation Services, Butler VA Healthcare System, 353 N. Duffy Road, Butler, Pennsylvania, USA.
| | - Muhammad Alrwaily
- Division of Physical Therapy, School of Medicine, West Virginia University, Morgantown, West Virginia, USA.,Department of Physical Therapy, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Emily Polakowski
- Private Practice, Independence Physical Therapy, Mystic, Connecticut, USA
| | - Kevin S Mathers
- VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
| | - Michael J Schneider
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
19
|
Siriphorn A, Eksakulkla S. Calf stretching and plantar fascia-specific stretching for plantar fasciitis: A systematic review and meta-analysis. J Bodyw Mov Ther 2020; 24:222-232. [PMID: 33218515 DOI: 10.1016/j.jbmt.2020.06.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 06/08/2020] [Accepted: 06/13/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Plantar fasciitis (PF) is the most common cause of heel pain. A calf stretching (CS) and a plantar fascia-specific stretching (PFSS) are two stretching techniques commonly administered by health care providers. OBJECTIVE To evaluate the literature on the application of these two stretching techniques in the treatment of PF and investigate their effectiveness and efficacy. METHOD A search of PubMed, Web of Sciences, PEDro, CINHAL and Scopus was conducted. Studies that applied stretching as a co-intervention were excluded. The risk of bias was assessed to determine the internal validity of the included trials. The GRADE approach was adopted to determine the overall quality. Pooled analysis was performed to determine the treatment effects of CS and PFSS in terms of the mean difference in the visual analog scale pain score. RESULTS Eight articles were found that represented randomized controlled trial and met the inclusion criteria. There was very low-quality evidence that the combined CS and PFSS was less effective in the short term than the other therapies. Comparison between CS and PFSS revealed moderate quality evidence for a larger effect of pain score reduction for PFSS treatment over CS, while very low-quality evidence supported that combined CS and PFSS or CS alone was superior to sham stretching. CONCLUSION There was moderate to very low-quality evidence of the effectiveness of stretching for PF. The treatment effect of stretching was large and comparable to other therapies. Future trials of higher quality are needed to clarify findings or to confirm findings.
Collapse
Affiliation(s)
- Akkradate Siriphorn
- Human Movement Performance Enhancement Research Unit, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Thailand.
| | - Sukanya Eksakulkla
- Human Movement Performance Enhancement Research Unit, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Thailand
| |
Collapse
|
20
|
Petrofsky J, Donatelli R, Laymon M, Lee H. Greater Postural Sway and Tremor during Balance Tasks in Patients with Plantar Fasciitis Compared to Age-Matched Controls. Healthcare (Basel) 2020; 8:E219. [PMID: 32698455 PMCID: PMC7551341 DOI: 10.3390/healthcare8030219] [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: 06/20/2020] [Revised: 07/07/2020] [Accepted: 07/13/2020] [Indexed: 12/20/2022] Open
Abstract
Plantar fasciitis (PF) is a common condition found in men and women and can reoccur throughout life. PF is commonly diagnosed by prolonged foot pain lasting more than 3 months and a plantar fascia over 0.4 mm thick, as measured using ultrasound imaging. This study examined the ability to balance and the occurrence of muscle tremor during different balance tasks in patients with PF compared to their control counterparts. Fifty subjects (25 patients with PF and 25 control subjects) participated in this study. Subjective pain (measured with a visual analog scale (VAS)), pressure pain threshold (PPT), and postural sway and tremor during eight different balance tasks were measured. Postural sway was measured by a balance platform, while tremor was measured as the mechanical movement of the platform in the 8 Hz frequency range. Thickness of plantar fascia, subjective pain, and PPT were significantly greater in the PF group compared to the controls (p < 0.001). Postural sway and 8 Hz tremor were significantly greater in the PF group compared to the control group for all eight balance tasks (p < 0.01). These results indicate that the lack of plantar fascia elasticity is probably the cause of the reduced balance and increased muscle tremor.
Collapse
Affiliation(s)
- Jerrold Petrofsky
- School of Physical Therapy, Touro University Nevada, Henderson, NV 89002, USA; (J.P.); (M.L.)
| | | | - Michael Laymon
- School of Physical Therapy, Touro University Nevada, Henderson, NV 89002, USA; (J.P.); (M.L.)
| | - Haneul Lee
- Modern Athletic Science, Las Vegas, NV 88901, USA;
- Department of Physical Therapy, Gachon University, Incheon 400011, Korea
| |
Collapse
|
21
|
Alotaibi A, Petrofsky J, Daher NS, Lohman E, Syed HM, Lee H. The Effect of Monophasic Pulsed Current with Stretching Exercise on the Heel Pain and Plantar Fascia Thickness in Plantar Fasciitis: A Randomized Controlled Trial. Healthcare (Basel) 2020; 8:healthcare8020079. [PMID: 32235475 PMCID: PMC7349871 DOI: 10.3390/healthcare8020079] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/27/2020] [Accepted: 03/27/2020] [Indexed: 11/16/2022] Open
Abstract
Plantar fasciitis (PF) is one of the most common causes of heel and foot pain. Monophasic pulsed current (MPC) is an electrical stimulation used to accelerate the healing processes. The purpose of this study was to determine the effect of MPC and MPC combined with plantar fascia stretching exercises (SE) on heel pain and plantar fascia thickness in treatment of PF and see if there is any relationship between heel pain and plantar fascia thickness after intervention. Forty-four participants diagnosed with PF were randomly assigned to two group; MPC group or MPC combined with plantar fascia SE. Plantar fascia thickness was measured with musculoskeletal ultrasound. Although no statistical differences between the two groups were found, heel pain and the plantar fascia thickness significantly decreased in both groups after the intervention (p < 0.001). No significant correlation was found between changes in heel pain and plantar fascia thickness after 4 weeks of treatment. Our results indicated that MPC can reduce heel pain and plantar fascia thickness caused by PF. However, MPC combined with plantar fascia SE is not superior to MCP only in terms of reduction in heel pain and plantar fascia thickening.
Collapse
Affiliation(s)
- Abdullah Alotaibi
- Department of Physical Therapy, Loma Linda University, Loma Linda, CA 92354, USA; (A.A.); (E.L.)
- Scientific Research Center, Saudi Armed Forces Medical Service Department, Riyadh 11461, Saudi Arabia
| | - Jerrold Petrofsky
- School of Physical Therapy, Touro University, Henderson, NV 89014, USA;
| | - Noha S. Daher
- School of Allied Health Professions, Loma Linda University, Loma Linda, CA 92354, USA;
| | - Everett Lohman
- Department of Physical Therapy, Loma Linda University, Loma Linda, CA 92354, USA; (A.A.); (E.L.)
| | - Hasan M. Syed
- Department of Orthopedic Surgery, School of Medicine, Loma Linda University, Loma Linda, CA 92354, USA;
| | - Haneul Lee
- Department of Physical Therapy, Gachon University, Incheon 21936, Korea
- Correspondence: ; Tel.: +82-32-820-4335; Fax: +82-32-820-4420
| |
Collapse
|
22
|
Pressure and Traction Technique Improves Postural Control More Than Tactile Stimulation in Foot Plantar Fascia: A Randomized Single-Blind Trial. Arch Phys Med Rehabil 2020; 101:978-984. [PMID: 32113972 DOI: 10.1016/j.apmr.2020.01.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 01/15/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To check the acute effects of manual pressure and traction technique on balance and plantar footprint variables. DESIGN A single-blind clinical study with 2 groups. SETTING Private practice. PARTICIPANTS Healthy participants (N=40; 28 female and 12 male) were recruited to carry out a single-blind study. INTERVENTIONS Experimental group performed a bilateral plantar fascia manual pressure and traction technique. Control group performed a tactile stimulation. The position of the participant, the therapist, and the time of application of the techniques (5min) were the same for both interventions. MAIN OUTCOME MEASURES We measured stabilometry variables and static footprint. The footprint variables were divided in rear, middle, and front foot areas. RESULTS Significant differences were found in stabilometry variables. There was an improvement in experimental group at X displacement with eyes open (P=.014) and surface eyes closed (P=.046) variables. CONCLUSIONS After technique the experimental group improved the stabilometry variables, specifically surface with eyes closed and X displacement with eyes open. The static footprint variables have not shown differences after the technique compared with the control group.
