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Stevens K, Winiger K, DiLiberto F. Foot and Ankle Curricular Guidelines in Entry-Level Physical Therapist Education: How Are We Doing? JOURNAL, PHYSICAL THERAPY EDUCATION 2024:00001416-990000000-00125. [PMID: 39116394 DOI: 10.1097/jte.0000000000000362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 05/30/2024] [Indexed: 08/10/2024]
Abstract
INTRODUCTION The Foot and Ankle Curricular Guidelines for Physical Therapist Professional Degree Programs (FACG) provided recommendations regarding essential entry-level content and skills. Eight years later, the extent of its implementation is unknown. This study characterizes entry-level Doctor of Physical Therapy (DPT) programs' foot and ankle curriculum with reference to the FACG. REVIEW OF LITERATURE Curricular guidelines offer recommendations to professional degree programs striving for excellence. Review and revisions of guidelines are important to keep pace with and reflect evolving evidence and practice. SUBJECTS One faculty member from 116 of 250 DPT programs participated (46.6% response rate). Participants were an average of 50.8 years old and taught a mean of 14.5 years. METHODS A cross-sectional 25-item online survey assessed foot and ankle contact hours, coverage of FACG recommended content, coverage of surgical procedures, and the use of FACG for curricular assessment, modification, and development. RESULTS Foot and ankle content was covered in physical therapy curriculum for a mean of 48.2 hours (range 12-120 hours). Eleven of the 25 recommended diagnoses, 29 of the 49 examination skills, 6 of the 7 intervention skills, and 3 of the 14 surgical procedures were covered by most (≥90%) of the programs. Reported use of FACG for curricular processes averaged 50.1-51.5 (0-100 numerical scale). DISCUSSION AND CONCLUSIONS Across a wide range of contact hours, coverage of FACG recommended content was approximately 57% (46/81 recommended elements in ≥90% of programs). Although not specifically recommended by FACG, surgical procedures were less commonly covered by programs. Study findings question FACG implementation and may reflect differences across programs in depth and breadth of content. Identified curricular gaps may warrant addressing in future guidelines.
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Affiliation(s)
- Karen Stevens
- Karen Stevens is an associate professor and assistant program director in the Department of Physical Therapy at the Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064 . Please address all correspondence to Karen Stevens
- Kyle Winiger is a senior assistant athletic trainer in the Sports Medicine Department at the University of Arkansas
- Frank DiLiberto is an associate professor in the Department of Physical Therapy at the Rosalind Franklin University of Medicine and Science
| | - Kyle Winiger
- Karen Stevens is an associate professor and assistant program director in the Department of Physical Therapy at the Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064 . Please address all correspondence to Karen Stevens
- Kyle Winiger is a senior assistant athletic trainer in the Sports Medicine Department at the University of Arkansas
- Frank DiLiberto is an associate professor in the Department of Physical Therapy at the Rosalind Franklin University of Medicine and Science
| | - Frank DiLiberto
- Karen Stevens is an associate professor and assistant program director in the Department of Physical Therapy at the Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064 . Please address all correspondence to Karen Stevens
- Kyle Winiger is a senior assistant athletic trainer in the Sports Medicine Department at the University of Arkansas
- Frank DiLiberto is an associate professor in the Department of Physical Therapy at the Rosalind Franklin University of Medicine and Science
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Fagundes MG, Mendes AAMT, Bezerra VF, Freitas WRMSD, Scattone Silva R, Pontes-Silva A, Barbosa GDM, Cardoso de Souza M. Effects of insoles adapted in flip-flop sandals in patients with persistent plantar heel pain: A sham-controlled randomised trial. Clin Rehabil 2024:2692155241267991. [PMID: 39094377 DOI: 10.1177/02692155241267991] [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: 08/04/2024]
Abstract
OBJECTIVE To evaluate the use of custom-made insoles adapted to flip-flops on pain intensity, foot function, and functional walking ability in individuals with persistent plantar heel pain in the short and medium term. DESIGN Randomised controlled trial. SETTING Flip-flop sandals in patients with persistent plantar heel pain. MAIN MEASURES Participants (n = 80) were assessed at baseline, six and 12 weeks after the intervention, and 4 weeks post-intervention. RESULTS For the primary outcomes, after 6 weeks of intervention, no between-group difference was observed in the intensity of morning pain or pain with walking, mean difference = -0.4 (95% confidence intervals = -1.5 to 0.8). Similarly, after 12 weeks of intervention, no between-group difference was observed in the intensity of morning pain or pain with walking, mean difference = -0.7 (95% confidence intervals = -1.9 to 0.6). Finally, at 4 weeks after the end of the intervention, there was no between-group difference in morning pain or pain on walking, mean difference = 0.01 (95% confidence intervals = -1.4 to 1.4). All differences and confidence intervals were smaller than the minimum clinically important difference for pain (2 points). There were no differences between the groups for the secondary outcomes. In addition, the mean differences were smaller than the minimum clinically important differences for pain intensity, foot function and functional walking ability. CONCLUSION Custom-made insoles fitted to flip-flops did not differ from flip-flops with sham insoles in improving pain intensity, foot function and functional walking ability in people with persistent heel pain.Trial registration: ClinicalTrials.gov (Identifier: NCT04784598). Data of registration: 2023-01-20.
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Affiliation(s)
- Marina Gomes Fagundes
- Postgraduate Program in Rehabilitation Sciences, School of Health Sciences of Trairi, Universidade Federal do Rio Grande do Norte, Santa Cruz, RN, Brazil
| | | | | | | | - Rodrigo Scattone Silva
- Postgraduate Program in Rehabilitation Sciences, School of Health Sciences of Trairi, Universidade Federal do Rio Grande do Norte, Santa Cruz, RN, Brazil
| | - André Pontes-Silva
- Postgraduate Program in Physical Therapy, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Germanna de Medeiros Barbosa
- Postgraduate Program in Rehabilitation Sciences, School of Health Sciences of Trairi, Universidade Federal do Rio Grande do Norte, Santa Cruz, RN, Brazil
| | - Marcelo Cardoso de Souza
- Postgraduate Program in Rehabilitation Sciences, School of Health Sciences of Trairi, Universidade Federal do Rio Grande do Norte, Santa Cruz, RN, Brazil
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Covelli I, De Giorgi S, Di Lorenzo A, Moretti B, Solarino G, Notarnicola A. The Role of Bone Edema in Plantar Fasciitis Treated with Temperature-Controlled High-Energy Adjustable Multi-Mode Emission Laser (THEAL) and Exercise: A Prospective Randomized Clinical Trial. Biomedicines 2024; 12:1729. [PMID: 39200194 PMCID: PMC11351923 DOI: 10.3390/biomedicines12081729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2024] [Revised: 07/28/2024] [Accepted: 07/30/2024] [Indexed: 09/02/2024] Open
Abstract
Plantar fasciitis is one of the most common causes of foot pain; in 35% of cases, it is also associated with bone edema of the heel. The aim of this study was to investigate the relationship between bone edema and the outcomes of temperature-controlled high-energy adjustable multi-mode emission laser (THEAL) and/or exercises in patients with plantar fasciitis. A prospective randomized clinical trial was designed, in which 48 patients suffering from plantar fasciitis, with or without bone edema, were treated with temperature-controlled high-energy adjustable multi-mode emission laser and exercises (the laser group) or with exercises only (the control group). The patients were evaluated at recruitment (T0) and at 2 (T1) and 6 months (T2), monitoring pain (with the Visual Analogue Scale), functionality (with the Foot Function Index), perception of improvement (with the Roles and Maudsley Score), and fascia thickness (with ultrasound examination). In both groups, there was a significant improvement in pain, functional recovery, perception of remission, and a reduction in plantar fascia thickness at T1 and T2. The laser group presented statistically better values at T2 for the Roles and Maudsley Score (z: 2.21; 0.027). The regression analysis showed that a greater reduction in fascia thickness occurred in the laser group (p-value: 0.047). In conclusion, the two conservative treatments were effective in patients suffering from plantar fasciitis, even in the presence of bone edema, but with lesser results.
