Effect of experimentally induced plantar pain on trunk posture during gait

[Purpose] Plantar pain is associated with the prevalence of low back pain. Therefore, it is reasonable to assume that some kind of physical change should be occurring in the trunk due to plantar pain. However, the physical effect of plantar pain on the trunk remains unknown. We evaluated the effect of plantar pain on trunk posture during gait. [Participants and Methods] Ten healthy volunteers participated in the present study. Participants walked under two conditions: without pain and with pain. In the with pain condition, we set pain-inducing devices to the right foot to induce plantar pain during stance phase. By using 3D motion analysis system, the angles of the head, thorax, and pelvis segments, as well as the neck, trunk, bilateral hip, bilateral knee, and bilateral ankle joints, were measured. We analyzed the angle data throughout the gait cycle by using one-dimensional statistical parametric mapping. [Results] The anterior trunk tilt was observed in the right stance phase. [Conclusion] The anterior trunk tilt observed in the with pain condition may be a burden on the trunk. Our results presented one of the possible reasons for increased prevalence of low back pain in the plantar pain patients.

Extracorporeal shockwave therapy in the management of plantar fasciitis: A randomized controlled trial

BACKGROUND

This study aimed at estimating the extent to which a combination therapy of extracorporeal shockwave therapy (ESWT) with usual care (exercise and orthotic support) improve functional ability in the patient with plantar fasciitis when compared to usual care alone.

METHODS

Participants with plantar fasciitis were randomly allocated into two groups: ESWT (n=23), and control (n=21). All participants received home exercise program with orthotic support. In addition, ESWT group received 2000 shock waves with 0.02 mJ/mm² for three sessions. Functional outcomes were measured by function subscale of American orthopedic foot and ankle society (AOFAS-F) score and 12 minutes walking test including walking speed, cadence. The scores were recorded at baseline, third week and third month after the treatment. Analysis was performed using repeated measures ANOVA, and an intention to treat approach using multiple imputations.

RESULTS

Results showed that there was a significant improvement in AOFAS-F total score and walking speed over three months in both groups (p<0.001, p=0.04 respectively); improvements in AOFAS-F were particularly in activity limitation (p=0.001), walking distance (p=0.02) and walking surface (p=0.02). Groups were comparable with each other for both walking speed and AOFAS-F in any assessment time (p>0.05). However, groups performed differently in cadence where there was an increase in cadence in ESWT group whereas a decline in control at the third month (p=0.07).

CONCLUSION

The results revealed that ESWT did not have an additive benefit over usual care to improve foot function and walking performance in patient with plantar fasciitis over three months post-treatment.

Plantar pain is not always fasciitis

The case is described of a patient with chronic plantar pain, diagnosed as fasciitis, which was not improved by conventional treatment. Magnetic resonance imaging revealed flexor hallucis longus tenosynovitis, which improved after local glucocorticoid injection.