Collapse
|
23
|
Acute effects of myofascial induction technique in plantar fascia complex in patients with myofascial pain syndrome on postural sway and plantar pressures: A quasi-experimental study. Phys Ther Sport 2020; 43:70-76. [PMID: 32114316 DOI: 10.1016/j.ptsp.2020.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 02/20/2020] [Accepted: 02/20/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The prevalence of myofascial pain syndrome varies from 21% 93%. Several studies have shown that myofascial induction is effective in treating myofascial pain syndrome. Although these techniques have shown some effectiveness in clinical practice, there have been little study into their effects, and have deep effects. The purpose of this study was to investigate if the application of a single myofascial induction technique for each foot, targeted to the plantar fascia resulted in changes in balance and footprint variables. DESIGN A quasi-experimental study. SETTING An outpatient clinic. SUBJECTS 20 healthy participants (12 females and 8 males) were evaluated pre and post Myofascial induction technique for each foot in plantar fascia during 5 min. METHODS We measured static footprint and stabilometry variables in asymptomatic subjects. The footprint surface area was divided: bilateral rear foot, bilateral midfoot, bilateral fore foot. RESULTS We found differences in the footprint variables: maximun pressure in forefoot (p = 0.025), surface in forefoot (p = 0.03). The myofascial induction has no effects on stabilometry variables. CONCLUSIONS The immediate effects of the longitudinal technique of myofascial induction of the plantar fascia are the increase of surface and maximum pressure in fore foot.
Collapse
|
24
|
Effectiveness of Mechanical Treatment for Plantar Fasciitis: A Systematic Review. J Sport Rehabil 2019; 29:657-674. [PMID: 31629333 DOI: 10.1123/jsr.2019-0036] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 05/02/2019] [Accepted: 06/02/2019] [Indexed: 11/18/2022]
Abstract
CONTEXT Plantar fasciitis is one of the most common foot injuries. Several mechanical treatment options, including shoe inserts, ankle-foot orthoses, tape, and shoes are used to relieve the symptoms of plantar fasciitis. OBJECTIVES To investigate the effectiveness of mechanical treatment in the management of plantar fasciitis. EVIDENCE ACQUISITION The review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. A systematic search was performed in PubMed, CINAHL, Embase, and Cochrane up to March 8, 2018. Two independent reviewers screened eligible articles and assessed risk of bias using the Cochrane Collaboration's risk of bias tool. EVIDENCE SYNTHESIS A total of 43 articles were included in the study, evaluating 2837 patients. Comparisons were made between no treatment and treatment with insoles, tape, ankle-foot orthoses including night splints and shoes. Tape, ankle-foot orthoses, and shoes were also compared with insoles. Follow-up ranged from 3 to 5 days to 12 months. Cointerventions were present in 26 studies. CONCLUSIONS Mechanical treatment can be beneficial in relieving symptoms related to plantar fasciitis. Contoured full-length insoles are more effective in relieving symptoms related to plantar fasciitis than heel cups. Combining night splints or rocker shoes with insoles enhances improvement in pain relief and function compared with rocker shoes, night splints, or insoles alone. Taping is an effective short-term treatment. Future studies should aim to improve methodological quality using blinding, allocation concealment, avoid cointerventions, and use biomechanical measures of treatment effects.
Collapse
|
25
|
Abstract
Heel pain presents frequently to primary care, commonly affecting athletic and elderly patients. Its presentation can be a common source of confusion for clinicians given the wide variety of differential diagnoses and the similarities in presenting symptoms and signs. This review classifies heel pain according to site of pain and explores the common pathologies clinicians may encounter. A brief summary of common imaging modalities used is provided. The literature is reviewed to guide evidence-based practice and to provide a framework to help clinicians investigate and manage heel pain before onward referral for specialist intervention. A linked article detailing the imaging of heel pain is included in this issue ( https://doi.org/10.12968/hmed.2019.80.4.192 ).
Collapse
Affiliation(s)
- Usman N Bhatty
- ST6 Registrar in Trauma and Orthopaedic Surgery, Department of Orthopaedics, East Lancashire Hospitals NHS Trust, Blackburn BB2 3HH
| | - Shah Hm Khan
- Consultant Musculoskeletal Radiologist, Department of Radiology, East Lancashire Teaching Hospitals NHS Trust, Blackburn and Honorary Senior Lecturer, University of Central Lancashire, Preston
| | - Aamir I Zubairy
- Consultant Trauma and Orthopaedic Surgeon, Department of Orthopaedics, East Lancashire Hospitals NHS Trust, Blackburn
| |
Collapse
|
26
|
Yesil H, Dundar U, Toktas H, Eyvaz N, Yeşil M. The effect of high intensity laser therapy in the management of painful calcaneal spur: a double blind, placebo-controlled study. Lasers Med Sci 2019; 35:841-852. [PMID: 31478095 DOI: 10.1007/s10103-019-02870-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 08/23/2019] [Indexed: 12/29/2022]
Abstract
To evaluate the effect of high-intensity laser therapy (HILT) in patients with calcaneal spur. The patients were randomized to receive either HILT + exercise (n = 21) (five times a week for a period of 3 weeks) or placebo HILT + exercise (n = 21) (five times a week for a period of 3 weeks). Pain severity (with visual analog scale (VAS) and with Roles and Maudsley score (RMS)), functionality (with Foot and Ankle Outcome Score (FAOS)), plantar pressure measurement, and quality of life (with short form-36 (SF-36)) of the patients were evaluated at baseline, at 4 weeks, and 12 weeks. A significant improvement in the VAS (p < 0.001), RMS (p < 0.001), and most of the SF-36 subgroup scores (p < 0.05) and most of the FAOS subgroup scores (p < 0.05) at 4 and 12 weeks after treatment was achieved in both groups. Besides, there was no significant difference in VAS (p > 0.05) and RMS (p > 0.05) between the groups. FAOS symptoms (p = 0.022) and quality of life (p = 0.038) subgroups were higher in the placebo group at 12 weeks. Significant improvements were observed in dynamic pedographic measurements in the HILT group (p < 0.05), and dynamic measurement values were significantly higher in the HILT group compared to placebo group (p < 0.05). Although the evaluation parameters, except dynamic pedographic measurements, have improved in both groups, our study results showed no superiority of HILT over placebo. To conclude, when the main complaint is pain in patients, only exercise therapy can be an economical, practical, and reliable treatment.
Collapse
Affiliation(s)
- Hilal Yesil
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey.
| | - Umit Dundar
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
| | - Hasan Toktas
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
| | - Nuran Eyvaz
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
| | - Murat Yeşil
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
| |
Collapse
|
27
|
Çatal B, Keskinbora M, Keskinöz EN, Tümentemur G, Azboy İ, Demiralp B. Percutaneous Plantar Fascia Release With Needle: Anatomic Evaluation with Cadaveric Specimens. J Foot Ankle Surg 2019; 58:842-846. [PMID: 31130478 DOI: 10.1053/j.jfas.2018.12.015] [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: 03/25/2018] [Indexed: 02/03/2023]
Abstract
Percutaneous plantar fascia release with needle is a novel procedure for the treatment of plantar fasciitis. The objective of this cadaveric study is to perform an anatomic evaluation of the percutaneous plantar fascia release method using a conventional hypodermic needle. In this study, we used 14 fresh-frozen cadaveric trans-tibial amputation specimens. Percutaneous plantar fasciotomy with a conventional hypodermic needle was performed. After a proper dissection, the width of the plantar fascia, the thickness of the medial border, and the width of the cut segment were measured and recorded. Any muscle damage on the flexor digitorum brevis and damaged area depth were recorded. Any damage on the lateral plantar nerve and the first branch of the lateral plantar nerve, also known as Baxter's nerve, and their distance to fasciotomy were also recorded. Mean width (± standard deviation) of the plantar fascia was measured as 20.34 ± 4.25 mm. The mean thickness of the medial border of the plantar fascia was 3.04 ± 0.54 mm. Partial fasciotomy was performed in all cadavers with 49.47% ± 7.25% relative width of the plantar fascia. No lateral plantar nerve, or its first branch Baxter's nerve, was damaged, and the mean distance from the deepest point of the fasciotomy up to the Baxter's nerve was 8.62 ± 2.62 mm. This cadaveric study demonstrated that partial plantar fasciotomy can be achieved via percutaneous plantar fascia release with a conventional hypodermic needle without any nerve damage.