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Affiliation(s)
- Ilaria Covelli
- Orthopedics Unit, Department of Translational Biomedicine and Neuroscience “DiBraiN”, School of Medicine and Surgery, University of Bari, General Hospital, Piazza Giulio Cesare 11, 70124 Bari, Italy; (I.C.); (S.D.G.); (B.M.); (G.S.)
| | - Silvana De Giorgi
- Orthopedics Unit, Department of Translational Biomedicine and Neuroscience “DiBraiN”, School of Medicine and Surgery, University of Bari, General Hospital, Piazza Giulio Cesare 11, 70124 Bari, Italy; (I.C.); (S.D.G.); (B.M.); (G.S.)
| | - Antonio Di Lorenzo
- Interdisciplinary Department of Medicine, University of Study of Bari, General Hospital, Piazza Giulio Cesare 11, 70124 Bari, Italy;
| | - Biagio Moretti
- Orthopedics Unit, Department of Translational Biomedicine and Neuroscience “DiBraiN”, School of Medicine and Surgery, University of Bari, General Hospital, Piazza Giulio Cesare 11, 70124 Bari, Italy; (I.C.); (S.D.G.); (B.M.); (G.S.)
| | - Giuseppe Solarino
- Orthopedics Unit, Department of Translational Biomedicine and Neuroscience “DiBraiN”, School of Medicine and Surgery, University of Bari, General Hospital, Piazza Giulio Cesare 11, 70124 Bari, Italy; (I.C.); (S.D.G.); (B.M.); (G.S.)
| | - Angela Notarnicola
- Orthopedics Unit, Department of Translational Biomedicine and Neuroscience “DiBraiN”, School of Medicine and Surgery, University of Bari, General Hospital, Piazza Giulio Cesare 11, 70124 Bari, Italy; (I.C.); (S.D.G.); (B.M.); (G.S.)
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Cortés-Pérez I, Moreno-Montilla L, Ibáñez-Vera AJ, Díaz-Fernández Á, Obrero-Gaitán E, Lomas-Vega R. Efficacy of extracorporeal shockwave therapy, compared to corticosteroid injections, on pain, plantar fascia thickness and foot function in patients with plantar fasciitis: A systematic review and meta-analysis. Clin Rehabil 2024; 38:1023-1043. [PMID: 38738305 DOI: 10.1177/02692155241253779] [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] [Indexed: 05/14/2024]
Abstract
OBJECTIVE To compare the efficacy of extracorporeal shock waves versus corticosteroids injections on pain, thickness of plantar fascia and foot function in patients with plantar fasciitis. Secondarily, to assess the efficacy of radial and focused extracorporeal shock waves and the most appropriated intensity (high, medium or low). DATA SOURCES PubMed, SCOPUS, CINAHL and PEDro, until April 2024, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. REVIEW METHODS Randomized controlled trials comparing the efficacy of extracorporeal shock waves versus corticosteroids injections on pain intensity and sensitivity, thickness of plantar fascia and foot function in patients with plantar fasciitis. Methodological quality and risk of bias were assessed using PEDro Scale and Cochrane Risk of Bias Tool. Pooled effect was calculated using the standardized mean difference (SMD) and its 95% confidence interval (95%CI). RESULTS Sixteen studies involving 1121 patients, showing a mean of 6 points in PEDro scale, were included. At three months, extracorporeal shock waves were better than corticosteroids injections in reducing pain (SMD -0.6; 95%CI -1.1 to -0.11) and thickness of the plantar fascia (SMD -0.4; 95%CI -0.8 to -0.01) and increasing foot function (SMD 0.27; 95%CI 0.12-0.44). At six months, extracorporeal shock waves are more effective in reducing pain (SMD -0.81; 95%CI -1.6 to -0.06) and increasing foot function (SMD 0.67; 95%CI 0.45-0.89). Local pain and slight erythema were the most frequent adverse events. CONCLUSIONS Extracorporeal shock waves are a safe therapy, presenting more efficacy than corticosteroids injections in improving pain, thickness of plantar fascia and foot function at mid-term.
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Affiliation(s)
- Irene Cortés-Pérez
- Physiotherapy Area, Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
| | - Laura Moreno-Montilla
- Physiotherapy Area, Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
| | - Alfonso Javier Ibáñez-Vera
- Physiotherapy Area, Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
| | - Ángeles Díaz-Fernández
- Physiotherapy Area, Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
| | - Esteban Obrero-Gaitán
- Physiotherapy Area, Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
| | - Rafael Lomas-Vega
- Physiotherapy Area, Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
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Montes-Salas R, Mahillo-Durán R, Gómez-Carrión Á, Gómez-Aguilar E, Fernández-Gibello A, Castillo-Lopez JM. Ultrasound-guided procedures for plantar fasciitis: a randomized clinical study. J Orthop Surg Res 2024; 19:436. [PMID: 39060929 PMCID: PMC11282737 DOI: 10.1186/s13018-024-04946-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Accepted: 07/23/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Corticosteroid injections are commonly used for the treatment of plantar fasciitis. In recent years, ultrasound-guided multipuncture treatment of the fascia has been described in the literature. Our study aimed to compare the effectiveness of these two techniques in the treatment of plantar fasciitis. METHODS The outcomes achieved over 120 days following the use of these techniques to treat plantar fasciitis were examined. A total of 81 patients were randomly selected for the study; 41 were treated with ultrasound-guided multipuncture and 40 with ultrasound-guided corticosteroid injection. Clinical examinations and ultrasound assessments were performed before treatment and at 30, 60 and 120 days post-treatment. Clinical assessments included the use of a visual analog scale (VAS) to record pain and the Foot Function Index (FFI) to evaluate function. Ultrasound was used to measure the thickness of the plantar fascia. RESULTS Both the ultrasound-guided multipuncture and corticosteroid injection techniques were associated with significant functional and echographic improvements at 4 months post-treatment (P < 0.001). Pain did not improve significantly after 120 days with ultrasound-guided corticosteroid injection, whereas significant pain reduction was observed with ultrasound-guided multipuncture. CONCLUSION Corticosteroid injection provides better short-term results in terms of VAS pain and FFI scores. However, ultrasound-guided multipuncture shows superior outcomes in VAS pain and FFI scores at 120 days.
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Affiliation(s)
- Rubén Montes-Salas
- Podiatry Department, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad de Sevilla, Sevilla, 41009, Spain
| | - Ramón Mahillo-Durán
- Podiatry Department, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad de Sevilla, Sevilla, 41009, Spain
| | - Álvaro Gómez-Carrión
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid, 28040, Spain.
| | | | | | - José Manuel Castillo-Lopez
- Podiatry Department, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad de Sevilla, Sevilla, 41009, Spain
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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.
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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
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Ryu SC, Lee DO, Park Y, Shin Y, Lee DY, Kyung MG. Clinical Efficacy of Application-Linked Stretching Ball as Digital Therapeutics in Plantar Fasciitis. J Clin Med 2024; 13:2722. [PMID: 38731253 PMCID: PMC11084766 DOI: 10.3390/jcm13092722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 04/30/2024] [Accepted: 05/02/2024] [Indexed: 05/13/2024] Open
Abstract
Background/Objectives: This study aimed to evaluate the efficacy of application-linked stretching ball instruments that record the rolling time and force of patients compared with a traditional simple stretching ball. Methods: Fourteen participants with plantar fasciitis were divided into a simple massage ball group (group A, n = 8) and an application-linked massage ball group (group B, n = 6). The application-linked massage ball sends information regarding the massages, such as the frequency and force of the massage on the foot, to the application on the patient's smartphone. All clinical outcomes were evaluated at the beginning of the study and 1-, 2-, and 3-month follow-up. The primary outcome measure was the Manchester-Oxford Foot Questionnaire (MOXFQ) score. Results: At the beginning of the study, the initial MOXFQ score was not significantly different between the two groups (p = 0.948). At each time point, the MOXFQ score of the whole population did not improve significantly compared to that of the initial state (p = 0.131). Generalized estimating equation modeling demonstrated that there was no significant difference in the improvement of the MOXFQ score between groups A and B during follow-up (p = 0.826). In addition, no group-by-time interactions were observed (p = 0.457). Conclusions: The efficacy of an application-linked massage ball for the treatment of plantar fasciitis was not as definite as that of a traditional simple stretching ball in patients whose symptoms persisted for at least six months. Future studies that include patients with acute plantar fasciitis are required.
