Differentiating Sitting, Standing, and Walking Through Regional Plantar Pressure Characteristics

2019 ◽  
Vol 142 (4) ◽  
Author(s):  
Kohle Merry ◽  
Megan MacPherson ◽  
Evan Macdonald ◽  
Michael Ryan ◽  
Edward J. Park ◽  
...  
Keyword(s):  
Plantar Pressure ◽  
Repeated Measures ◽  
Weight Bearing ◽  
Heel Pain ◽  
Average Pressure ◽  
Sedentary Behaviors ◽  
Plantar Heel Pain ◽  
Measurement Tools ◽  
Pressure Peak ◽  
Foot Function

Abstract Prolonged static weight bearing (WBR) is thought to aggravate plantar heel pain and is common in the workplace, which may put employees at greater risk of developing plantar heel pain. However, objective measures of physical activity and sedentary behaviors in the workplace are lacking, making it difficult to establish or refute the connection between work exposure and plantar heel pain. Characterizing loading patterns during common workplace postures will enhance the understanding of foot function and inform the development of new measurement tools. Plantar pressure data during periods of sitting, standing, and walking were measured in ten healthy participants using the F-Scan in-shoe measurement system (Tekscan Inc, Boston, MA). Peak and average pressure, peak and average contact area, and average pressure differential were analyzed in ten different regions of the foot. A two-way repeated measures analysis of variance (ANOVA) assessed the posture by foot region interaction for each measurement parameter; significant effects of posture by foot region were identified for all five measurement parameters. Ten foot region by measurement parameter combinations were found to significantly differentiate all three postures simultaneously; seven used pressure measures to differentiate while three used area measures. The heel, lateral midfoot (LM), and medial and central forefoot (CFF) encompassed nine of ten areas capable of differentiating all postures simultaneously. This work demonstrates that plantar pressure is a viable means to characterize and differentiate three common workplace postures. The results of this study can inform the development of measurement tools for quantifying posture duration at work.

Efficacy of electroacupuncture plus warm needling therapy for plantar heel pain: a randomised waitlist-controlled trial

2020 ◽  
pp. 096452842094604
Author(s):  
Lai Fun Ho ◽  
Yuanqi Guo ◽  
Jessica Yuet-Ling Ching ◽  
Kam Leung Chan ◽  
Ping Him Tsang ◽  
...  
Keyword(s):  
Treatment Group ◽  
Controlled Trial ◽  
Heel Pain ◽  
Community Dwelling ◽  
Control Group ◽  
Therapeutic Effects ◽  
Global Rating ◽  
Plantar Heel Pain ◽  
Foot Function ◽  
Warm Needling

Objective: To investigate the therapeutic effects of electroacupuncture plus warm needling (EAWN) therapy on pain and foot function in adults with plantar heel pain (PHP). Methods: This prospective, randomised, parallel-group, waitlist-controlled trial was conducted at a Chinese medicine centre in Hong Kong between May 2018 and February 2019. Eighty eligible community-dwelling subjects with PHP (mean age 59.7 years; 85% female) were equally randomised to receive EAWN therapy or remain on a waitlist. The treatment group received six 30-min sessions of standardised EAWN therapy over 4 weeks; the control group received no treatment. The outcome measures were the visual analogue scale (VAS) score for first-step pain, foot function index (FFI) scores and global rating of change (GRC) scale scores. Assessments were made at baseline, week 2 and week 4 (primary endpoint). The treatment group underwent additional assessments at week 8. Outcomes were evaluated by intention-to-treat analysis. Results: Patients who received EAWN therapy exhibited greater improvements in the mean first-step pain VAS and all FFI scores than did those in the control group at weeks 2 and 4, with significant between-group differences (all P < 0.001). Compared with baseline, there were significant decreases in mean first-step pain VAS scores at weeks 2 and 4, and FFI scores at week 4, in the treatment group but not in the control group. The improvements in the treatment group continued until week 8. GRC scores at week 4 indicated improvement in all treated patients and only 22.5% of the control group patients ( P < 0.001). There were no study-related adverse events. Conclusion: EAWN therapy could be an effective treatment for PHP in middle-aged and older adults. Trial registration number: ChiCTR1800014906 (Chinese Clinical Trials Registry)

scholarly journals Effect of a Toe-Walking Protocol in Plantar Heel Pain: A Proof of Concept

2021 ◽  
Author(s):  
Dean Huffer ◽  
Wayne Hing ◽  
John Charles ◽  
Richard Newton ◽  
Mike Clair ◽  
...  
Keyword(s):  
Plantar Fascia ◽  
Primary Outcome Measure ◽  
Heel Pain ◽  
Cortical Inhibition ◽  
Secondary Outcome ◽  
Patient Reports ◽  
Plantar Heel Pain ◽  
Pain Disability ◽  
Foot Function ◽  
Toe Walking