Collapse
Affiliation(s)
- Bilgehan Çatal
- Orthopedic Surgeon, Department of Orthopedic Surgery, Medipol Koşuyolu Hospital, İstanbul, Turkey.
| | - Mert Keskinbora
- Orthopedic Surgeon, Department of Orthopedic Surgery, Medipol Koşuyolu Hospital, İstanbul, Turkey
| | - Elif Nedret Keskinöz
- Associate Registrar, Department of Anatomy, Acıbadem University Medical School, İstanbul, Turkey
| | - Gamze Tümentemur
- Associate Registrar, Department of Anatomy, Acıbadem University Medical School, İstanbul, Turkey
| | - İbrahim Azboy
- Associate Professor, Department of Orthopedic Surgery, Medipol University Medical School, İstanbul, Turkey
| | - Bahtiyar Demiralp
- Professor, Department of Orthopedic Surgery, Güven Hospital, Ankara, Turkey
| |
Collapse
|
28
|
Chen TLW, Wong DWC, Peng Y, Zhang M. Prediction on the plantar fascia strain offload upon Fascia taping and Low-Dye taping during running. J Orthop Translat 2019; 20:113-121. [PMID: 31908942 PMCID: PMC6938939 DOI: 10.1016/j.jot.2019.06.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 06/18/2019] [Accepted: 06/24/2019] [Indexed: 11/29/2022] Open
Abstract
Background Taping is commonly prescribed to treat plantar fasciitis for runners by virtue of its alleged ability to offload the plantar fascia and facilitate positive injury prognosis. Our study aimed to investigate how different taping methods could change the loading on the plantar fascia during running using computational simulations. Methods A finite element foot model was modified from a previous version to fit the study's purpose. The model featured twenty bones, bulk soft tissue, foot muscles, ligaments/tendons, and a solid part representing the plantar fascia. A runner performed several running trials under one untaped condition and two taped conditions—Low-Dye taping and Fascia taping, which were implemented by a physiotherapist using the Kinesio tapes. The captured motion data were processed to drive a scaled musculoskeletal model and calculate segmental kinematics, foot muscle force, and joint reaction force. These variables were then input as the boundary/loading conditions for finite element analyses of running. The principal tensile strain on the plantar fascia, subtalar eversion, and navicular height during the stance phase were averaged across five trials of each condition and compared using Friedman's test. Results Maximal subtalar eversion did not differ among conditions (p = 0.449). Fascia taping significantly reduced maximal strains on the fascia band (p = 0.034, Kendall's W = 0.64–0.76) and increased the navicular height (p = 0.013, Kendall's W = 0.84) compared with nontaping. There were no significant differences in all outcome variables between Low-Dye taping and nontaping (p = 0.173–0.618). Conclusion From a mechanical point of view, our study provided quantitative evidence to support the application of taping treatments for overstrained plantar fascia. The untensed fascia band by Fascia taping could be a potential indicator of pain relief for the runners. However, a prospective study targeting the patient population would be needed to address the point. The Translational Potential of this Article The study quantified the loading status of the plantar fascia during running and provided mechanical evidence to support the usage of taping as a mean to reduce fascial strain, thus possibly controlling injury risks for the runners. The results of the study also highlighted the importance of selecting specific taping methods based on individuals' needs.
Collapse
Affiliation(s)
- Tony Lin-Wei Chen
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China.,The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Yinghu Peng
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China.,The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| |
Collapse
|
29
|
Wu FL, Shih YF, Lee SH, Luo HJ, Wang WTJ. Can short-term effectiveness of anti-pronation taping predict the long-term outcomes of customized foot orthoses: developing predictors to identify characteristics of patients with plantar heel pain likely to benefit from customized foot orthoses. BMC Musculoskelet Disord 2019; 20:264. [PMID: 31151391 PMCID: PMC6543557 DOI: 10.1186/s12891-019-2648-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 05/21/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Foot orthoses are widely used to manage plantar heel pain (PHP). However, the evidence concerning the effect of foot orthoses on PHP is not conclusive. The study aims to identify the characteristics of patients with PHP likely to achieve a positive outcome after customized foot orthoses and to verify the concept that patients who respond positively to anti-pronation taping would achieve a positive prognosis after wearing foot orthoses for six months. METHODS This is a prospective observational cohort study. Seventy-four patients with PHP underwent a baseline examination and received anti-pronation taping to their painful feet. The taping effects on pain and function were assessed at the 7-day follow-up visit. Then, all patients received an intervention for their PHP with customized foot orthoses for six months. Outcome was assessed with a numeric pain rating scale, the patient-specific functional scale, the foot function index, and the global rating of perceived change. Significant reduction of pain, increase of function, and perception of a meaningful improvement were considered a positive response. RESULTS Of 74 patients, 49 had a positive response to the customized foot orthosis treatment. Five predictors were identified: (1) the average pain intensity decreased by over 1.5 points with taping, (2) the range of ankle plantarflexion > 54 degrees, (3) the strength of ankle plantarflexors on the symptomatic side was equal to or stronger than that on the other side, (4) the range of hip internal rotation < 39 degrees, and (5) the range of hip external rotation > 45 degrees. The presence of three or more predictors increased the rate of achieving positive outcome from 66 to 89%. CONCLUSIONS The predictors of customized foot orthosis outcome in patients with PHP are related to several physical measures of a lower extremity. Findings of the study can be used to screen and select patients with PHP for foot orthosis intervention. Moreover, patients who respond positively to anti-pronation taping would also benefit from the customized foot orthoses. However, since there was no control group in the current study, it is inappropriate to draw conclusions about the effectiveness of the foot orthoses treatment. TRIAL REGISTRATION The trial was retrospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN 12617000119392 ).
Collapse
Affiliation(s)
- Fu-Lien Wu
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 112 Taiwan, Republic of China
| | - Yi-Fen Shih
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 112 Taiwan, Republic of China
| | - Si-Huei Lee
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hong-Ji Luo
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 112 Taiwan, Republic of China
| | - Wendy Tzyy-Jiuan Wang
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 112 Taiwan, Republic of China
| |
Collapse
|
30
|
Effect of In-Shoe Foot Orthosis Contours on Heel Pain Due to Calcaneal Spurs. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9030495] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objective of this study is to investigate the effect of contouring the shoe insole on calcaneal pressure and heel pain in calcaneal spur patients. Calcaneal pressure was measured using three force sensors from 13 patients including three males and 10 females. These patients have plantar heel pain due to calcaneal spurs, and we examined five customized contour insole foot areas (0–100%). Sensors were attached at the central heel (CH), lateral heel (LH) and medial heel (MH) of the foot. The pain was measured using an algometer and evaluated by the pain minimum compressive pressure (PMCP). In this study, it was observed that the calcaneal pressure decreased with increasing insole foot area. In addition, increasing the insole foot area from 25% to 50% can reduce the calcaneal pressure approximately 17.4% at the LH and 30.9% at the MH, which are smaller than the PMCP, while at the MH, pressure reduced 6.9%, which is greater than the PMCP. Therefore, to reduce pain, one can use 50% insole foot area, even though at MH it is still 19.3% greater than the PMCP. Excellent pain relief was observed when using 100% insole foot area, as the pressures in those three areas are lower than the PMCPs, but it is not recommended because it requires large production costs.