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Affiliation(s)
- Seok Chang Ryu
- BioRobotics Laboratory, Division of Mechanical and Biomedical Engineering, Ewha Womans University, Seoul 03760, Republic of Korea;
| | - Dong-Oh Lee
- Department of Orthopedic Surgery, SNU Seoul Hospital, Seoul 08703, Republic of Korea
| | - Yoojin Park
- Graduate Program in Smart Factory, Division of Mechanical and Biomedical Engineering, Ewha Womans University, Seoul 03760, Republic of Korea; (Y.P.); (Y.S.)
| | - Yujeong Shin
- Graduate Program in Smart Factory, Division of Mechanical and Biomedical Engineering, Ewha Womans University, Seoul 03760, Republic of Korea; (Y.P.); (Y.S.)
| | - Dong Yeon Lee
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul 03080, Republic of Korea;
| | - Min Gyu Kyung
- Department of Orthopedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul 05278, Republic of Korea
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A. L. Kalbani F, Shalash R, Qadah R, Shousha T. Comparing two protocols of shock wave therapy for patients with plantar fasciitis: A pilot study. PLoS One 2024; 19:e0302553. [PMID: 38709797 PMCID: PMC11073689 DOI: 10.1371/journal.pone.0302553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 03/29/2024] [Indexed: 05/08/2024] Open
Abstract
OBJECTIVES This pilot study primarily aimed to detect the adherence as well as the effect size required to estimate the actual sample size needed for a larger scale study to compare and evaluate the effectiveness of two extracorporeal shock wave therapy (ESWT) protocols along, with a physical therapy program in reducing pain and improving function among patients suffering from plantar fasciitis. The study also aimed to report the effects of the ESWT protocols used on pain and function. METHODS A total of 26 participants took part in the study, including 17 females and 9 males. The average age of the participants was 34 years with a body mass index (BMI) of 23 kg/m2. Participants were divided into three equal groups; Group A received ESWT at a frequency of 15 Hz and intensity of 3, Group B received ESWT at a frequency of 10 Hz and intensity of 4, while Group C underwent the selected physical therapy program along with sham shock wave therapy as a control. Pain levels were assessed using the Visual Analog Scale (VAS) while functional improvements were evaluated using the Foot Function Index (FFI). Data was collected prior to treatment, after three sessions and at the end of six weeks (after six sessions). RESULTS The three groups were well matched, and the results revealed high adherence rates (90%, 90% and 80% respectively). Results also indicated reductions in pain levels and improvements in function for both intervention groups when compared to the control group. Group A demonstrated better outcomes compared to Group B while Group C showed relatively less improvement. CONCLUSION The study concluded a high adherence rate for the three groups as well as a small effect size detected of 0.282 that would suggest a total of 123 participants to be required to replicate the study on a larger scale. With regards to the findings of this pilot, the combination of ESWT and a targeted physical therapy program revealed a possible effective therapeutic approach for plantar fasciitis, with a higher frequency potentially yielding more favourable results.
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Affiliation(s)
- Fatima A. L. Kalbani
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, UAE
| | - Reime Shalash
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, UAE
- Research Institute of Medical and Health Sciences, Neuromusculoskeletal Rehabilitation Research Group, University of Sharjah, Sharjah, UAE
| | - Raneen Qadah
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, UAE
- Research Institute of Medical and Health Sciences, Neuromusculoskeletal Rehabilitation Research Group, University of Sharjah, Sharjah, UAE
| | - Tamer Shousha
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, UAE
- Research Institute of Medical and Health Sciences, Neuromusculoskeletal Rehabilitation Research Group, University of Sharjah, Sharjah, UAE
- Faculty of Physical Therapy, Department of Physical Therapy for Musculoskeletal Disordered and its Surgery, Cairo University, Cairo, Egypt
- University of Sharjah Center of Excellence for Healthy Aging, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences, Healthy Aging, longevity, and Sustainability Research Group, University of Sharjah, Sharjah, UAE
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Bajaj S, Chhabra A, Taneja AK. 3D isotropic MRI of ankle: review of literature with comparison to 2D MRI. Skeletal Radiol 2024; 53:825-846. [PMID: 37978990 DOI: 10.1007/s00256-023-04513-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/01/2023] [Accepted: 11/06/2023] [Indexed: 11/19/2023]
Abstract
The ankle joint has complex anatomy with different tissue structures and is commonly involved in traumatic injuries. Magnetic resonance imaging (MRI) is the primary imaging modality used to assess the soft tissue structures around the ankle joint including the ligaments, tendons, and articular cartilage. Two-dimensional (2D) fast spin echo/turbo spin echo (FSE/TSE) sequences are routinely used for ankle joint imaging. While the 2D sequences provide a good signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) with high spatial resolution, there are some limitations to their use owing to the thick slices, interslice gaps leading to partial volume effects, limited fluid contrast, and the need to acquire separate images in different orthogonal planes. The 3D MR imaging can overcome these limitations and recent advances have led to technical improvements that enable its widespread clinical use in acceptable time periods. The volume imaging renders the advantage of reconstructing into thin continuous slices with isotropic voxels enabling multiplanar reconstructions that helps in visualizing complex anatomy of the structure of interest throughout their course with improved sharpness, definition of anatomic variants, and fluid conspicuity of lesions and injuries. Recent advances have also reduced the acquisition time of the 3D datasets making it more efficient than 2D sequences. This article reviews the recent technical developments in the domain 3D MRI, compares imaging with 3D versus 2D sequences, and demonstrates the use-case scenarios with interesting cases, and benefits of 3D MRI in evaluating various ankle joint components and their lesions.
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Affiliation(s)
- Suryansh Bajaj
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Avneesh Chhabra
- Musculoskeletal Radiology Division, Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
- Department of Orthopaedic Surgery, UT Southwestern Medical Center, Dallas, TX, USA
- Johns Hopkins University, Baltimore, MD, USA
- Walton Center of Neurosciences, Liverpool, UK
- University of Dallas, Richardson, TX, USA
| | - Atul Kumar Taneja
- Musculoskeletal Radiology Division, Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.
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Mansur H, Ferreira GF, Ferreira-Junior JB, de Araújo BAS, Maranho DA. Leg length discrepancy is not a risk factor for plantar fasciitis. Arch Orthop Trauma Surg 2024; 144:1485-1490. [PMID: 38285221 DOI: 10.1007/s00402-024-05197-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 01/01/2024] [Indexed: 01/30/2024]
Abstract
PURPOSE Plantar fasciitis (PF) is a main source of heel pain, and only about one-third of patients have bilateral symptomatic involvement, although age, body mass index (BMI), and physical activities are known risk factors. The high prevalence of unilateral involvement is poorly understood. We aimed to assess the potential association between PF and the leg length discrepancy (LLD) in unilateral PF. METHODS A transversal case-control study was conducted from January 2019 to December 2020, including 120 participants allocated to two groups matched by BMI and sex: cases (with a diagnosis of PF; 50 ± 13 years) and control (without foot pain; 40 ± 15 years). For both groups, a difference greater than 0.64 cm in the scanometry determined the criteria for the presence of LLD. RESULTS The multivariate logistic regression analysis showed an independent association of PF only with age (p < 0.001), and no association with LLD. We did not observe differences in the mean discrepancy (1.37 ± 0.83 cm in the PF group in comparison with 1.13 ± 0.37 cm in the control group, [p > 0.05]) or in the prevalence of LLD between groups (48% [n = 29] in the PF group compared with 42% [n = 25] in the control group, [p > 0.05]). In the PF group, 80% of the participants reported unilateral pain. We observed a higher prevalence of pain in the shorter limb (p < 0.05). CONCLUSION Age was the only factor associated with the diagnosis of PF when groups were matched by sex and BMI. LLD was not an independent factor associated with the diagnosis of PF. However, when PF is unilateral, the shorter limb is more affected with 70% of prevalence. LEVEL OF EVIDENCE Level III, case-control.
