1
|
Guimarães JDS, Arcanjo FL, Leporace G, Metsavaht LF, Conceição CS, Moreno MVMG, Vieira TEM, Moraes CC, Gomes Neto M. Effects of therapeutic interventions on pain due to plantar fasciitis: A systematic review and meta-analysis. Clin Rehabil 2022; 37:727-746. [PMID: 36571559 DOI: 10.1177/02692155221143865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To determine the effects of different therapeutic interventions that have ever been evaluated in randomized controlled trials on pain due to plantar fasciitis. METHODS We searched different electronic databases until September 2022. Mean differences (MDs) and 95% confidence intervals (CIs) were calculated. The Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the overall certainty evidence. RESULTS A total of 236 studies met the study criteria, including 15,401 patients. Botulinum toxin MD -2.14 (CI: -4.15, -0.14), micronized dehydrated human amnion/chorion membrane injection MD -3.31 (CI: -5.54, -1.08), dry needling MD -2.34 (CI: -4.64, -0.04), low-dye taping MD -3.60 (CI: -4.16, -3.03), low-level laser therapy MD -2.09 (CI: -2.28, -1.90), myofascial releases MD -1.79 (CI: -2.63, -0.94), platelet-rich plasma MD -2.40 (CI: -4.16, -0.63), radiofrequency MD -2.47 (CI: -4.65, -0.29), and stretching MD -1.14 (CI: -2.02, -0.26) resulted in being effective treatments for pain when compared to the control in the short term. In the medium and long term, only extracorporeal shock wave therapy MD -0.97 (CI: -1.13, -0.81)/MD -2.49 (CI: -3.17, -1.82) was effective for improving pain when compared to the control. CONCLUSIONS Considering the available studies, this systematic review and meta-analysis showed that different therapeutic interventions seem to be useful strategies for improving pain in patients with plantar fasciitis. In the medium and long term, only extracorporeal shock wave therapy was effective in improving pain when compared to the control.
Collapse
Affiliation(s)
- Janice de S Guimarães
- Postgraduate Program in Medicine and Health at the Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Foot and Ankle Medicine and Surgery Department, 534569Cardiopulmonar Hospital, Salvador, Bahia, Brazil
| | - Fabio L Arcanjo
- Postgraduate Program in Medicine and Health at the Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, 28111Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Gustavo Leporace
- Physiotherapy Research Group, 28111Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Biocinética, Rua Visconde de Pirajá, Rio de Janeiro, Brazil
| | | | - Cristiano Sena Conceição
- Postgraduate Program in Medicine and Health at the Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, 28111Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Marcus V M G Moreno
- Foot and Ankle Medicine and Surgery Department, 534569Cardiopulmonar Hospital, Salvador, Bahia, Brazil
| | - Tulio E Marçal Vieira
- Foot and Ankle Medicine and Surgery Department, 534569Cardiopulmonar Hospital, Salvador, Bahia, Brazil
| | - Carolina Cunha Moraes
- Foot and Ankle Medicine and Surgery Department, Portuguese Hospital of Bahia, Salvador, Bahia, Brazil
| | - Mansueto Gomes Neto
- Postgraduate Program in Medicine and Health at the Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, 28111Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Department, Physiotherapy course, 28111Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| |
Collapse
|
2
|
Relph N, Greaves H, Armstrong R, Prior TD, Spencer S, Griffiths IB, Dey P, Langley B. Running shoes for preventing lower limb running injuries in adults. Cochrane Database Syst Rev 2022; 8:CD013368. [PMID: 35993829 PMCID: PMC9394464 DOI: 10.1002/14651858.cd013368.pub2] [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] [Indexed: 11/12/2022]
Abstract
BACKGROUND Lower-limb running injuries are common. Running shoes have been proposed as one means of reducing injury risk. However, there is uncertainty as to how effective running shoes are for the prevention of injury. It is also unclear how the effects of different characteristics of running shoes prevent injury. OBJECTIVES To assess the effects (benefits and harms) of running shoes for preventing lower-limb running injuries in adult runners. SEARCH METHODS We searched the following databases: CENTRAL, MEDLINE, Embase, AMED, CINAHL Plus and SPORTDiscus plus trial registers WHO ICTRP and ClinicalTrials.gov. We also searched additional sources for published and unpublished trials. The date of the search was June 2021. SELECTION CRITERIA We included randomised controlled trials (RCTs) and quasi-RCTs involving runners or military personnel in basic training that either compared a) a running shoe with a non-running shoe; b) different types of running shoes (minimalist, neutral/cushioned, motion control, stability, soft midsole, hard midsole); or c) footwear recommended and selected on foot posture versus footwear not recommended and not selected on foot posture for preventing lower-limb running injuries. Our primary outcomes were number of people sustaining a lower-limb running injury