Collapse
|
31
|
Additive Effect of Therapeutic Ultrasound in the Treatment of Plantar Fasciitis: A Randomized Controlled Trial. J Orthop Sports Phys Ther 2018; 48:847-855. [PMID: 29996734 DOI: 10.2519/jospt.2018.8110] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Plantar fasciitis is the chief cause of pain in the plantar surface of the heel. Therapeutic ultrasound is one of the most common conservative treatment modalities used by physical therapists worldwide, despite scarce evidence of its efficacy in treating plantar fasciitis. OBJECTIVE To evaluate the additive effect of therapeutic ultrasound in the treatment of plantar fasciitis in terms of pain, function, and quality of life. METHODS In this prospective, randomized, double-blind, placebo-controlled clinical trial, 54 patients with plantar fasciitis, aged 24 to 80 years, who met the inclusion criteria were randomized into an active intervention and a control group. Individuals in the active intervention group were treated with self-performed stretching of the plantar fascia and calf muscles and with therapeutic ultrasound. Individuals in the control group were treated with the same stretching exercises and sham ultrasound. Both groups received 8 treatments, twice weekly. Outcome measures included a numeric pain-rating scale, the computerized adaptive test for the foot and ankle, and an algometric test. RESULTS Both groups showed statistically significant improvement in all outcome measures (P<.001, both groups). At the completion of the study, no statistically significant differences were found between the groups in any of the outcomes. CONCLUSION The addition of therapeutic ultrasound did not improve the efficacy of conservative treatment for plantar fasciitis. Therefore, the authors recommend excluding therapeutic ultrasound from the treatment of plantar fasciitis and agree with results of previous studies that stretching may be an effective treatment for healing plantar fasciitis. LEVEL OF EVIDENCE Therapy, level 1b. J Orthop Sports Phys Ther 2018;48(11):847-855. Epub 11 Jul 2018. doi:10.2519/jospt.2018.8110.
Collapse
|
32
|
Wheeler PC, Tattersall C. Extracorporeal Shockwave Therapy Plus Rehabilitation for Patients With Chronic Plantar Fasciitis Might Reduce Pain and Improve Function but Still Not Lead to Increased Activity: A Case-Series Study With Multiple Outcome Measures. J Foot Ankle Surg 2018; 57:339-345. [PMID: 29032913 DOI: 10.1053/j.jfas.2017.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Indexed: 02/03/2023]
Abstract
Plantar fasciitis is a common cause of plantar-aspect heel pain. Although many patients will improve, a proportion will have ongoing and sometimes debilitating symptoms. Evidence from randomized controlled trials has shown that extracorporeal shockwave therapy (ESWT) results in benefits in treating pain. However, uncertainties remain whether these benefits translate to improvements in overall function. The present prospective case series examined the results from 35 patients with chronic plantar fasciitis who had undergone a course of ESWT in addition to a graded rehabilitation program. Of the 35 subjects, 34% were male, and the median age was 50.9 years. The duration of symptoms before ESWT was 24 months. The results of the present case series demonstrated statistically significant improvements in measures of self-reported "average pain" from a median of 7.0 of 10 at baseline to 5.0 of 10 at 3 months (p < .001) and of "worst pain" from 9.0 of 10 at baseline to 7.0 of 10 at 3 months (p < .001). In addition, significant improvements were found in several validated patient-rated outcome measures of local foot/ankle function but not in overall markers of health, anxiety/depression scores, or activity levels, despite the improvements in pain. No statistically significant correlations were found between gender, age, or chronicity of symptoms and the improvements seen. No significant side effects occurred in the present study. The results of our series support the use of ESWT for patients with chronic plantar fasciitis for local pain symptoms; however, uncertainties remain regarding global benefits to health.
Collapse
Affiliation(s)
- Patrick C Wheeler
- Consultant, Sport and Exercise Medicine, Department of Sport and Exercise Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Senior Lecturer and Visiting Fellow, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom; Consultant, Sport and Exercise Medicine, National Centre of Sport and Exercise Medicine-East Midlands, Loughborough United Kingdom.
| | - Chloe Tattersall
- Nurse Practitioner, Department of Sport and Exercise Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| |
Collapse
|
33
|
Schneider HP, Baca JM, Carpenter BB, Dayton PD, Fleischer AE, Sachs BD. American College of Foot and Ankle Surgeons Clinical Consensus Statement: Diagnosis and Treatment of Adult Acquired Infracalcaneal Heel Pain. J Foot Ankle Surg 2018; 57:370-381. [PMID: 29284574 DOI: 10.1053/j.jfas.2017.10.018] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Indexed: 02/03/2023]
Abstract
Adult acquired inferior calcaneal heel pain is a common pathology seen in a foot and ankle practice. A literature review and expert panel discussion of the most common findings and treatment options are presented. Various diagnostic and treatment modalities are available to the practitioner. It is prudent to combine appropriate history and physical examination findings with patient-specific treatment modalities for optimum success. We present the most common diagnostic tools and treatment options, followed by a discussion of the appropriateness of each based on the published data and experience of the expert panel.
Collapse
Affiliation(s)
- Harry P Schneider
- Chairperson, Heel Pain Clinical Consensus Statement, Chicago, IL; Assistant Professor of Surgery, Harvard Medical School, Cambridge, MA; Residency Program Director, Cambridge Health Alliance, Cambridge, MA.
| | - John M Baca
- Private Practice, Dallas Podiatry Works, Dallas, TX
| | - Brian B Carpenter
- Professor, Department of Orthopedics, The University of North Texas Health Science Center, Fort Worth, TX; Private Practice, Paradise, TX
| | - Paul D Dayton
- Assistant Professor, College of Podiatric Medicine and Surgery, Des Moines, IA; Residency Program Director, UnityPoint Health, Fort Dodge, IA
| | - Adam E Fleischer
- Associate Professor, Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, North Chicago, IL; Director of Research, Weil Foot and Ankle Institute, Chicago, IL
| | - Brett D Sachs
- Private Practice, Rocky Mountain Foot & Ankle Center, Wheat Ridge, CO; Faculty, Highlands-Presbyterian/St. Luke's Podiatric Medicine and Surgery Residency Program, Denver, CO
| |
Collapse
|
34
|
Çatal B, Keskinbora M, Uysal MA, Şahin M, Gulabi D, Demiralp B. Endoscopic Plantar Fasciotomy; Deep Fascial Versus Superficial Fascial Approach: A Prospective Randomized Study. J Foot Ankle Surg 2018; 56:1001-1008. [PMID: 28842084 DOI: 10.1053/j.jfas.2017.04.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Indexed: 02/03/2023]
Abstract
In the present randomized prospective study, 2 different surgical techniques of endoscopic plantar fascia release were compared. Of 547 patients with a diagnosis of plantar fasciitis, 46 with no response to conservative treatment for ≥6 months were included. Of the 46 patients, 5 were lost to follow-up. In group 1 (n = 21), plantar fascia release was performed using a deep fascial approach (DFA), and in group 2 (n = 20), the superficial fascial approach (SFA) with a slotted cannula technique was used. Patients were evaluated using the American Orthopaedic Foot and Ankle Society Ankle Hindfoot scale and visual analog scale at baseline and 3 weeks and 3, 6, and 12 months after the initial surgery. At the final follow-up appointment, the Roles-Maudsley score was used to determine patient satisfaction. At the final follow-up examination, the mean American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale scores had increased from 53.12 to 83.68, with a decrease in the mean visual analog scale score from 7.95 to 1.65 noted. According to the Roles-Maudsley score, the success rate after 1 year was 90.47% for DFA group, 95% for the SFA group, and 92.68% for all patients. Although no significant difference was found between the final functional scores, better early postoperative scores were found in the SFA group. The mean duration of the procedure was measured as 27.22 ± 9.41 minutes overall, 35 ± 5.62 minutes in the DFA group, and 19.05 ± 4.01 minutes in the SFA group. Two early and two late complications occurred in the DFA group with none reported in the SFA group. In conclusion, the SFA is a faster and safer method of endoscopic plantar fascia release with better early postoperative scores.