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Affiliation(s)
- Henrique Mansur
- Orthopedic and Traumatology Department, Return to Play Institute, Brasília, DF, Brazil.
| | - Gabriel Ferraz Ferreira
- Foot and Ankle Surgery Group, Orthopedics and Traumatology Unit, Prevent Senior, São Paulo, SP, Brazil
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Rhim HC, Schon JM, Xu R, Nolan D, Ahn J, Short K, Schon LC. Prehabilitation for Patients Undergoing Elective Foot and Ankle Surgery: A Contemporary Review. FOOT & ANKLE ORTHOPAEDICS 2024; 9:24730114241255136. [PMID: 38812567 PMCID: PMC11135079 DOI: 10.1177/24730114241255136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024] Open
Affiliation(s)
- Hye Chang Rhim
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, MA, USA
- Foot & Ankle Research and Innovation Lab (FARIL), Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Jason M. Schon
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, MA, USA
| | - Raylin Xu
- Harvard Medical School, Boston, MA, USA
| | - David Nolan
- Department of Physical Therapy, Movement, and Rehabilitation Science, Northeastern University, Boston, MA, USA
- Sports Physical Therapy Service, Massachusetts General Hospital, Boston, MA, USA
| | - Jiyong Ahn
- Foot & Ankle Research and Innovation Lab (FARIL), Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
- Department of Orthopaedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kelly Short
- Center for Restorative Therapies, Mercy Medical Center, Baltimore, MD, USA
| | - Lew C. Schon
- Director of Orthopaedic Innovation, Institute for Foot and Ankle Reconstruction, Mercy Medical Center, Baltimore, MD, USA
- Division of Foot and Ankle Surgery, Department of Orthopaedic Surgery, New York University Langone Health, NY, USA
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Alhakami AM, Babkair RA, Sahely A, Nuhmani S. Effectiveness of therapeutic ultrasound on reducing pain intensity and functional disability in patients with plantar fasciitis: a systematic review of randomised controlled trials. PeerJ 2024; 12:e17147. [PMID: 38529309 PMCID: PMC10962347 DOI: 10.7717/peerj.17147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 03/01/2024] [Indexed: 03/27/2024] Open
Abstract
Background Ultrasound therapy is one of the preferred conservative treatments for patients with plantar fasciitis. This study aims to evaluate the effectiveness of therapeutic ultrasound in decreasing pain intensity and improving functional disability in patients with plantar fasciitis. Methods Five randomised control trials (RCT) were selected based on an electronic search in PubMed, Trip Database and PEDro. To be included in the systematic review, the study should be an RCT which investigated the effectiveness of therapeutic ultrasound conducted in patients with plantar fasciitis with pain intensity and functional disability as outcome measures. Only studies published in peer-reviewed journals written in the English language were included. The quality of the selected studies was measured by the PEDro scale. Results All the included studies showed that ultrasound therapy is beneficial in reducing pain score and improving functional disability, except one study did not recommend using ultrasound therapy for plantar fasciitis. Moreover, regarding another outcome measure, two studies found that ultrasound therapy reduces thickness and tenderness in plantar fasciitis and improves static and dynamic balance. Conclusion After reviewing the five studies, this systematic review support using ultrasound therapy to decrease pain and improve functional disability in patients with plantar fasciitis. Study Registration https://osf.io/xftzy/.
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Affiliation(s)
- Anas Mohammed Alhakami
- Department of Physical Therapy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Reem Abdullah Babkair
- Department of Physical Therapy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ahmad Sahely
- Physiotherapy Department, Faculty of Applied Medical Science, Jazan University, Jazan, Saudi Arabia
- School of Sports, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Shibili Nuhmani
- Department of Physical Therapy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Wang B, Wang XL, Ma YT, Wu W, Zheng YJ. Evaluation of the efficacy of trigger points combined with extracorporeal shock waves in the treatment of plantar fasciitis: heel temperature and plantar pressure. BMC Musculoskelet Disord 2024; 25:191. [PMID: 38431558 PMCID: PMC10908045 DOI: 10.1186/s12891-024-07296-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 02/20/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Plantar fasciitis (PF) is the most common cause of heel pain. Among conservative treatments, extracorporeal shock wave therapy (ESWT) is considered effective for refractory PF. Studies have shown that applying ESWT to the trigger points (TrPs) in the triceps surae may play an important role in pain treatment in patients with PF. Therefore, the purpose of this study was to combine the concept of trigger points and ESWT to explore the effect of this combination on plantar temperature and pressure in patients with PF. METHODS After applying inclusion and exclusion criteria, 86 patients with PF were recruited from the pain clinic of Huadong Hospital, Fudan University and randomly divided into experimental (n = 43) and control groups (n = 43). The experimental group was treated with extracorporeal shock waves to treat the medial heel pain point and the gastrocnemius and soleus TrPs. The control group was only treated with extracorporeal shock waves at the medial heel pain point. The two groups were treated twice with an interval of 1 week. Primary measurements included a numerical rating scale (NRS) score (overall, first step, heel pain during daily activities), and secondary measurements included heel temperature, Roles-Maudsley score (RMS), and plantar pressure. All assessments were performed before treatment (i.e., baseline) and 6 and 12 weeks after treatment. RESULTS During the trial, 3 patients in the experimental group withdrew from the study, 2 due to interruption of the course of treatment by the COVID-19 epidemic and 1 due to personal reasons. In the control group, 3 patients fell and were removed due to swelling of the heel. Therefore, only 80 patients with PF were finally included. After treatment, the two groups showed good results in NRS score (overall, first step, heel pain during daily activities), RMS, and plantar temperature, especially in the experimental group, who showed a significantly better effect than the control group. CONCLUSION ESWT of the heel combined with the triceps trigger point of the calf can more effectively improve the pain, function and quality of life of refractory PF than ESWT of the heel alone. In addition, ESWT of the heel combined with the triceps trigger point of the calf can effectively reduce the skin temperature of the heel on the symptomatic side, indicating that the heel temperature as measured by infrared thermal imaging may be used as an independent tool to evaluate the therapeutic effect for patients with chronic PF. Although extracorporeal shock waves combined with TrPs treatment can cause changes in the patients' gait structure, plantar pressure is still difficult to use as an independent tool to evaluate the therapeutic effect for PF. TRIAL REGISTRATION Registered in the Chinese Clinical Trial Registry ( www.chictr.org.cn ) on 12/17/2021 with the following code: ChiCTR-INR-2,100,054,439.
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Affiliation(s)
- Bo Wang
- Department of Pain Management, Huadong Hospital affiliated to Fudan University, 221 West Yan'an RD, Shanghai, China
| | - Xiao-Lei Wang
- Department of Pain Management, Huadong Hospital affiliated to Fudan University, 221 West Yan'an RD, Shanghai, China
| | - Yan-Tao Ma
- Department of Pain Management, Huadong Hospital affiliated to Fudan University, 221 West Yan'an RD, Shanghai, China
| | - Wei Wu
- Department of Elite Sport, School of Athletic Performance, Shanghai University of Sport, 188 Hengren RD, Shanghai, China.
| | - Yong-Jun Zheng
- Department of Pain Management, Huadong Hospital affiliated to Fudan University, 221 West Yan'an RD, Shanghai, China.
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14
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Orhan Ö, Ağır H, Sarıkaya B, Dolap MA, Akif Altay M. Pain relief and functional improvement provided by extracorporeal shock wave therapy in plantar fasciitis is better than corticosteroid injection and kinesio taping: A randomized trial. Turk J Phys Med Rehabil 2023; 69:469-478. [PMID: 38766588 PMCID: PMC11099853 DOI: 10.5606/tftrd.2023.12824] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 06/16/2023] [Indexed: 05/22/2024] Open
Abstract
Objectives This study aimed to evaluate the results of extracorporeal shock wave therapy (ESWT), corticosteroid injection (CI), and kinesio taping (KT) in terms of pain and function in plantar fasciitis (PF). Patients and methods In this prospective study, 90 feet of 64 patients (11 males, 53 females; mean age: 38.3±10.4 years; range, 22 to 70 years) who presented with chronic PF between November 2021 and March 2022 were evaluated. The patients were randomized to three groups, with 30 feet in each group: the CI group, the ESWT group, and the KT group. Each group received only the respective treatment modalities assigned to their group. Pain assessment of the patients before the treatment and at six weeks, three months, and six months was evaluated with the Visual Analog Scale (VAS), and their functions were evaluated with the American Orthopedic Foot and Ankle Society (AOFAS) score. Results There was no statistical difference in the demographic data (age, body mass index, and VAS; all p>0.05). At six weeks, VAS was statistically significantly lower in the CI group compared to the other groups (p<0.001), but there was no difference in AOFAS between the groups (p=0.666). At three months, there was no statistical difference between the groups regarding VAS (p=0.311), while the AOFAS was higher in the ESWT group (p=0.006). At six months, VAS was lower (p<0.001) and AOFAS was higher (p=0.003) in the ESWT group. Conclusion All three commonly used treatment modalities, ESWT, CI, and KT, are effective in reducing pain and increasing function in chronic PF. However, while CIs can be more effective in relieving pain in the early period, the most significant improvement at the end of the sixth month was achieved by ESWT.