and number of lower-limb running injuries. Our secondary outcomes were number of runners who failed to return to running or their previous level of running, runner satisfaction with footwear, adverse events other than musculoskeletal injuries, and number of runners requiring hospital admission or surgery, or both, for musculoskeletal injury or adverse event. DATA COLLECTION AND ANALYSIS Two review authors independently assessed study eligibility and performed data extraction and risk of bias assessment. The certainty of the included evidence was assessed using GRADE methodology. MAIN RESULTS We included 12 trials in the analysis which included a total of 11,240 participants, in trials that lasted from 6 to 26 weeks and were carried out in North America, Europe, Australia and South Africa. Most of the evidence was low or very low certainty as it was not possible to blind runners to their allocated running shoe, there was variation in the definition of an injury and characteristics of footwear, and there were too few studies for most comparisons. We did not find any trials that compared running shoes with non-running shoes. Neutral/cushioned versus minimalist (5 studies, 766 participants) Neutral/cushioned shoes may make little or no difference to the number of runners sustaining a lower-limb running injuries when compared with minimalist shoes (low-certainty evidence) (risk ratio (RR) 0.77, 95% confidence interval (CI) 0.59 to 1.01). One trial reported that 67% and 92% of runners were satisfied with their neutral/cushioned or minimalist running shoes, respectively (RR 0.73, 95% CI 0.47 to 1.12). Another trial reported mean satisfaction scores ranged from 4.0 to 4.3 in the neutral/ cushioned group and 3.6 to 3.9 in the minimalist running shoe group out of a total of 5. Hence neutral/cushioned running shoes may make little or no difference to runner satisfaction with footwear (low-certainty evidence). Motion control versus neutral / cushioned (2 studies, 421 participants) It is uncertain whether or not motion control shoes reduce the number of runners sustaining a lower-limb running injuries when compared with neutral / cushioned shoes because the quality of the evidence has been assessed as very low certainty (RR 0.92, 95% CI 0.30 to 2.81). Soft midsole versus hard midsole (2 studies, 1095 participants) Soft midsole shoes may make little or no difference to the number of runners sustaining a lower-limb running injuries when compared with hard midsole shoes (low-certainty of evidence) (RR 0.82, 95% CI 0.61 to 1.10). Stability versus neutral / cushioned (1 study, 57 participants) It is uncertain whether or not stability shoes reduce the number of runners sustaining a lower-limb running injuries when compared with neutral/cushioned shoes because the quality of the evidence has been assessed as very low certainty (RR 0.49, 95% CI 0.18 to 1.31). Motion control versus stability (1 study, 56 participants) It is uncertain whether or not motion control shoes reduce the number of runners sustaining a lower-limb running injuries when compared with stability shoes because the quality of the evidence has been assessed as very low certainty (RR 3.47, 95% CI 1.43 to 8.40). Running shoes prescribed and selected on foot posture (3 studies, 7203 participants) There was no evidence that running shoes prescribed based on static foot posture reduced the number of injuries compared with those who received a shoe not prescribed based on foot posture in military recruits (Rate Ratio 1.03, 95% CI 0.94 to 1.13). Subgroup analysis confirmed these findings were consistent between males and females. Therefore, prescribing running shoes and selecting on foot posture probably makes little or no difference to lower-limb running injuries (moderate-certainty evidence). Data were not available for all other review outcomes. AUTHORS' CONCLUSIONS Most evidence demonstrates no reduction in lower-limb running injuries in adults when comparing different types of running shoes. Overall, the certainty of the evidence determining whether different types of running shoes influence running injury rates was very low to low, and as such we are uncertain as to the true effects of different types of running shoes upon injury rates. There is no evidence that prescribing footwear based on foot type reduces running-related lower-limb injures in adults. The evidence for this comparison was rated as moderate and as such we can have more certainty when interpreting these findings. However, all three trials included in this comparison used military populations and as such the findings may differ in recreational runners. Future researchers should develop a consensus definition of running shoe design to help standardise classification. The definition of a running injury should also be used consistently and confirmed via health practitioners. More researchers should consider a RCT design to increase the evidence in this area. Lastly, future work should look to explore the influence of different types or running shoes upon injury rates in specific subgroups.