Collapse
Affiliation(s)
- Bilgehan Çatal
- Orthopedic Surgeon, Department of Orthopedic Surgery, Medipol Koşuyolu Hospital, Kadıköy/İstanbul, Turkey.
| | - Mert Keskinbora
- Orthopedic Surgeon, Department of Orthopedic Surgery, Medipol Koşuyolu Hospital, İstanbul, Turkey
| | - Mehmet Ali Uysal
- Orthopedic Surgeon, Department of Orthopedic Surgery, Kartal Lütfi Kırdar Education and Research Hospital, Sağlık Bilimleri University, İstanbul, Turkey
| | - Mustafa Şahin
- Asstistant Professor, Department of Orthopeadic Surgery, Medipol University Medical School, Kadıköy/İstanbul, Turkey
| | - Deniz Gulabi
- Associate Professor, Department of Orthopedic Surgery, Kartal Lütfi Kırdar Education and Research Hospital, Sağlık Bilimleri University, İstanbul, Turkey
| | - Bahtiyar Demiralp
- Professor, Department of Orthopedic Surgery, Güven Hospital, Ankara, Turkey
| |
Collapse
|
35
|
Wu FL, Shih YF, Lee SH, Luo HJ, Wang WTJ. Development of a clinical prediction rule to identify patients with plantar heel pain likely to benefit from biomechanical anti-pronation taping: A prospective cohort study. Phys Ther Sport 2018; 31:58-67. [PMID: 29655069 DOI: 10.1016/j.ptsp.2018.01.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 01/21/2018] [Accepted: 01/30/2018] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To develop a clinical prediction rule (CPR) to identify patients with plantar heel pain (PHP) likely to benefit from biomechanical anti-pronation taping (BAPT). DESIGN A prospective cohort study. SETTING An outpatient rehabilitation department in a general hospital. PARTICIPANTS Seventy-five patients with PHP. MAIN OUTCOME MEASURES After completing a series of physical examinations, all patients received BAPT and were evaluated with a numeric rating scale for pain intensity, the patient-specific functional scale and foot function index (FFI) for function, and the global rating of change for perceived improvement. RESULTS Twenty-eight patients achieved a successful outcome. A CPR with 6 significant variables was identified by a multivariate logistic regression: FFI score less than 33.3, hip adduction angle of the most affected side was greater than the contralateral side, ankle plantarflexors and hip abductors on the most affected side were not weaker than those on the contralateral side, ankle invertors on the most affected side were weaker than the contralateral side, and having more than 2 painful sites in the low back and lower extremity regions. If 5 or more of the 6 predictors were presented, the probability of success increased from 37% to 80%. CONCLUSIONS A CPR has been developed to identify patients with PHP likely to benefit from BAPT.
Collapse
Affiliation(s)
- Fu-Lien Wu
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan
| | - Yi-Fen Shih
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan
| | - Si-Huei Lee
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hong-Ji Luo
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan
| | - Wendy Tzyy-Jiuan Wang
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan.
| |
Collapse
|
36
|
Nakale NT, Strydom A, Saragas NP, Ferrao PNF. Association Between Plantar Fasciitis and Isolated Gastrocnemius Tightness. Foot Ankle Int 2018; 39:271-277. [PMID: 29198141 DOI: 10.1177/1071100717744175] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND An association between plantar fasciitis and isolated gastrocnemius tightness (IGT) has been postulated in the literature; however, there have been few studies to prove this relationship. This prospective cross-sectional cohort study was aimed at determining the association between plantar fasciitis and IGT. METHODS Three groups comprising 45 patients with plantar fasciitis (group 1), 117 patients with foot and ankle pathology other than plantar fasciitis (group 2), and 61 patients without foot and ankle pathology (group 3) were examined for the presence of IGT using the Silfverskiöld test. Statistical tests included chi-square test, Student t test, and analysis of variance. RESULTS Of the patients, 101 (45.3%) had IGT: 36 (80%) in group 1, 53 (45.3%) in group 2, and 12 (19.7%) in group 3. The difference in IGT prevalence between the groups was statistically significant at P < .001. The prevalence of IGT was similar between acute and chronic plantar fasciitis at 78.9% and 80.6%, respectively. CONCLUSION There was a very strong association between plantar fasciitis and IGT using group 3 as a reference. This study suggests that IGT should be actively sought out and managed in patients with plantar fasciitis. LEVEL OF EVIDENCE Level II, cross-sectional cohort prospective study.
Collapse
Affiliation(s)
- Ngenomeulu T Nakale
- 1 Orthopaedic Surgery Department, University of Witwatersrand, Johannesburg, South Africa
| | - Andrew Strydom
- 2 The Orthopaedic Foot and Ankle Unit, University of the Witwatersrand and Netcare Linksfield Hospital, Johannesburg, South Africa
| | - Nick P Saragas
- 2 The Orthopaedic Foot and Ankle Unit, University of the Witwatersrand and Netcare Linksfield Hospital, Johannesburg, South Africa
| | - Paulo N F Ferrao
- 2 The Orthopaedic Foot and Ankle Unit, University of the Witwatersrand and Netcare Linksfield Hospital, Johannesburg, South Africa
| |
Collapse
|
37
|
Young JL, Rhon DI, de Zoete RMJ, Cleland JA, Snodgrass SJ. The influence of dosing on effect size of exercise therapy for musculoskeletal foot and ankle disorders: a systematic review. Braz J Phys Ther 2018; 22:20-32. [PMID: 29157736 PMCID: PMC5816081 DOI: 10.1016/j.bjpt.2017.10.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 10/18/2017] [Accepted: 10/23/2017] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE The purpose of this review was to identify doses of exercise therapy associated with greater treatment effect sizes in individuals with common musculoskeletal disorders of the foot and ankle, namely, achilles tendinopathy, ankle sprains and plantar heel pain. METHODS AMED, EMBASE and MEDLINE were searched from 2005 to August 2017 for randomized controlled trials related to exercise for these three diagnoses. The Physiotherapy Evidence Database scale was used for methodological quality assessment. Exercise dosing variables and outcome measures related to pain and function were extracted from the studies, and standardized mean differences were calculated for the exercise groups. RESULTS Fourteen studies met the final inclusion. A majority of the studies showed large effects and two small trends were identified. Patients with plantar heel pain may benefit more from a daily home exercise program than two supervised visits per week (SMD=3.82), but this recommendation is based on weak evidence. In achilles tendinopathy, a relationship was also seen when sets and repetitions of eccentric exercise were performed as tolerated (SMD=1.08 for function, -1.29 for pain). CONCLUSIONS Session duration, frequency, total number of visits, and overall length of care may all be dosing variables with limited value for determining effective exercise prescription. However, the limited number of studies prevents any definitive conclusions. Further investigation is warranted to improve our understanding of the influence exercise dosing has on treatment effect sizes. Future randomized controlled trials comparing specific exercise dose variables should be conducted to clarify the impact of these variables.