Abstract Background: Plantar heel pain (PHP) is one of most common disorders of the foot treated in primary care. It affects athletic and sedentary populations, with patient reports of activity-limiting pain and reduced quality of life. Recently, atrophy of the forefoot plantar intrinsic musculature was identified in patients with PHP. Therefore, the purpose of this study was to assess whether loading the plantar fascia strengthens the intrinsic foot musculature (IFM) and decreases symptoms in subjects with PHP Methods: A within-subjects experimental design assessed foot function, foot pain, disability, and activity limitation in 12 subjects with PHP prior to and at the end of a six-week toe-walking program. The primary outcome measure was the Foot Function Index (FFI). IFM strength (both hallux flexion and lesser toe flexion) was measured as a secondary outcome. Results: After six weeks of treatment, the mean (SD) FFI score significantly decreased from 73.2 (32.4) to 43.3 (22.8) points (p = 0.010, ES=1.1). HHD measures: Both great toe flexion and lesser toes flexion strength measures demonstrated significant force increases from 21.8N to 29.6N (+7.8N) 95%CI [1.3, 14.4] (p=0.024, ES=1.0) and from 21.4N to 28.4N (+6.6N) 95%CI [1.8, 11.4] (p=0.010, ES=0.9), respectively. Conclusion: Results suggest that toe-walking may reduce PHP symptoms and increase IFM strength. There was no identified correlation between the IFM and FFI changes. Symptom reduction may be due to a reduction in cortical inhibition rather than IFM strength changes. Findings provide foundation for future larger and more controlled studies, to further validate the effectiveness of toe-walking in reducing symptoms of PHP patients. Trial registration: Bond University Ethics Committee (BUHREC Protocol No. 1908)

A Preliminary Study on the Effect of Computer-Aided Designed and Manufactured Orthoses on Chronic Plantar Heel Pain

2017 ◽  
Vol 11 (2) ◽  
pp. 112-116
Author(s):  
Alfred Gatt ◽  
Mark Grech ◽  
Nachiappan Chockalingam ◽  
Cynthia Formosa
Keyword(s):  
Computer Aided Design ◽  
Comparative Trial ◽  
Heel Pain ◽  
Painful Condition ◽  
Plantar Heel Pain ◽  
Pain Scores ◽  
Computer Aided ◽  
Cad Cam ◽  
Foot Function ◽  
Aided Design

Introduction. Chronic plantar heel pain (CPHP) is a significant, painful condition referring to a range of undifferentiated foot conditions that affect the heel of the foot. Method. Participants presenting with CPHP of more than 6 months’ duration were recruited on a first through the door basis. Computer-Aided Design and Computer-Aided Manufactured (CAD-CAM) orthoses were designed and constructed for each participant, then dispensed as per normal practice. Pre- and postintervention assessment of pain was performed at baseline and after 6 weeks of use, utilizing the pain subset of the Foot Function Index (FFI). Results. There was a significant reduction in the mean pain scores for all participants in all constructs of the FFI. Total FFI score was also significant ( P = .003). Conclusion. CAD-CAM orthoses have the potential to become a treatment modality of choice in CPHP since they have resulted in a significant improvement in heel pain after only 6 weeks’ use. Levels of Evidence: Therapeutic, Level IV: Prospective, comparative trial

scholarly journals Proximal Medial Gastrocnemius Recession and Stretching Versus Stretching as Treatment of Chronic Plantar Heel Pain

2018 ◽  
Vol 39 (12) ◽  
pp. 1423-1431 ◽  
Author(s):  
Marius Molund ◽  
Elisabeth Ellingsen Husebye ◽  
Jan Hellesnes ◽  
Fredrik Nilsen ◽  
Kjetil Hvaal
Keyword(s):  
Plantar Pressure ◽  
Short Form ◽  
Heel Pain ◽  
Ankle Dorsiflexion ◽  
Medial Gastrocnemius ◽  
Plantar Heel Pain ◽  
Sf 36 ◽  
Gastrocnemius Recession ◽  
Nonoperative Group