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Affiliation(s)
- Özlem Orhan
- Department of Orthopedics and Traumatology, Harran University Faculty of Medicine, Şanlıurfa, Türkiye
| | - Hatice Ağır
- Department of Physical Medicine and Rehabilitation, Şanlıurfa Regional Training and Research Hospital, Şanlıurfa, Türkiye
| | - Baran Sarıkaya
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Türkiye
| | - Mehmet Ali Dolap
- Department of Orthopedics and Traumatology, Harran University Faculty of Medicine, Şanlıurfa, Türkiye
| | - Mehmet Akif Altay
- Department of Orthopedics and Traumatology, Harran University Faculty of Medicine, Şanlıurfa, Türkiye
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Miladi S, Bouzid S, Fazaa A, Boussaa H, Makhlouf Y, Souabni L, Ouenniche K, Kassab S, Chekili S, Ben Abdelghani K, Laatar A. Is there an association between plantar fasciitis and knee osteoarthritis? Musculoskeletal Care 2023; 21:1045-1052. [PMID: 37212781 DOI: 10.1002/msc.1784] [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: 03/26/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND Knee osteoarthritis (OA) and plantar fasciitis share similar risk factors including ageing, occupation, obesity, and inappropriate shoe wear. However, the association between knee OA and heel pain caused by plantar fasciitis has received limited attention to date. AIM We aimed to assess the prevalence of plantar fasciitis using ultrasound in patients with knee OA and to identify factors associated with plantar fasciitis in these patients. PATIENTS AND METHODS We conducted a cross-sectional study including patients with Knee OA, fulfiling the European League Against Rheumatism criteria. The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and the Lequesne indexes were used to evaluate pain and function of the knees. The Manchester Foot Pain and Disability Index (MFPDI) was used to estimate foot pain and disability. Each patient underwent a physical examination, plain radiographs of the knees and the heels, and an ultrasound examination of both heels to find signs of plantar fasciitis. Statistical analysis was performed using SPSS. RESULTS We included 40 knee OA patients, with a mean age of 59.85 ± 9.65 years [32-74] and a male-to-female ratio of 0.17. The mean WOMAC was 34.03 ± 19.9 [4-75]. The mean Lequesne for knees was 9.62 ± 4.57 [3-16.5]. Among our patients, 52% (n = 21) experienced heel pain. The heel pain was severe in 19% (n = 4). The mean MFPDI was 4.67 ± 4.16 [0-8]. Limited ankle dorsiflexion and plantar flexion were noted in 47% of patients (n = 17) each. High and low arch deformities were seen in 23% (n = 9) and 40% (n = 16) of patients. Ultrasound revealed a thickened plantar fascia in 62% (n = 25). An abnormal hypoechoic plantar fascia was noted in 47% (n = 19), with the loss of normal fibrillar architecture in 12 cases (30%). No Doppler signal was exhibited. Patients with plantar fasciitis had significantly limited dorsiflexion (n = 2 (13%) versus n = 15 (60%), p = 0.004) and plantar flexion (n = 3 (20%) versus n = 14 (56%), p = 0.026). The range of supination was also less important in the plantar fasciitis group (17.73 ± 4.1 vs. 12.8 ± 6.46, p = 0.027). The low arch was statistically more present in patients with plantar fasciitis (G1: 36% [n = 9] vs. G0: 0% [n = 0], p = 0.015). However, the high arch deformity was statistically more present in patients without plantar fasciitis (G1: 28% [n = 7] vs. G0: 60% [n = 9], p = 0.046). Multivariate analysis showed that the risk factor for plantar fasciitis in knee OA patients was limited dorsiflexion (OR = 3.889, 95% CI [0.017-0.987], p = 0.049). CONCLUSION In conclusion, our work showed that plantar fasciitis is frequent in knee OA patients, with reduced ankle dorsiflexion being the main risk factor for plantar fasciitis in these patients.
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Affiliation(s)
- Saoussen Miladi
- Department of Rheumatology, Mongi Slim Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Sirine Bouzid
- Department of Rheumatology, Mongi Slim Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Alia Fazaa
- Department of Rheumatology, Mongi Slim Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Hiba Boussaa
- Department of Rheumatology, Mongi Slim Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Yasmine Makhlouf
- Department of Rheumatology, Mongi Slim Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Leila Souabni
- Department of Rheumatology, Mongi Slim Hospital, Tunis, Tunisia
| | - Kmar Ouenniche
- Department of Rheumatology, Mongi Slim Hospital, Tunis, Tunisia
| | - Salma Kassab
- Department of Rheumatology, Mongi Slim Hospital, Tunis, Tunisia
| | - Salma Chekili
- Department of Rheumatology, Mongi Slim Hospital, Tunis, Tunisia
| | - Kaouther Ben Abdelghani
- Department of Rheumatology, Mongi Slim Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Ahmed Laatar
- Department of Rheumatology, Mongi Slim Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
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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.
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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
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Viglione V, Boffa A, Previtali D, Vannini F, Faldini C, Filardo G. The 'placebo effect' in the conservative treatment of plantar fasciitis: a systematic review and meta-analyses. EFORT Open Rev 2023; 8:719-730. [PMID: 37787480 PMCID: PMC10562949 DOI: 10.1530/eor-23-0082] [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: 10/04/2023] Open
Abstract
Purpose The study of the placebo effect is key to elucidate the 'real effect' of conservative interventions for plantar fasciitis. The aim of this meta-analysis was to quantify the impact of placebo in the different conservative treatments of plantar fasciitis. Methods A systematic literature review was performed on double-blind placebo-controlled trials (RCTs) according to PRISMA guidelines on PubMed, Embase, and Web of Science. The meta-analysis primary outcome was the 0-10 pain variation after placebo treatments analyzed at 1 week, 1, 3, 6, and 12 months. The risk of bias was assessed using the RoB 2.0 tool, while the overall quality of evidence was graded according to the GRADE guidelines. Results The placebo effect for conservative treatments was studied in 42 double-blind RCTs on 1724 patients. The meta-analysis of VAS pain showed a statistically significant improvement after placebo administration of 2.13/10 points (P < 0.001), being highest at 12 months with 2.79/10 points (P < 0.001). The improvement of the placebo groups was higher in the extracorporeal shock wave therapy studies compared to the injection studies (2.59 vs 1.78; P = 0.05). Eight studies had a low risk of bias, 23 studies had 'some concerns,' and 4 studies had a high risk of bias. The GRADE evaluation showed an overall high quality of evidence. Conclusion This systematic review and meta-analysis demonstrated that the placebo effect represents an important component of all conservative approaches to treat plantar fasciitis. This effect is statistically and clinically significant, increases over time, and depends on the type of conservative treatment applied to address plantar fasciitis.
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Affiliation(s)
- Valentina Viglione
- Clinica Ortopedica e Traumatologica 1 IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Angelo Boffa
- Applied and Translational Research (ATR) Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Davide Previtali
- Department of Surgery, EOC, Service of Orthopaedics and Traumatology, Lugano, Switzerland
| | - Francesca Vannini
- Clinica Ortopedica e Traumatologica 1 IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Cesare Faldini
- Clinica Ortopedica e Traumatologica 1 IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Giuseppe Filardo
- Applied and Translational Research (ATR) Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Department of Surgery, EOC, Service of Orthopaedics and Traumatology, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
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Escalada Barrado J, Saiz Modol C, Llombart Blanco R. Medial gastrocnemius proximal fasciotomy in patients with chronic plantar fasciitis: A systematic review. Rev Esp Cir Ortop Traumatol (Engl Ed) 2023:S1888-4415(23)00191-1. [PMID: 37730117 DOI: 10.1016/j.recot.2023.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/20/2023] [Accepted: 08/16/2023] [Indexed: 09/22/2023] Open
Abstract
INTRODUCTION Plantar fasciitis is the main cause of heel pain in middle-aged patients. In chronic cases, limited ankle dorsiflexion caused by isolated gastrocnemius contracture is considered the main risk factor for suffering it. Therefore, in recent years the number of patients operated on by proximal fasciotomy of the medial gastrocnemius (FPGM) has increased to treat chronic plantar fasciitis. MATERIAL AND METHODS Systematic review following the PRISMA guidelines. We have carried out a bibliographic search in Pubmed, Science Direct, Cochrane Library and Web of Science databases. One hundred and eighty-four articles were found. Data extraction was performed using the Covidence software, and a quality and risk of bias analysis of the included articles was performed based on the Cochrane risk of bias Tool 2.0. RESULTS Three articles were included in the review: two randomized clinical trials and one cohort study with a total of 138 patients. In the analyzed studies, patients after proximal fasciotomy of the medial gastrocnemius showed significant improvements in pain and in the AOFAS score with high levels of patient satisfaction. Increases in ankle dorsiflexion angle were found after 12 months of follow-up, with no loss of gastrocnemius strength. The complication rate was low and fewer occurred in the proximal fasciotomy compared to plantar fasciotomy. CONCLUSION Proximal fasciotomy of the medial gastrocnemius provides clinical benefit in patients with chronic plantar fasciitis, with a low probability of complications and high patient satisfaction.