Collapse
Affiliation(s)
- Jodi L Young
- Arizona School of Health Sciences, Department of Physical Therapy, AT Still University, Mesa, AZ, USA; The University of Newcastle, School of Health Sciences, Discipline of Physiotherapy, Callaghan, Australia.
| | - Daniel I Rhon
- The University of Newcastle, School of Health Sciences, Discipline of Physiotherapy, Callaghan, Australia; Center for the Intrepid, San Antonio, TX, USA; Physical Therapy, Baylor University, Joint Base San Antonio - Fort Sam Houston, TX, USA
| | - Rutger M J de Zoete
- The University of Newcastle, School of Health Sciences, Discipline of Physiotherapy, Callaghan, Australia
| | - Joshua A Cleland
- Franklin Pierce University, Manchester, Department of Physical Therapy, NH, USA
| | - Suzanne J Snodgrass
- The University of Newcastle, School of Health Sciences, Discipline of Physiotherapy, Callaghan, Australia
| |
Collapse
|
38
|
Yoo SD, Kim HS, Lee JH, Yun DH, Kim DH, Chon J, Lee SA, Han YJ, Soh YS, Kim Y, Han S, Lee W, Han YR. Biomechanical Parameters in Plantar Fasciitis Measured by Gait Analysis System With Pressure Sensor. Ann Rehabil Med 2017; 41:979-989. [PMID: 29354574 PMCID: PMC5773441 DOI: 10.5535/arm.2017.41.6.979] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 05/23/2017] [Indexed: 11/05/2022] Open
Abstract
Objective To investigate the differences in biomechanical parameters measured by gait analysis systems between healthy subjects and subjects with plantar fasciitis (PF), and to compare biomechanical parameters between ‘normal, barefooted’ gait and arch building gait in the participants. Methods The researchers evaluated 15 subjects (30 feet) with bilateral foot pain and 15 subjects (15 feet) with unilateral foot pain who had a clinical diagnosis of PF. Additionally, 17 subjects (34 feet) who had no heel pain were recruited. Subjects were excluded if they had a traumatic event, prior surgery or fractures of the lower limbs, a leg length discrepancy of 1 cm or greater, a body mass index greater than 35 kg/m2, or had musculoskeletal disorders. The participants were asked to walk with an arch building gait on a treadmill at 2.3 km/hr for 5 minutes. Various gait parameters were measured. Results With the arch building gait, the PF group proved that gait line length and single support line were significantly decreased, and lateral symmetry of the PF group was increased compared to that of the control group. The subjects with bilateral PF displayed significantly increased maximum pressure over the heel and the forefoot during arch building gait. In addition, the subjects with unilateral PF showed significantly increased maximum pressure over the forefoot with arch building gait. Conclusion The researchers show that various biomechanical differences exist between healthy subjects and those with PF. Employing an arch building gait in patients with PF could be helpful in changing gait patterns to normal biomechanics.
Collapse
Affiliation(s)
- Seung Don Yoo
- Department of Physical Medicine and Rehabilitation, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Hee Sang Kim
- Department of Physical Medicine and Rehabilitation, Kyung Hee University Medical Center, Seoul, Korea
| | - Jong Ha Lee
- Department of Physical Medicine and Rehabilitation, Kyung Hee University Medical Center, Seoul, Korea
| | - Dong Hwan Yun
- Department of Physical Medicine and Rehabilitation, Kyung Hee University Medical Center, Seoul, Korea
| | - Dong Hwan Kim
- Department of Physical Medicine and Rehabilitation, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jinmann Chon
- Department of Physical Medicine and Rehabilitation, Kyung Hee University Medical Center, Seoul, Korea
| | - Seung Ah Lee
- Department of Physical Medicine and Rehabilitation, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Yoo Jin Han
- Department of Physical Medicine and Rehabilitation, Kyung Hee University Medical Center, Seoul, Korea
| | - Yun Soo Soh
- Department of Physical Medicine and Rehabilitation, Kyung Hee University Medical Center, Seoul, Korea
| | - Yong Kim
- Department of Physical Medicine and Rehabilitation, Kyung Hee University Medical Center, Seoul, Korea
| | - Seonyoung Han
- Department of Physical Medicine and Rehabilitation, Kyung Hee University Medical Center, Seoul, Korea
| | - Woojin Lee
- Department of Physical Medicine and Rehabilitation, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Young Rok Han
- Department of Physical Medicine and Rehabilitation, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| |
Collapse
|
39
|
Wheeler PC. The addition of a tension night splint to a structured home rehabilitation programme in patients with chronic plantar fasciitis does not lead to significant additional benefits in either pain, function or flexibility: a single-blinded randomised controlled trial. BMJ Open Sport Exerc Med 2017; 3:e000234. [PMID: 29259809 PMCID: PMC5731230 DOI: 10.1136/bmjsem-2017-000234] [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] [Subscribe] [Scholar Register] [Accepted: 05/03/2017] [Indexed: 11/15/2022] Open
Abstract
Objective To identify any improvements in pain or function in patients with chronic plantar fasciitis following the use of a tension night splint (TNS). Methods Single-blinded randomised controlled trial, with participants split evenly between intervention group (TNS + home exercise programme/HEP) and control group (HEP only). Follow-up at 3 months, with interim data at 6 weeks. Results 40 patients recruited. Mean age 52.1 years, 33% male, mean body mass index 30.8 kg/m2, mean duration of symptoms of 25 months. Improvement in self-reported ‘average pain' in the intervention group from 6.8/10 at baseline to 5.6/10 at 6 weeks, and 5.3/10 at 3 months (both clinically and statistically significant at both time points), compared with control group of 7.1/10 at baseline to 6.2/10 at 6 weeks and 5.6/10 at 3 months (significant only at 3 months). Improvements in self-reported ‘worst pain', ‘pain walking' and ‘pain first thing in the morning' in both groups at all time periods. Improvements were seen in revised Foot Function Index at all time points in both groups, but limited changes seen in flexibility and no significant changes in anxiety or depression Hospital Anxiety and Depression Scale domains or sleep quality in either group. However, no differences were seen between the outcomes seen in the two groups for the majority of the measures studied. Conclusions Improvements in pain and some functional measures seen in both groups, with few, if any, differences seen in outcomes between the intervention group compared with the control group. However, ongoing pain symptoms were reported in both groups, suggesting that ‘help' rather than ‘cure' was obtained for the majority. There is a possibility of earlier benefit seen in the intervention group compared with the control group, but data are unclear and further work may be needed. Trial registration number ClinicalTrials.gov: NCT02546115; results.
Collapse
Affiliation(s)
- Patrick C Wheeler
- Department of Sport & Exercise Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK.,School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,National Centre of Sport and Exercise Medicine - East Midlands (NCSEM), Loughborough, UK
| |
Collapse
|
40
|
Salvioli S, Guidi M, Marcotulli G. The effectiveness of conservative, non-pharmacological treatment, of plantar heel pain: A systematic review with meta-analysis. Foot (Edinb) 2017; 33:57-67. [PMID: 29126045 DOI: 10.1016/j.foot.2017.05.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 05/09/2017] [Accepted: 05/12/2017] [Indexed: 02/04/2023]
Abstract
Plantar heel pain is one of the most common causes of pain and musculoskeletal pathologies of the foot. The aim of this systematic review was to identify the most effective, conservative and non-pharmacological treatments regarding pain in patients with plantar heel pain. The authors searched 5 databases and included only randomized control trials which investigated the efficacy of a conservative non-pharmacological treatment compared to the placebo, for the outcome of pain. Study selection, data collection and risk of bias assessment were conducted independently by two authors, and consensus was reached with a third author. Results were quantitatively summarized in meta-analyses, by separating homogeneous subgroups of trials by type of intervention. A total of 20 studies that investigated the efficacy of 9 different types of interventions were included, with a total of 4 meta-analyses carried out. The interventions: shock waves, laser therapy, orthoses, pulsed radiofrequency, dry-needling, and calcaneal taping resulted in being effective treatments for the outcome pain in patients with plantar heel pain when compared to the placebo. However, considering that the improvements were very small, and the quality of evidence was mostly low or moderate for many of the interventions, it was not possible to give definitive conclusions for clinical practice.