Background: Plantar heel pain is a common disorder that can lead to substantial pain and disability. Gastrocnemius recession has been described as an operative treatment option, but there is a lack of prospective clinical and biomechanical outcome data. The aim of this study was to evaluate the clinical and biomechanical outcomes of gastrocnemius recession and stretching compared with a stretching exercise protocol for patients with plantar heel pain lasting more than 12 months. Methods: Forty patients with plantar heel pain lasting more than 1 year were randomized to a home stretching exercise program only or to surgery consisting of a proximal medial gastrocnemius recession in addition to stretching exercises. The main outcome was the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score at 12 months. Secondary clinical outcomes were the Short Form–36 (SF-36) and visual analogue scale (VAS) pain scores. The biomechanical outcome parameters were ankle dorsiflexion, Achilles function evaluated by a test battery with 6 independent tests, and plantar pressure evaluated by pedobarography. All data were obtained at baseline and at 12-month follow-up. Results: The AOFAS score increased from 59.5 (42-76) to 88.0 (50-100; P < .001) for the operative group and from 52.5 (37-73) to 65.5 (31-88; P = .138) for the nonoperative group. The AOFAS, VAS pain, and SF-36 scores were significantly better in the operative compared with the nonoperative group at 12-month follow-up ( P < .05). Ankle dorsiflexion increased from 6 degrees (–3 to 15) to 10.5 degrees (0 to 23; P < .001). No between-group difference was observed for Achilles function at follow-up. The average forefoot plantar pressure for the operative group increased from 536 KPa (306-708) to 642 KPa (384-885) at follow-up ( P < .001). Conclusion: Proximal medial gastrocnemius recession with a stretching program was a safe and efficient method of treating chronic plantar heel pain. Level of Evidence: Level 1, randomized clinical trial.

scholarly journals Effect of a toe-walking protocol in plantar heel pain: A pilot study

2021 ◽  
Author(s):  
Dean Huffer ◽  
Wayne Hing ◽  
John Charles ◽  
Richard Newton ◽  
Mike Clair ◽  
...  
Keyword(s):  
Plantar Fascia ◽  
Heel Pain ◽  
Cortical Inhibition ◽  
Patient Reports ◽  
Plantar Heel Pain ◽  
Walking Program ◽  
Force Increase ◽  
Within Subjects ◽  
Foot Function ◽  
Toe Walking

Abstract Introduction/Purpose: Plantar heel pain (PHP) is one of most common disorders of the foot treated in primary care. It affects athletic and sedentary populations, with patient reports of activity-limiting pain and reduced quality of life. Recently, atrophy of the forefoot plantar intrinsic musculature was identified in patients with PHP.Therefore, the purpose of this study was to assess whether loading the plantar fascia strengthens the intrinsic foot musculature (IFM) and decreases PHP sufferers’ symptoms.Methods: A within-subjects experimental design assessed Foot Function Index (FFI) and IFM strength via hand-held dynamometry (HHD) in 12 patients with PHP prior to and at the end of a six-week toe-walking program.Results: After six weeks of treatment, the mean (SD) FFI score significantly decreased from 73.2 (32.4) to 43.3 (22.8) points (p = 0.010, ES = 1.1). HHD measures: Both great toe flexion and lesser toes flexion strength measures demonstrated significant force increase of 7.8N 95%CI [1.3, 14.4] (p = 0.024, ES = 1.0) and 6.6N 95%CI [1.8, 11.4] (p = 0.010, ES = 0.9), respectively.Conclusion: Results suggest toe-walking reduces PHP symptoms and increases IFM strength. There was no identified correlation between the IFM and FFI changes. Symptom reduction may potentially be due to a reduction in cortical inhibition rather than IFM strength changes. Findings provide foundation for future studies, employing imaging, to further validate the effectiveness of toe-walking in reducing symptoms of PHP patients.Trial registration: PROSPERO 2016 CRD42016036302 Registered 10 March 2016, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42016036302

scholarly journals Predictors of response to foot orthoses and corticosteroid injection for plantar heel pain

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Glen A. Whittaker ◽  
Karl B. Landorf ◽  
Shannon E. Munteanu ◽  
Hylton B. Menz
Keyword(s):  
Corticosteroid Injection ◽  
Heel Pain ◽  
Ankle Dorsiflexion ◽  
Foot Orthoses ◽  
Foot Pain ◽  
Fear Avoidance ◽  
Foot Health ◽  
Fear Avoidance Beliefs ◽  
Plantar Heel Pain ◽  
Foot Function