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Affiliation(s)
| | - C Saiz Modol
- Departamento de Cirugía Ortopédica y Traumatología, Clínica Universidad de Navarra, Pamplona, España
| | - R Llombart Blanco
- Departamento de Cirugía Ortopédica y Traumatología, Clínica Universidad de Navarra, Pamplona, España.
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Çil ET, Serif T, Şaylı U, Subaşı F. The effectiveness of "Dijital Steps" web based telerehabilitation system for patient with hindfoot pain: A randomised controlled trial. Foot (Edinb) 2023; 56:102040. [PMID: 37209492 DOI: 10.1016/j.foot.2023.102040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/31/2023] [Accepted: 05/06/2023] [Indexed: 05/22/2023]
Abstract
OBJECTIVE The aim of the study was to evaluate and compare effective therapeutic options for hindfoot pain, develop and investigate the effectiveness of tele-rehabilitation systems, and ensure patients perform their exercises and preventive measures regularly and accurately, while monitoring results. METHODS Hindfoot pain (HP) patients (N = 77 with 120 feet) were admitted to this study and divided into two pathologies; Plantar Fasciitis and Achilles Tendinopathy. Patients in each pathology were randomized into three different rehabilitation programs-web-based telerehabilitation (PF-T & AT-T), -hands-on healing techniques combined with exercise (PF-C & AT-C)-unsupervised home exercise (PF-H & AT-H) program. Disability, activity restrictions, first-step pain, dorsiflexion-plantar flexion range of motion and kinesiophobia scores were recorded. The outcomes of the study groups were collected pre-post intervention (8thweek). Telerehabilitation system was developed via user-driven innovation and tested before using formally. RESULTS Each group had significant improvements in pain, disability, functional status and kinesiophobia (p < 0.001). In terms of functional status, PF-C had a statistically significant difference from others (p < 0.001). There was no difference between the groups for the pain scores in both pathologies. (p > 0.001). However, web-based telerehabilitation (PF-T & AT-T) were found to be more effective on kinesiophobia compared to the other groups (p < 0.001). CONCLUSIONS The presented web-based telerehabilitation system for management of hindfoot pain is an effective way and might be preferred instead of unsupervised home exercise specially for kinesiophobia. Additionally, Foot and ankle stretching and strengthening exercises protocols, myofascial releasing and mulligan concept manual therapy are effective modalities in terms of ROM, VISA-A, FAAM, FFI, TSK and VAS scores for hindfoot pain. The results indicated that three promised different rehabilitation protocols could be an effective strategy for HP.
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Affiliation(s)
- Elif Tuğçe Çil
- Yeditepe University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey.
| | - Tacha Serif
- Yeditepe University, Faculty of Engineering, Department of Computer Engineering, Istanbul, Turkey
| | - Uğur Şaylı
- Sonomed-OsteoAcademy Medical Center Istanbul, Turkey
| | - Feryal Subaşı
- Yeditepe University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
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Alshammari SA, Alshwieer MA, Dammas SS, Alrasheed AM, Alasmari MA, Alahmari MM. Impact of Plantar Fasciitis on Foot-Specific and Generic Health-Related Quality of Life in King Khalid University Hospital, Saudi Arabia. Cureus 2023; 15:e41912. [PMID: 37583733 PMCID: PMC10423962 DOI: 10.7759/cureus.41912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2023] [Indexed: 08/17/2023] Open
Abstract
Objectives The objective is to assess the extent of foot-specific and generic health-related quality of life (HRQoL) impairment among individuals diagnosed with plantar fasciitis (PF) at King Khalid University, Saudi Arabia, and to determine the influence of various sociodemographic and clinical factors. Methods In this cross-sectional study, we administered an online survey from March to June 2023 to patients with PF at King Khalid University Hospital. This questionnaire covered sociodemographic, and clinical characteristics, and included the translated Foot Health Status Questionnaire (FHSQ). Further, patient data were obtained from hospital records between 2016 and 2023 using the E-SIHI system. Results We recruited 209 patients for the study. Lower FHSQ scores were found in unemployed and low-income participants indicating a worse quality of life (QoL) in the Foot Pain domain, while those aged over 40 years and with low income showed greater impairment in the General Foot Health domain. No single factor influenced the Foot Function or Footwear domains. Worse General Health and Physical Activity scores were associated with low-education and low-income participants and those who did not exercise. Women exhibited a lower QoL than men in all domains except for General Health. Conclusion The QoL of Saudi women with PF was similar to that of women in other countries. However, the patients in the present study reported poorer footwear scores but better General Health scores. Therefore, focusing more on proper footwear-related treatments may help improve the QoL of patients with PF.
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Affiliation(s)
| | | | - Saad S Dammas
- Family and Community Medicine, King Saud University Medical City, Riyadh, SAU
| | | | - Mohammed A Alasmari
- Family and Community Medicine, King Saud University Medical City, Riyadh, SAU
| | - Mansour M Alahmari
- Family and Community Medicine, King Saud University Medical City, Riyadh, SAU
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21
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Boob MA, Phansopkar P, Somaiya KJ. Physiotherapeutic Interventions for Individuals Suffering From Plantar Fasciitis: A Systematic Review. Cureus 2023; 15:e42740. [PMID: 37654968 PMCID: PMC10467524 DOI: 10.7759/cureus.42740] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/31/2023] [Indexed: 09/02/2023] Open
Abstract
The foot and the lower leg comprise the ankle joint complex. The foot is crucial for the maintenance of posture. Frequently, overuse or repeated microtrauma to the fascia causes plantar fasciitis. This review aims to suggest the efficacy of various plantar fasciitis (PF) interventions based on modifications in clinical results. This review included studies from 2019 to March 2023 identified through a systematic literature search. The measures used to predict improvement in pain, discomfort, and foot function symptoms included the Visual Analog scale, Numerical Pain Rating Scale, Pressure Point Threshold by algometer, Weight-Bearing Lunge Test by inch tape, and range of motion. The review included 20 studies that fulfilled the inclusion criteria. Therapeutic interventions included insoles, foot orthosis, foam roller stretching, manual stretching, muscle strengthening, intrinsic muscle activities, extracorporeal shock wave lithotripsy, dry needling, laser, ultrasound, and others, which resulted in pain reduction, improved foot function, and ease of everyday routine. All therapeutic strategies used impacts resulting from minimal to maximal recovery. Various advanced approaches are more effective than conventional physical therapy. In conclusion, conservative therapeutic strategies with manual techniques, orthoses, and alternative intervention strategies can be combined to effectively relieve pain and improve function and overall results. Further high-quality studies are essential to learn more about the ideal dose, treatment approaches, and long-term impacts of these therapies.
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Affiliation(s)
- Manali A Boob
- Department of Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Pratik Phansopkar
- Department of Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Kamya J Somaiya
- Department of Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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22
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He L, Eastburn M, Smirk J, Zhao H. Smart Chemical Sensor and Biosensor Networks for Healthcare 4.0. SENSORS (BASEL, SWITZERLAND) 2023; 23:5754. [PMID: 37420917 DOI: 10.3390/s23125754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/05/2023] [Accepted: 06/15/2023] [Indexed: 07/09/2023]
Abstract
Driven by technological advances from Industry 4.0, Healthcare 4.0 synthesizes medical sensors, artificial intelligence (AI), big data, the Internet of things (IoT), machine learning, and augmented reality (AR) to transform the healthcare sector. Healthcare 4.0 creates a smart health network by connecting patients, medical devices, hospitals, clinics, medical suppliers, and other healthcare-related components. Body chemical sensor and biosensor networks (BSNs) provide the necessary platform for Healthcare 4.0 to collect various medical data from patients. BSN is the foundation of Healthcare 4.0 in raw data detection and information collecting. This paper proposes a BSN architecture with chemical sensors and biosensors to detect and communicate physiological measurements of human bodies. These measurement data help healthcare professionals to monitor patient vital signs and other medical conditions. The collected data facilitates disease diagnosis and injury detection at an early stage. Our work further formulates the problem of sensor deployment in BSNs as a mathematical model. This model includes parameter and constraint sets to describe patient body characteristics, BSN sensor features, as well as biomedical readout requirements. The proposed model's performance is evaluated by multiple sets of simulations on different parts of the human body. Simulations are designed to represent typical BSN applications in Healthcare 4.0. Simulation results demonstrate the impact of various biofactors and measurement time on sensor selections and readout performance.