Collapse
Affiliation(s)
- Stefano Salvioli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal-Infantile Sciences, University of Genoa, Italy.
| | | | | |
Collapse
|
41
|
Thompson JV, Saini SS, Reb CW, Daniel JN. Diagnosis and management of plantar fasciitis. J Osteopath Med 2016; 114:900-6. [PMID: 25429080 DOI: 10.7556/jaoa.2014.177] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Plantar fasciitis, a chronic degenerative process that causes medial plantar heel pain, is responsible for approximately 1 million physician visits each year. Individuals with plantar fasciitis experience pain that is most intense during their first few steps of the day or after prolonged standing. The authors provide an overview of the diagnosis and management of a common problem encountered in the primary care setting. Routine imaging is not initially recommended for the evaluation of plantar fasciitis but may be required to rule out other pathologic conditions. Overall, plantar fasciitis carries a good prognosis when patients use a combination of several conservative treatment modalities. Occasionally, referral to a specialist may be necessary.
Collapse
Affiliation(s)
- John V Thompson
- From the Department of Orthopaedic Surgery at Memorial Hospital in York, Pennsylvania (Dr Thompson); the Rowan University School of Osteopathic Medicine (RowanSOM) in Stratford, New Jersey (Student Doctor Saini); the Department of Orthopedics at RowanSOM in Stratford, New Jersey (Dr Reb); and the Department of Surgery at Jefferson Medical College in Philadelphia, Pennsylvania (Dr Daniel). Dr Thompson is in his second year of residency training, and Dr Reb is in his fifth year of residency training
| | - Sundeep S Saini
- From the Department of Orthopaedic Surgery at Memorial Hospital in York, Pennsylvania (Dr Thompson); the Rowan University School of Osteopathic Medicine (RowanSOM) in Stratford, New Jersey (Student Doctor Saini); the Department of Orthopedics at RowanSOM in Stratford, New Jersey (Dr Reb); and the Department of Surgery at Jefferson Medical College in Philadelphia, Pennsylvania (Dr Daniel). Dr Thompson is in his second year of residency training, and Dr Reb is in his fifth year of residency training
| | - Christopher W Reb
- From the Department of Orthopaedic Surgery at Memorial Hospital in York, Pennsylvania (Dr Thompson); the Rowan University School of Osteopathic Medicine (RowanSOM) in Stratford, New Jersey (Student Doctor Saini); the Department of Orthopedics at RowanSOM in Stratford, New Jersey (Dr Reb); and the Department of Surgery at Jefferson Medical College in Philadelphia, Pennsylvania (Dr Daniel). Dr Thompson is in his second year of residency training, and Dr Reb is in his fifth year of residency training
| | - Joseph N Daniel
- From the Department of Orthopaedic Surgery at Memorial Hospital in York, Pennsylvania (Dr Thompson); the Rowan University School of Osteopathic Medicine (RowanSOM) in Stratford, New Jersey (Student Doctor Saini); the Department of Orthopedics at RowanSOM in Stratford, New Jersey (Dr Reb); and the Department of Surgery at Jefferson Medical College in Philadelphia, Pennsylvania (Dr Daniel). Dr Thompson is in his second year of residency training, and Dr Reb is in his fifth year of residency training
| |
Collapse
|
42
|
Petrofsky J, Lee H. Greater Reduction of Balance as a Result of Increased Plantar Fascia Elasticity at Ovulation during the Menstrual Cycle. TOHOKU J EXP MED 2016; 237:219-26. [PMID: 26537843 DOI: 10.1620/tjem.237.219] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
One of the sexual hormones, estrogen, increases elasticity of human connective tissue such as the anterior cruciate ligament during the menstrual cycle in women. In the present investigation, the plantar fascia was investigated to see if there is a difference in elasticity with the menstrual cycle. Fifteen young healthy females in the age range of 18-35 years old with a regular menstrual cycle were tested twice throughout one full menstrual cycle; once during the early follicular phases and once at ovulation. Foot length, while standing on both feet and one foot were used to assess plantar fascia elasticity, ultrasound measured plantar fascia thickness while lying and standing, and posture sway and tremor using a balance platform during 8 different balance tests were assessed to see the impact of elasticity changes. Foot length increased significantly at ovulation compared to menstruation when standing on two feet (p = 0.03) and standing on one foot (p < 0.001). There was also a significant increase in plantar fascia in thinning per kilogram weight applied to the foot at ovulation compared to menstruation (p = 0.014). Associated with this increase in elasticity at ovulation, there was a reduction in balance in the most difficult balance tasks and an increase in tremor during ovulation (p < 0.05). Plantar fascia elasticity change during the menstrual cycle might have effects on posture sway and tremor, which could have a potential risk of falling. Therefore, healthy professionals working with young female adults should recognize these physiological effects.
Collapse
Affiliation(s)
- Jerrold Petrofsky
- Department of Physical Therapy, School of Allied Health Professions, Loma Linda University
| | | |
Collapse
|
43
|
Ho SWL, Thevendran G. Sports Medicine and Arthroscopic Treatment of the Foot and Ankle: What Is New and Current in Singapore. Foot Ankle Clin 2016; 21:283-95. [PMID: 27261807 DOI: 10.1016/j.fcl.2016.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Foot and ankle abnormalities are common in Singapore because of the compulsory conscription, the slipper-wearing culture, and the promotion of healthy living through exercise. The rapidly aging population, lack of elite sportsmen, and social and cultural norms pose unique challenges to foot and ankle surgery. Orthopedic surgery in Singapore has progressed because of the good infrastructure and modern practices executed by fellowship-trained surgeons. Evolving local practices are polarized by practice trends emulated from North America and Europe. The small community of foot and ankle surgeons currently practicing in Singapore allows for easier communication, corroborative educational events, and research initiatives.
Collapse
Affiliation(s)
- Sean Wei Loong Ho
- Department of Orthopaedic Surgery, 11 Jalan Tan Tock Seng, Tan Tock Seng Hospital, Singapore 308433, Singapore.
| | - Gowreeson Thevendran
- Department of Orthopaedic Surgery, 11 Jalan Tan Tock Seng, Tan Tock Seng Hospital, Singapore 308433, Singapore
| |
Collapse
|
44
|
Kamonseki DH, Gonçalves GA, Yi LC, Júnior IL. Effect of stretching with and without muscle strengthening exercises for the foot and hip in patients with plantar fasciitis: A randomized controlled single-blind clinical trial. ACTA ACUST UNITED AC 2015; 23:76-82. [PMID: 26654252 DOI: 10.1016/j.math.2015.10.006] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 10/12/2015] [Accepted: 10/19/2015] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To compare the effect of stretching with and without muscle strengthening of the foot alone or foot and hip on pain and function in patients with plantar fasciitis. DESIGN Single blind randomized controlled trial. METHOD Eighty-three patients with plantar fasciitis were allocated to one of three treatment options for an eight-week period: Foot Exercise Group (FEG - extrinsic and intrinsic foot muscles), Foot and Hip Exercise Group (FHEG - abductor and lateral rotator muscles) and Stretching Alone Exercise Group (SAEG). MAIN MEASURES A visual analog scale for pain, the Foot and Ankle Outcome Score and the Star Excursion Balance Test. All evaluations were performed before treatment and after the last treatment session. RESULTS Improvements were found in all groups regarding the visual analog scale, the pain, activities of daily living, sports and recreation, quality of life (p < 0.001) and other symptoms (p < 0.01) subscales of the Foot and Ankle Outcome Score as well as posterolateral movement, posteromedial movement and composite score (p < 0.001) on the Star Excursion Balance Test. No time-group interactions were found for any of the variables (p > 0.05). CONCLUSIONS All three exercise protocols analyzed led to improvements at eight-week follow-up in pain, function and dynamic lower limb stability in patients with plantar fasciitis.