Collapse
Affiliation(s)
- Nicola Relph
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK
| | | | - Ross Armstrong
- Institute of Health, University of Cumbria, Carlisle, UK
| | - Trevor D Prior
- Podiatric Surgery, Homerton University Hospital, London, UK
| | - Sally Spencer
- Health Research Institute, Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK
| | | | - Paola Dey
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK
| | - Ben Langley
- Department of Sport & Physical Activity, Edge Hill University, Ormskirk, UK
| |
Collapse
|
3
|
Tajerian M, Garcia J. Garments and Footwear for Chronic Pain. FRONTIERS IN PAIN RESEARCH 2021; 2:757240. [PMID: 35295438 PMCID: PMC8915652 DOI: 10.3389/fpain.2021.757240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 09/28/2021] [Indexed: 11/13/2022] Open
Abstract
In most human societies, wearing clothing and shoes, particularly in public settings, is commonplace and may even be legally required. Consequently, there is an abundance of clothing and footwear options for individuals of different ages, genders, body shapes and catering to different needs such as workwear and active-wear. However, many of the available options may not be viable for the millions and pain sufferers worldwide, indicating a need for adaptive apparel for the pain patient. In this perspective manuscript, we focus on the availability and efficacy of clothing designed to prevent pain in the general population as well as reduce or treat pain in pain patients. Furthermore, we put forth some considerations for the construction of adaptive garments. Such efforts and needed and could significantly improve well-being and quality of life in the pain patient.
Collapse
Affiliation(s)
- Maral Tajerian
- Department of Biology, Queens College, City University of New York, New York, NY, United States
- The Graduate Center, City University of New York, New York, NY, United States
- *Correspondence: Maral Tajerian
| | - Jaqueline Garcia
- Department of Biology, Queens College, City University of New York, New York, NY, United States
| |
Collapse
|
4
|
Effectiveness of Mechanical Treatment for Plantar Fasciitis: A Systematic Review. J Sport Rehabil 2019; 29:657-674. [PMID: 31629333 DOI: 10.1123/jsr.2019-0036] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 05/02/2019] [Accepted: 06/02/2019] [Indexed: 11/18/2022]
Abstract
CONTEXT Plantar fasciitis is one of the most common foot injuries. Several mechanical treatment options, including shoe inserts, ankle-foot orthoses, tape, and shoes are used to relieve the symptoms of plantar fasciitis. OBJECTIVES To investigate the effectiveness of mechanical treatment in the management of plantar fasciitis. EVIDENCE ACQUISITION The review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. A systematic search was performed in PubMed, CINAHL, Embase, and Cochrane up to March 8, 2018. Two independent reviewers screened eligible articles and assessed risk of bias using the Cochrane Collaboration's risk of bias tool. EVIDENCE SYNTHESIS A total of 43 articles were included in the study, evaluating 2837 patients. Comparisons were made between no treatment and treatment with insoles, tape, ankle-foot orthoses including night splints and shoes. Tape, ankle-foot orthoses, and shoes were also compared with insoles. Follow-up ranged from 3 to 5 days to 12 months. Cointerventions were present in 26 studies. CONCLUSIONS Mechanical treatment can be beneficial in relieving symptoms related to plantar fasciitis. Contoured full-length insoles are more effective in relieving symptoms related to plantar fasciitis than heel cups. Combining night splints or rocker shoes with insoles enhances improvement in pain relief and function compared with rocker shoes, night splints, or insoles alone. Taping is an effective short-term treatment. Future studies should aim to improve methodological quality using blinding, allocation concealment, avoid cointerventions, and use biomechanical measures of treatment effects.
Collapse
|
5
|
Chen TLW, Sze LKY, Davis IS, Cheung RTH. Effects of training in minimalist shoes on the intrinsic and extrinsic foot muscle volume. Clin Biomech (Bristol, Avon) 2016; 36:8-13. [PMID: 27195735 DOI: 10.1016/j.clinbiomech.2016.05.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 05/09/2016] [Accepted: 05/09/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Minimalist shoes have gained popularity recently because it is speculated to strengthen the foot muscles and foot arches, which may help to resist injuries. However, previous studies provided limited evidence supporting the link between changes in muscle size and footwear transition. Therefore, this study sought to examine the effects of minimalist shoes on the intrinsic and extrinsic foot muscle volume in habitual shod runners. The relationship between participants' compliance with the minimalist shoes and changes in muscle õvolume was also evaluated. METHODS Twenty habitual shod runners underwent a 6-month self-monitoring training program designed for minimalist shoe transition. Another 18 characteristics-matched shod runners were also introduced with the same program but they maintained running practice with standard shoes. Runners were monitored using an online surveillance platform during the program. We measured overall intrinsic and extrinsic foot muscle volume before and after the program using MRI scans. FINDINGS Runners in the experimental group exhibited significantly larger leg (P=0.01, Cohen's d=0.62) and foot (P<0.01, Cohen's d=0.54) muscle after transition. Foot muscle growth was mainly contributed by the forefoot (P<0.01, Cohen's d=0.64) but not the rearfoot muscle (P=0.10, Cohen's d=0.30). Leg and foot muscle volume of runners in the control group remained similar after the program (P=0.33-0.95). A significant positive correlation was found between participants' compliance with the minimalist shoes and changes in leg muscle volume (r=0.51; P=0.02). INTERPRETATION Habitual shod runners who transitioned to minimalist shoes demonstrated significant increase in leg and foot muscle volume. Additionally, the increase in leg muscle volume was significantly correlated associated with the compliance of minimalist shoe use.