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Affiliation(s)
- Lawrence He
- Princeton High School, Princeton, NJ 08540, USA
| | | | - James Smirk
- Princeton High School, Princeton, NJ 08540, USA
| | - Hong Zhao
- Gildart Haase School of Computer Sciences and Engineering, Fairleigh Dickinson University, Teaneck, NJ 07666, USA
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23
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Rhim HC, Borg-Stein J, Sampson S, Tenforde AS. Utilizing Extracorporeal Shockwave Therapy for in-Season Athletes. Healthcare (Basel) 2023; 11:healthcare11071006. [PMID: 37046934 PMCID: PMC10093829 DOI: 10.3390/healthcare11071006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 03/25/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023] Open
Abstract
An athlete’s health and availability to train and compete at an optimal performance level is a growing focus for professional sports organizations [...]
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Affiliation(s)
- Hye Chang Rhim
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115, USA
| | - Joanne Borg-Stein
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115, USA
| | - Steven Sampson
- David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Adam S. Tenforde
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115, USA
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24
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Sharma R, Chaudhary NK, Karki M, Sunuwar DR, Singh DR, Pradhan PMS, Gyawali P, Duwal Shrestha SK, Bhandari KK. Effect of platelet-rich plasma versus steroid injection in plantar fasciitis: a randomized clinical trial. BMC Musculoskelet Disord 2023; 24:172. [PMID: 36882804 PMCID: PMC9989576 DOI: 10.1186/s12891-023-06277-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/27/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Plantar fasciitis (PF) is a common orthopaedic problem, with heel pain worsening the quality of life. Although steroid injection is often used if the conservative treatment fails, Platelet-Rich Plasma (PRP) injection is gaining popularity due to its safety and long-lasting effect. However, the effect of PRP versus steroid injection in PF has not been studied yet in Nepal. Therefore, this study aimed to assess the effect of PRP compared with steroid injection in the treatment of PF. METHODS This study was a single-center, hospital-based, open-label, parallel-group randomized clinical trial to compare the effect of PRP injection with steroid injection in plantar fasciitis between August 2020 and March 2022. A total of 90 randomly selected participants aged 18 to 60 years suffering from plantar fasciitis with failed conservative treatment were intervened. The American Orthopaedic Foot and Ankle Society (AOFAS) and the Visual Analog Scale (VAS) scoring system were used to evaluate functional mobility and pain before and after the intervention for three and six months, respectively. Statistical analyses were performed using a Student's two-sample t-test. P-value < 0.05 was considered statistically significant. RESULTS The PRP injection showed a better outcome than the steroid injection in six months follow-up. The mean (± SD) VAS score was significantly decreased in the PRP group (1.97 + 1.13) than in the steroid group (2.71 ± 0.94) with the group difference of -0.73 (95% CI: -1.18 to -0.28) at six months. Similarly, there was a significant increase in the AOFAS scores in the PRP group (86.04 ± 7.45) compared to the steroid group (81.23 ± 9.60) at six months of follow-up with a group difference of 4.80 (95% CI: 1.15 to 8.45). There was also a significant reduction of plantar fascia thickness in the PRP group compared to that of the steroid group (3.53 ± 0.81 versus 4.58 ± 1.02) at six months of follow-up with the group difference of -1.04 (95% CI: -1.44 to -0.65). CONCLUSION The PRP injection showed better outcomes than steroid injection in plantar fasciitis treatment over the course of six months. Further research with a larger population and longer follow-up than six months is needed to generalize the findings and their long-term efficacy. TRIAL REGISTRATION NCT04985396. First registered on 02 August 2021. ( https://clinicaltrials.gov/ct2/show/NCT04985396 ).
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Affiliation(s)
| | | | | | - Dev Ram Sunuwar
- Department of Nutrition and Dietetics, Nepal Armed Police Force Hospital, Kathmandu, Nepal
| | - Devendra Raj Singh
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Pranil Man Singh Pradhan
- Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Tribhuvan, Nepal
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25
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Rhim HC, Dhawan R, Gureck AE, Lieberman DE, Nolan DC, Elshafey R, Tenforde AS. Characteristics and Future Direction of Tibialis Posterior Tendinopathy Research: A Scoping Review. Medicina (B Aires) 2022; 58:medicina58121858. [PMID: 36557060 PMCID: PMC9781788 DOI: 10.3390/medicina58121858] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Background and Objectives: Tibialis posterior tendon pathologies have been traditionally categorized into different stages of posterior tibial tendon dysfunction (PTTD), or adult acquired flatfoot deformity (AAFD), and more recently to progressive collapsing foot deformity (PCFD). The purpose of this scoping review is to synthesize and characterize literature on early stages of PTTD (previously known as Stage I and II), which we will describe as tibialis posterior tendinopathy (TPT). We aim to identify what is known about TPT, identify gaps in knowledge on the topics of TPT, and propose future research direction. Materials and Methods: We included 44 studies and categorized them into epidemiology, diagnosis, evaluation, biomechanics outcome measure, imaging, and nonsurgical treatment. Results: A majority of studies (86.4%, 38 of 44 studies) recruited patients with mean or median ages greater than 40. For studies that reported body mass index (BMI) of the patients, 81.5% had mean or median BMI meeting criteria for being overweight. All but two papers described study populations as predominantly or entirely female gender. Biomechanical studies characterized findings associated with TPT to include increased forefoot abduction and rearfoot eversion during gait cycle, weak hip and ankle performance, and poor balance. Research on non-surgical treatment focused on orthotics with evidence mostly limited to observational studies. The optimal exercise regimen for the management of TPT remains unclear due to the limited number of high-quality studies. Conclusions: More epidemiological studies from diverse patient populations are necessary to better understand prevalence, incidence, and risk factors for TPT. The lack of high-quality studies investigating nonsurgical treatment options is concerning because, regardless of coexisting foot deformity, the initial treatment for TPT is typically conservative. Additional studies comparing various exercise programs may help identify optimal exercise therapy, and investigation into further nonsurgical treatments is needed to optimize the management for TPT.
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Affiliation(s)
- Hye Chang Rhim
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115, USA
| | - Ravi Dhawan
- Department of Epidemiology and Biostatistics, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
| | - Ashley E. Gureck
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115, USA
| | - Daniel E. Lieberman
- Department of Human Evolutionary Biology, Harvard University, Cambridge, MA 02138, USA
| | - David C. Nolan
- Department of Physical Therapy, Movement, and Rehabilitation Science, Northeastern University, Boston, MA 02115, USA
| | - Ramy Elshafey
- Department of Orthopedics & Rehabilitation, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA
| | - Adam S. Tenforde
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115, USA
- Correspondence:
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26
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Coye TL, Tirabassi N, Foote CM, Heddy B. An Umbrella Systematic Review and Meta-Analysis of Systematic Reviews on the Topic of Foot and Ankle Arthrodesis Nonunion Rates. J Foot Ankle Surg 2022; 61:1341-1347. [PMID: 35705455 DOI: 10.1053/j.jfas.2022.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/20/2022] [Accepted: 04/29/2022] [Indexed: 02/03/2023]
Abstract
The purpose of this systematic review and meta-analysis was to appraise and combine the available systematic reviews reporting nonunion incidence and prevalence in foot and ankle arthrodesis procedures. The Cochrane Library and MEDLINE were searched for relevant systematic reviews from inception to January 2022. Two independent reviewers selected and reviewed eligible studies. Studies were included if they were systematic reviews or meta-analyses reporting nonunion incidence and prevalence in foot or ankle arthrodesis procedures. Fourteen systematic reviews of 8 types of joint arthrodesis procedures were included for meta-analysis. These reviews comprised 138 studies with 5793 joint arthrodesis procedures. Quality of the included reviews were assessed using the AMSTAR2 checklist. Overall and subgroup meta-analysis of prevalence were performed using random effects model. Publication bias was determined by evaluation of a DOI plot with the Luis Furuya-Kanamori index of asymmetry. The pooled prevalence for foot and ankle nonunion rate was 8.1% (95% confidence interval [CI] 6.5%-9.9%). Overall prevalence of nonunion for single joint foot and ankle joint arthrodesis was 6.1% (95% CI 4.8%-7.6%). Subgroup analysis found that the highest rate of nonunion occurred during tibiotalocalcaneal arthrodesis with 27.1% (95% CI 19.4%-35.2%). We have reported the first meta-analysis of systematic reviews on nonunion rates in foot and ankle arthrodesis procedures. The overall nonunion rate for foot and ankle arthrodesis procedures was 8.1%. For single joint fusion procedures, the nonunion prevalence was 6.1%. Our reported nonunion rates are lower than previously published numbers.