Collapse
Affiliation(s)
- Danilo H Kamonseki
- Department of Bioscience, Universidade Federal de São Paulo, Santos, SP, Brazil.
| | - Geiseane A Gonçalves
- Department of Bioscience, Universidade Federal de São Paulo, Santos, SP, Brazil.
| | - Liu C Yi
- Department of Bioscience, Universidade Federal de São Paulo, Santos, SP, Brazil.
| | - Império Lombardi Júnior
- Department of Human Movement Sciences, Universidade Federal de São Paulo, Santos, SP, Brazil.
| |
Collapse
|
45
|
Sullivan J, Pappas E, Adams R, Crosbie J, Burns J. Determinants of footwear difficulties in people with plantar heel pain. J Foot Ankle Res 2015; 8:40. [PMID: 26288656 PMCID: PMC4539852 DOI: 10.1186/s13047-015-0102-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 08/12/2015] [Indexed: 11/10/2022] Open
Abstract
Background Plantar heel pain is a common foot disorder aggravated by weight-bearing activity. Despite considerable focus on therapeutic interventions such as orthoses, there has been limited investigation of footwear-related issues in people with plantar heel pain. The aim of this study was to investigate whether people with plantar heel pain experience footwear-related difficulties compared to asymptomatic individuals, as well as identifying factors associated with footwear comfort, fit and choice. Methods The footwear domain of the Foot Health Status Questionnaire (FHSQ) was assessed in 192 people with plantar heel pain and 69 asymptomatic controls. The plantar heel pain group was also assessed on a variety of measures including: foot posture, foot strength and flexibility, pedobarography and pain level. A univariate analysis of covariance, with age as the covariate, was used to compare the heel pain and control groups on the FHSQ footwear domain score. A multiple regression model was then constructed to investigate factors associated with footwear scores among participants with plantar heel pain. Results When compared to asymptomatic participants, people with plantar heel pain reported lower FHSQ footwear domain scores (mean difference −24.4; p < 0.001; 95 % CI: −32.0 to −17.0). In the participants with heel pain, footwear scores were associated with maximum force beneath the postero-lateral heel during barefoot walking, toe flexor strength and gender. Conclusions People with plantar heel pain experience difficulty with footwear comfort, fit and choice. Reduced heel loading during barefoot walking, toe flexor weakness and female gender are all independently associated with reports of footwear difficulties in people with heel pain. Increased focus, in both clinical and research settings, is needed to address footwear-related issues in people with plantar heel pain.
Collapse
Affiliation(s)
- Justin Sullivan
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, NSW Australia ; Faculty of Health Sciences, The University of Sydney, P.O Box 170, Lidcombe, Sydney, NSW 1825 Australia
| | - Evangelos Pappas
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, NSW Australia ; Arthritis and Musculoskeletal Research Group, Faculty of Health Sciences, The University of Sydney, Sydney, NSW Australia
| | - Roger Adams
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, NSW Australia
| | - Jack Crosbie
- School of Science and Health, The University of Western Sydney, Sydney, NSW Australia
| | - Joshua Burns
- Paediatric Gait Analysis Service of New South Wales, Sydney Children's Hospitals Network (Randwick and Westmead), Sydney, NSW Australia ; Arthritis and Musculoskeletal Research Group, Faculty of Health Sciences, The University of Sydney, Sydney, NSW Australia
| |
Collapse
|
46
|
Wheeler PC. The role of autologous blood injections in the treatment for patients with chronic plantar fasciitis – A case series and longer-term follow-up. ACTA ACUST UNITED AC 2015. [DOI: 10.1179/1753615415y.0000000004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
47
|
The effect of additional ankle and midfoot mobilizations on plantar fasciitis: a randomized controlled trial. J Orthop Sports Phys Ther 2015; 45:265-72. [PMID: 25739844 DOI: 10.2519/jospt.2015.5155] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN A single-blind randomized controlled trial. OBJECTIVE To evaluate the efficacy of ankle and midfoot mobilization on pain and function of patients with plantar fasciitis (PF). BACKGROUND Plantar fasciitis is a degenerative process of the plantar fascia, with a lifetime prevalence of approximately 10%. Limited ankle dorsiflexion is a common finding and apparently acts as a contributing factor to the development of PF. METHODS Fifty patients with PF, aged 23 to 73 years, were randomly assigned to either the intervention or control group. Both groups received 8 treatments, twice a week, consisting of stretching exercises and ultrasound. In addition, the intervention group received mobilization of the ankle and midfoot joints. Dorsiflexion range of motion was measured at the beginning and at the end of treatment. The results were evaluated by 3 outcomes: the numeric pain-rating scale, Lower Extremity Functional Scale, and algometry. RESULTS No significant difference was found between groups in any of the outcomes. Both groups showed a significant difference in the numeric pain-rating scale and Lower Extremity Functional Scale. Both groups significantly improved in dorsiflexion range of motion, with no difference between groups. CONCLUSION The addition of ankle and foot joint mobilization aimed at improving dorsiflexion range of motion is not more effective than stretching and ultrasound alone in treating PF. The association between limited ankle dorsiflexion and PF is most probably due to soft tissue limitations, not the joints. Trial registered at ClinicalTrials.gov (registration number NCT01439932). LEVEL OF EVIDENCE Therapy, level 1b.
Collapse
|
48
|
Alotaibi AK, Petrofsky JS, Daher NS, Lohman E, Laymon M, Syed HM. Effect of monophasic pulsed current on heel pain and functional activities caused by plantar fasciitis. Med Sci Monit 2015; 21:833-9. [PMID: 25791231 PMCID: PMC4378229 DOI: 10.12659/msm.891229] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Plantar fasciitis (PF) is a soft tissue disorder considered to be one of the most common causes of inferior heel pain. The aim of this study was to investigate the effect of monophasic pulsed current (MPC) and MPC coupled with plantar fascia-specific stretching exercises (SE) on the treatment of PF. MATERIAL AND METHODS Forty-four participants (22 women and 22 men, with a mean age of 49 years) diagnosed with PF were randomly assigned to receive MPC (n=22) or MPC coupled with plantar fascia-specific SE (n=22). Prior to and after 4 weeks of treatment, participants underwent baseline evaluation; heel pain was evaluated using a visual analogue scale (VAS), heel tenderness threshold was quantified using a handheld pressure algometer (PA), and functional activities level was assessed using the Activities of Daily Living subscale of the Foot and Ankle Ability Measure (ADL/FAAM). RESULTS Heel pain scores showed a significant reduction in both groups compared to baseline VAS scores (P<0.001). Heel tenderness improved significantly in both groups compared with baseline PA scores (P<0.001). Functional activity level improved significantly in both groups compared with baseline (ADL/FAAM) scores (P<0.001). However, no significant differences existed between the 2 treatment groups in all post-intervention outcome measures. CONCLUSIONS This trial showed that MPC is useful in treating inferior heel symptoms caused by PF.
Collapse
Affiliation(s)
| | | | - Noha S Daher
- Department of Physical Therapy, Loma Linda University, Loma Linda, CA, USA
| | - Everett Lohman
- Department of Physical Therapy, Loma Linda University, Loma Linda, CA, USA
| | - Michael Laymon
- Department of Physical Therapy, Touro University Nevada, Henderson, NV, USA
| | - Hasan M Syed
- School of Medicine, Loma Linda University, Loma Linda, CA, USA
| |
Collapse
|
49
|
Rajasekaran S, Finnoff JT. Plantar Fasciopathy: A Clinical Review. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2014. [DOI: 10.1007/s40141-014-0069-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
50
|
Abstract
One challenge in the treatment of plantar fasciitis is that very few high-quality studies exist comparing different treatment modalities to guide evidence-based management. Current literature suggests a change to the way that plantar fasciitis is managed. This article reviews the most current literature on plantar fasciitis and showcases recommended treatment guidelines. This serves to assist physicians in diagnosing and treating heel pain with plantar fasciitis.
Collapse
Affiliation(s)
- Emily N Schwartz
- Family Medicine Physician at the Los Angeles Medical Center in CA.
| | - John Su
- Family Medicine Physician at the Los Angeles Medical Center in CA.
| |
Collapse
|