Collapse
Affiliation(s)
- Tony Lin-Wei Chen
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Louis K Y Sze
- Industrial Centre, The Hong Kong Polytechnic University, Hong Kong
| | - Irene S Davis
- Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, The Harvard University, MA, Cambridge, USA
| | - Roy T H Cheung
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
| |
Collapse
|
6
|
Sullivan J, Pappas E, Adams R, Crosbie J, Burns J. Determinants of footwear difficulties in people with plantar heel pain. J Foot Ankle Res 2015; 8:40. [PMID: 26288656 PMCID: PMC4539852 DOI: 10.1186/s13047-015-0102-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 08/12/2015] [Indexed: 11/10/2022] Open
Abstract
Background Plantar heel pain is a common foot disorder aggravated by weight-bearing activity. Despite considerable focus on therapeutic interventions such as orthoses, there has been limited investigation of footwear-related issues in people with plantar heel pain. The aim of this study was to investigate whether people with plantar heel pain experience footwear-related difficulties compared to asymptomatic individuals, as well as identifying factors associated with footwear comfort, fit and choice. Methods The footwear domain of the Foot Health Status Questionnaire (FHSQ) was assessed in 192 people with plantar heel pain and 69 asymptomatic controls. The plantar heel pain group was also assessed on a variety of measures including: foot posture, foot strength and flexibility, pedobarography and pain level. A univariate analysis of covariance, with age as the covariate, was used to compare the heel pain and control groups on the FHSQ footwear domain score. A multiple regression model was then constructed to investigate factors associated with footwear scores among participants with plantar heel pain. Results When compared to asymptomatic participants, people with plantar heel pain reported lower FHSQ footwear domain scores (mean difference −24.4; p < 0.001; 95 % CI: −32.0 to −17.0). In the participants with heel pain, footwear scores were associated with maximum force beneath the postero-lateral heel during barefoot walking, toe flexor strength and gender. Conclusions People with plantar heel pain experience difficulty with footwear comfort, fit and choice. Reduced heel loading during barefoot walking, toe flexor weakness and female gender are all independently associated with reports of footwear difficulties in people with heel pain. Increased focus, in both clinical and research settings, is needed to address footwear-related issues in people with plantar heel pain.
Collapse
Affiliation(s)
- Justin Sullivan
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, NSW Australia ; Faculty of Health Sciences, The University of Sydney, P.O Box 170, Lidcombe, Sydney, NSW 1825 Australia
| | - Evangelos Pappas
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, NSW Australia ; Arthritis and Musculoskeletal Research Group, Faculty of Health Sciences, The University of Sydney, Sydney, NSW Australia
| | - Roger Adams
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, NSW Australia
| | - Jack Crosbie
- School of Science and Health, The University of Western Sydney, Sydney, NSW Australia
| | - Joshua Burns
- Paediatric Gait Analysis Service of New South Wales, Sydney Children's Hospitals Network (Randwick and Westmead), Sydney, NSW Australia ; Arthritis and Musculoskeletal Research Group, Faculty of Health Sciences, The University of Sydney, Sydney, NSW Australia
| |
Collapse
|
7
|
Abstract
The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The purpose of these revised clinical practice guidelines is to review recent peer-reviewed literature and make recommendations related to nonarthritic heel pain.