Abstract Background Foot orthoses and corticosteroid injection are common interventions used for plantar heel pain, however few studies have investigated the variables that predict response to these interventions. Methods Baseline variables (age, weight, height, body mass index (BMI), sex, education, foot pain, foot function, fear-avoidance beliefs and feelings, foot posture, weightbearing ankle dorsiflexion, plantar fascia thickness, and treatment preference) from a randomised trial in which participants received either foot orthoses or corticosteroid injection were used to predict change in the Foot Health Status Questionnaire foot pain and foot function subscales, and first-step pain measured using a visual analogue scale. Multivariable linear regression models were generated for different dependent variables (i.e. foot pain, foot function and first-step pain), for each intervention (i.e. foot orthoses and corticosteroid injection), and at different timepoints (i.e. weeks 4 and 12). Results For foot orthoses at week 4, greater ankle dorsiflexion with the knee extended predicted reduction in foot pain (adjusted R2 = 0.16, p = 0.034), and lower fear-avoidance beliefs and feelings predicted improvement in foot function (adjusted R2 = 0.43, p = 0.001). At week 12, lower BMI predicted reduction in foot pain (adjusted R2 = 0.33, p < 0.001), improvement in foot function (adjusted R2 = 0.37, p < 0.001) and reduction in first-step pain (adjusted R2 0.19, p = 0.011). For corticosteroid injection at week 4, there were no significant predictors for change in foot pain or foot function. At week 12, less weightbearing hours predicted reduction in foot pain (adjusted R2 = 0.25, p = 0.004) and lower baseline foot pain predicted improvement in foot function (adjusted R2 = 0.38, p < 0.001). Conclusions People with plantar heel pain who use foot orthoses experience reduced foot pain if they have greater ankle dorsiflexion and lower BMI, while they experience improved foot function if they have lower fear-avoidance beliefs and lower BMI. People who receive a corticosteroid injection experience reduced foot pain if they weightbear for fewer hours, while they experience improved foot function if they have less baseline foot pain.

Comparison of Injection Modalities in the Treatment of Plantar Heel Pain

2006 ◽  
Vol 96 (4) ◽  
pp. 293-296 ◽  
Author(s):  
Esat Kiter ◽  
Ersen Çelikbaş ◽  
Semih Akkaya ◽  
Fahir Demirkan ◽  
B. Alper Kiliç
Keyword(s):  
Visual Analog Scale ◽  
Repeated Measures ◽  
Corticosteroid Injection ◽  
Autologous Blood ◽  
Randomized Study ◽  
Heel Pain ◽  
Analog Scale ◽  
Plantar Heel Pain ◽  
Autologous Blood Injection ◽  
Blood Injection

In a prospective randomized study of plantar heel pain, 44 patients were treated with injection of 1 mL of 2% prilocaine using the peppering technique, 1 mL of 2% prilocaine combined with 2 mL of autologous blood, or 1 mL of 2% prilocaine mixed with 40 mg of methylprednisolone acetate. At 6-month follow-up, clinical improvement was evaluated by using a 10-cm visual analog scale and the rearfoot score of the American Orthopaedic Foot and Ankle Society. Results were analyzed using sample t-tests within groups and repeated-measures analyses of variance between groups. Mean ± SD visual analog scale scores in the peppering technique, autologous blood injection, and corticosteroid injection groups improved from 6.4 ± 1.1, 7.6 ± 1.3, and 7.28 ± 1.2 to 2.0 ± 2.2 (P &lt; .001), 2.4 ± 1.8 (P &lt; .001), and 2.57 ± 2.9 (P &lt; .001), respectively. Mean ± SD rearfoot scores in the same groups improved from 64.1 ± 15.1, 71.6 ± 1, and 65.7 ± 12.7 to 78.2 ± 12.4 (P = .018), 80.9 ± 13.9 (P = .025), and 80.07 ± 17.5 (P = .030), respectively. There were no statistically significant differences among the groups. Good outcomes have been documented using the peppering technique and autologous blood injection for the treatment of lateral epicondylitis. Although the curative mechanisms of both injection modalities are based on a hypothesis, they seem to be good alternatives to corticosteroid injection for the treatment of plantar heel pain. (J Am Podiatr Med Assoc 96(4): 293–296, 2006)

Chronic Plantar Heel Pain: Treatment with a Short Leg Walking Cast

1996 ◽  
Vol 17 (1) ◽  
pp. 41-42 ◽  
Author(s):  
Christopher L. Tisdel ◽  
Marion C. Harper
Keyword(s):  
Complete Resolution ◽  
Surgical Intervention ◽  
Pain Treatment ◽  
Heel Pain ◽  
Treatment Modalities ◽  
Plantar Heel Pain ◽  
Long Term Follow Up

The efficacy of a short leg walking cast in the treatment of chronic plantar heel pain was assessed for 32 patients with 37 involved extremities treated over a 2-year period. All patients had failed numerous other treatment modalities and had been symptomatic for an average of 1 year. Long-term follow-up for 24 patients with 28 involved extremities revealed complete resolution of pain for 7 extremities (25%), improvement for 17 (61%), and no improvement for 4 (14%). Ten (42%) patients were completely satisfied with cast treatment, 3 (12%) were satisfied with reservations, and 11 (46%) were dissatisfied. Casting appears to be a reasonable option for patients with recalcitrant heel pain and should be offered before surgical intervention.

Sign in / Sign up

Export Citation Format

Share Document