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Affiliation(s)
- Tyler L Coye
- Resident (PGY-3), Division of Podiatric Medicine and Surgery, Department of Orthopedics, Rochester General Hospital, Rochester, NY.
| | - Nathan Tirabassi
- Resident (PGY-3), Division of Podiatric Medicine and Surgery, Department of Orthopedics, Rochester General Hospital, Rochester, NY
| | - Courtney M Foote
- Resident (PGY-3), Division of Podiatric Medicine and Surgery, Department of Orthopedics, Rochester General Hospital, Rochester, NY
| | - Benjamin Heddy
- Resident (PGY-3), Division of Podiatric Medicine and Surgery, Department of Orthopedics, Rochester General Hospital, Rochester, NY
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27
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Seasonal Variation for Plantar Fasciitis: Evidence from Google Trends Search Query Data. Healthcare (Basel) 2022; 10:healthcare10091676. [PMID: 36141288 PMCID: PMC9498888 DOI: 10.3390/healthcare10091676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 11/17/2022] Open
Abstract
We aimed to determine the seasonal trends in internet searches for plantar fasciitis and related symptoms in various countries using search engine query data on Google. We used Google Trends to obtain internet search query data from January 2009 to December 2019. We collected monthly search volumes for the query terms “plantar fasciitis” and “heel pain” in the USA, Canada, the U.K., Ireland, Australia, and New Zealand. Statistical analysis of the seasonal effects on plantar fasciitis was performed using a cosinor model. The cosinor analyses confirmed statistically significant seasonal patterns in the relative search volumes for the terms “plantar fasciitis” and “heel pain” in the USA, Canada, the U.K., Ireland, and Australia, with peaks during the summer and troughs during the winter. For New Zealand, the seasonal trend was statistically significant only for the term “plantar fasciitis”, while a similar trend for the term “heel pain” was present without achieving statistical significance for seasonality. This seasonality is thought to be related to more frequent occurrence of plantar fasciitis due to increased physical activity of people during the warmer months. In this study, the search query data using the terms “plantar fasciitis” and “heel pain” on Google Trends show significant seasonal variation across several countries, with a peak in the summer and a trough in the winter.
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28
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Ríos-León M, Valera-Calero JA, Ortega-Santiago R, Varol U, Fernández-de-las-Peñas C, Plaza-Manzano G. Analyzing the Interaction between Clinical, Neurophysiological and Psychological Outcomes Underlying Chronic Plantar Heel Pain: A Network Analysis Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10301. [PMID: 36011936 PMCID: PMC9408584 DOI: 10.3390/ijerph191610301] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
Plantar heel pain (PHP) is one of the most common foot pain conditions in adults. Several biological and psychological factors could be involved in chronic PHP in a complex matrix. However, reciprocal interactions between these factors are unknown. The aim of the present study was to use network analysis to quantify potential multivariate relationships between pain-related, function, clinical, mechanosensitivity, psychological, and health-related variables in individuals with PHP. Demographic (age, gender), pain-related (pain intensity), function, clinical (myofascial trigger points [TrPs]), mechanosensitivity (pressure pain thresholds), psychological (Beck Depression Inventory), and health-related variables (EQ-5D-5L) were collected in 81 PHP patients. Network connectivity analysis was conducted to quantify the adjusted correlations between the modeled variables and to assess their centrality indices. The connectivity network showed local associations between pain-related variables, foot function, and mechanosensitivity. Additionally, associations between quality of life, depression, and pain-related variables were found, while TrPs was associated with quality of life and mechanosensitivity. The node with the highest strength centrality was the worst pain intensity, while mechanosensitivity and worst pain intensity showed the highest closeness and betweenness centrality. This is the first study to apply network modeling to understand the connections between pain-related, function, clinical, mechanosensitivity, psychological, and health-related variables in PHP. The role of pain severity and mechanosensitivity is highlighted and supported by the network. Thus, this study reveals potential factors that could be the target in the management of PHP, promoting a comprehensive and effective therapeutic approach.
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Affiliation(s)
- Marta Ríos-León
- Hospital Nacional de Parapléjicos, SESCAM, 45004 Toledo, Spain
| | - Juan Antonio Valera-Calero
- Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, 28692 Madrid, Spain
- VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, 28692 Madrid, Spain
| | - Ricardo Ortega-Santiago
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Umut Varol
- VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, 28692 Madrid, Spain
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
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Immunopathogenesis, early Detection, current therapies and prevention of plantar Fasciitis: A concise review. Int Immunopharmacol 2022; 110:109023. [PMID: 35834954 DOI: 10.1016/j.intimp.2022.109023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/29/2022] [Accepted: 06/30/2022] [Indexed: 11/21/2022]
Abstract
Plantar fasciitis or the inflammation of the fascial lining on the plantar aspect of the foot continues to be the leading cause of heel pain for many Americans. Common causes can range from anatomical deformities such as pes planus or flat foot, biomechanical etiology such as excessive pronation of the subtalar joint, or chronic diseases such as obesity and diabetes mellitus. The pathophysiology of plantar fasciitis can be either inflammatory due to vasodilation and immune system activation or non-inflammatory involving fibroblastic hypertrophy. Worsening pain of the inferior and medial heel after periods of prolonged rest and late in the day after hours of ambulation and weight-bearing activities is the most common symptom of plantar fasciitis. Common treatments for plantar fasciitis include plantar fascia stretching, physical therapy, orthotics, corticosteroid injections, and even surgery. Despite these treatment strategies, fasciitis remains a clinical problem and better treatment modalities are warranted. Late diagnosis is a common issue for prolonged and equivocal treatment and early diagnostic measures might be beneficial. In this concise review, we discussed the etiology, immunopathogenesis, current treatments of plantar fasciitis and potentially preventative measures prior to the onset of chronic treatment resistant condition.
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Muscle Quality Assessment by Ultrasound Imaging of the Intrinsic Foot Muscles in Individuals with and without Plantar Fasciitis: A Case-Control Study. Healthcare (Basel) 2022; 10:healthcare10030526. [PMID: 35327004 PMCID: PMC8951853 DOI: 10.3390/healthcare10030526] [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: 02/07/2022] [Revised: 03/04/2022] [Accepted: 03/10/2022] [Indexed: 01/27/2023] Open
Abstract
Objective: The primary aim of the present study was to compare the echo intensity (EI) and echovariation (EV) of the intrinsic foot muscles (IFMs) between individuals with and without plantar fasciitis (PF), using ultrasound imaging. The secondary objective was to study the intra-rater reliability of the echotexture variables. Methods: A case−control study was conducted with 64 participants, who were divided into the following two groups: A, the PF group (n = 32); B, the healthy group (n = 32). Results: The comparison between the two groups did not identify significant differences (p > 0.05) between the flexor hallucis brevis (FHB), flexor digitorum brevis (FDB), quadratus plantae (QP) and abductor hallucis brevis (AHB) variables for the EI and EV. Moreover, excellent intra-rater reliability was reported for the following ultrasound imaging EI variables: ABH (ICC = 0.951), FHB (ICC = 0.949), FDB (ICC = 0.981) and QP (ICC = 0.984). Conclusions: The muscle quality assessment using the EI and EV variables did not identify differences in the FHB, FDB, AHB and QP muscles between individuals with and without PF through USI evaluation. The reliability of all the IFM measurements was reported to be excellent.
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The Efficacy of Instrumental Physical Therapy through Extracorporeal Shock Wave Therapy in the Treatment of Plantar Fasciitis: An Umbrella Review. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12062841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
(1) Background: Plantar fasciitis (PF) is the most common cause of heel pain in adults. Extracorporeal shockwave therapy (ESWT) is a minimally invasive treatments commonly used for treating PF. Our aim is to provide a complete overview of which treatments have been compared to ESWT, with a focus on the modalities that have been used. (2) Methods: A thorough search of the literature was performed on Medline via Pubmed, Cochrane Database of Systematic Reviews (CDSR) of the Cochrane Library and Physiotherapy Evidence Databases (PEDro) up to 18 November 2021. In the study were included only systematic reviews and meta-analysis in English language, published from 2010 to date. (3) Results: A total of 14 systematic reviews and meta-analysis were included in the umbrella review. A total of eight studies compared the efficacy of ESWT treatment with placebo, three studies compared ESWT with another therapy (two studies compared ESWT and corticosteroids, one study ESWT and ultrasound therapy), and three studies had more than one comparison. (4) Conclusions: When compared to placebo, ESWT demonstrated to be effective. More randomized trials with specific comparisons between different types and intensity of SW are needed to obtain more precise information on SW effectiveness.
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