Collapse
|
8
|
Comparison of a physiotherapy program versus dexamethasone injections for plantar fasciopathy in prolonged standing workers: a randomized clinical trial. Clin J Sport Med 2014; 24:211-7. [PMID: 24172656 DOI: 10.1097/jsm.0000000000000021] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the effectiveness of a physiotherapy-based exercise program versus dexamethasone injection for chronic plantar fasciopathy in workers standing for prolonged periods of time. DESIGN A parallel group nonblinded randomized controlled trial with 12-week follow-up. SETTING An outpatient sports medicine clinic in Vancouver, British Columbia, Canada. PARTICIPANTS Fifty-six workers required to stand for greater than 5 h/d with chronic plantar fasciopathy took part. Diagnosis from a physiotherapist must include signs of structural changes to the plantar fascia seen on ultrasound. INTERVENTIONS The PHYSIO group included 7 physiotherapy-led exercises performed daily over a 12-week period. The INJECTION group received 1 palpation-guided dexamethasone injection followed by a daily routine of calf stretching. MAIN OUTCOME MEASURES The Foot and Ankle Disability Index (FADI) scores 12-weeks postintervention and ultrasound-based measures of ligament appearance. RESULTS At follow-up, both groups reported significant improvements in FADI and visual analog scales for pain at work and with activities of daily living at 6 and 12 weeks compared with baseline scores (P < 0.001). There were no significant between-group differences. There were no significant changes to plantar fascia thickness reported at the 6- and 12-week follow-up point. Both the number of cases with focal anechoic areas and the size of these anechoic areas improved significantly in the PHYSIO (P = 0.003) and INJECTION (P < 0.001) groups at 12-week follow-up. CONCLUSIONS Workers standing for prolonged periods experienced the same short-term therapeutic effectiveness with a physiotherapy-led exercise program compared with an injection of corticosteroid with stretching.
Collapse
|
9
|
Ryan M, Elashi M, Newsham-West R, Taunton J. Examining injury risk and pain perception in runners using minimalist footwear. Br J Sports Med 2013; 48:1257-62. [DOI: 10.1136/bjsports-2012-092061] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
10
|
|
11
|
Footwear for Distance Runners: The Minimalism Trend. INTERNATIONAL JOURNAL OF ATHLETIC THERAPY AND TRAINING 2012. [DOI: 10.1123/ijatt.17.6.14] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
12
|
Chang R, Kent-Braun JA, Hamill J. Use of MRI for volume estimation of tibialis posterior and plantar intrinsic foot muscles in healthy and chronic plantar fasciitis limbs. Clin Biomech (Bristol, Avon) 2012; 27:500-5. [PMID: 22166747 DOI: 10.1016/j.clinbiomech.2011.11.007] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2011] [Revised: 11/20/2011] [Accepted: 11/21/2011] [Indexed: 02/07/2023]
Abstract
BACKGROUND Due to complexity of the plantar intrinsic foot muscles, little is known about their muscle architecture in vivo. Chronic plantar fasciitis may be accompanied by muscle atrophy of plantar intrinsic foot muscles and tibialis posterior compromising the dynamic support of the foot prolonging the injury. Magnetic resonance images of the foot may be digitized to quantify muscle architecture. The first purpose of this study was to estimate in vivo the volume and distribution of healthy plantar intrinsic foot muscles. The second purpose was to determine whether chronic plantar fasciitis is accompanied by atrophy of plantar intrinsic foot muscles and tibialis posterior. METHODS Magnetic resonance images were taken bilaterally in eight subjects with unilateral plantar fasciitis. Muscle perimeters were digitally outlined and muscle signal intensity thresholds were determined for each image for volume computation. FINDINGS The mean volume of contractile tissue in healthy plantar intrinsic foot muscles was 113.3 cm(3). Forefoot volumes of plantar fasciitis plantar intrinsic foot muscles were 5.2% smaller than healthy feet (P=0.03, ES=0.26), but rearfoot (P=0.26, ES=0.08) and total foot volumes (P=0.07) were similar. No differences were observed in tibialis posterior size. INTERPRETATIONS While the total volume of plantar intrinsic foot muscles was similar in healthy and plantar fasciitis feet, atrophy of the forefoot plantar intrinsic foot muscles may contribute to plantar fasciitis by destabilizing the medial longitudinal arch. These results suggest that magnetic resonance imaging measures may be useful in understanding the etiology and rehabilitation of chronic plantar fasciitis.
Collapse
Affiliation(s)
- Ryan Chang
- Biomechanics, Department of Kinesiology, University of Massachusetts Amherst, Amherst 01003, USA.
| | | | | |
Collapse
|
13
|
Lohman EB, Balan Sackiriyas KS, Swen RW. A comparison of the spatiotemporal parameters, kinematics, and biomechanics between shod, unshod, and minimally supported running as compared to walking. Phys Ther Sport 2011; 12:151-63. [DOI: 10.1016/j.ptsp.2011.09.004] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Revised: 09/20/2011] [Accepted: 09/21/2011] [Indexed: 10/16/2022]
|