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 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)

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)

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.

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 Online questionnaire, clinical and biomechanical measurements for outcome prediction of plantar heel pain: feasibility for a cohort study

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Halime Gulle ◽  
Trevor Prior ◽  
Stuart Miller ◽  
Aleksandra V. Birn-Jeffery ◽  
Dylan Morrissey
Keyword(s):  
Cohort Study ◽  
Plantar Fascia ◽  
Step Length ◽  
Order Effect ◽  
Heel Pain ◽  
Future Research ◽  
Online Questionnaire ◽  
Level Of Evidence ◽  
Face To Face ◽  
Plantar Heel Pain

Abstract Background Plantar heel pain (PHP) accounts for 11–15% of foot symptoms requiring professional care in adults. Recovery is variable, with no robust prognostic guides for sufferers, clinicians or researchers. Therefore, we aimed to determine the validity, reliability and feasibility of questionnaire, clinical and biomechanical measures selected to generate a prognostic model in a subsequent cohort study. Methods Thirty-six people (19 females & 17 males; 20–63 years) were recruited with equal numbers in each of three groups: people with PHP (PwPHP), other foot pain (PwOP) and healthy (H) controls. Eighteen people performed a questionnaire battery twice in a randomised order to determine online and face-to-face agreement. The remaining 18 completed the online questionnaire once, plus clinical measurements including strength and range of motion, mid-foot mobility, palpation and ultrasound assessment of plantar fascia. Nine of the same people underwent biomechanical assessment in the form of a graded loaded challenge augmenting walking with added external weight and amended step length on two occasions. Outcome measures were (1) feasibility of the data collection procedure, measurement time and other feedback; (2) establishing equivalence to usual procedures for the questionnaire battery; known-group validity for clinical and imaging measures; and initial validation and reliability of biomechanical measures. Results There were no systematic differences between online and face-to-face administration of questionnaires (p-values all > .05) nor an administration order effect (d = − 0.31–0.25). Questionnaire reliability was good or excellent (ICC2,1_absolute)(ICC 0.86–0.99), except for two subscales. Full completion of the survey took 29 ± 14 min. Clinically, PwPHP had significantly less ankle-dorsiflexion and hip internal-rotation compared to healthy controls [mean (±SD) for PwPHP-PwOP-H = 14°(±6)-18°(±8)-28°(±10); 43°(±4)- 45°(±9)-57°(±12) respectively; p < .02 for both]. Plantar fascia thickness was significantly higher in PwPHP (3.6(0.4) mm vs 2.9(0.4) mm, p = .01) than the other groups. The graded loading challenge demonstrated progressively increasing ground reaction forces. Conclusion Online questionnaire administration was valid therefore facilitating large cohort recruitment and being relevant to remote service evaluation and research. The physical and ultrasound examination revealed the expected differences between groups, while the graded loaded challenge progressively increases load and warrants future research. Clinician and researchers can be confident about these methodological approaches and the cohort study, from which useful clinical tools should result, is feasible. Level of evidence IV

scholarly journals Plantar fasciitis

2012 ◽  
Vol 94 (8) ◽  
pp. 539-542 ◽  
Author(s):  
S Cutts ◽  
N Obi ◽  
C Pasapula ◽  
W Chan
Keyword(s):  
Plantar Fasciitis ◽  
Plantar Fascia ◽  
Heel Pain ◽  
Management Options ◽  
Heel Spur ◽  
New Techniques ◽  
Extracorporeal Shockwave Therapy ◽  
Shockwave Therapy ◽  
Plantar Heel Pain ◽  
History Of

INTRODUCTION In this article we look at the aetiology of plantar fasciitis, the other common differentials for heel pain and the evidence available to support each of the major management options. We also review the literature and discuss the condition. METHODS A literature search was performed using PubMed and MEDLINE®. The following keywords were used, singly or in combination: ‘plantar fasciitis’, ‘plantar heel pain’, ‘heel spur’. To maximise the search, backward chaining of reference lists from retrieved papers was also undertaken. FINDINGS Plantar fasciitis is a common and often disabling condition. Because the natural history of plantar fasciitis is not understood, it is difficult to distinguish between those patients who recover spontaneously and those who respond to formal treatment. Surgical release of the plantar fascia is effective in the small proportion of patients who do not respond to conservative measures. New techniques such as endoscopic plantar release and extracorporeal shockwave therapy may have a role but the limited availability of equipment and skills means that most patients will continue to be treated by more traditional techniques.

scholarly journals EFFECTIVENESS OF STRETCHING EXERCISES IN COMPARISON TO KINESIO TAPING FOR THE CURE OF PLANTAR FASCIITIS PAIN

2014 ◽  
Vol 3 (2) ◽  
pp. 31-35
Author(s):  
Syeda Rida Baqir ◽  
Syed Abid Mehdi Kazmi
Keyword(s):  
Plantar Fasciitis ◽  
Tertiary Care ◽  
Plantar Fascia ◽  
Heel Pain ◽  
Warning Signs ◽  
Care Hospital ◽  
Plantar Heel Pain ◽  
Kinesio Taping ◽  
Cold Pack ◽  
Stretching Exercises

OBJECTIVE To determine the efficacy of stretching exercises verses kinesio taping for the cure of plantar fasciitis pain. BACKGROUND It is the apparent problem of foot that influences athletes. It transpires when rhythmic pressure is occurred on the heel as of a chronic or acute state. Physical therapists had apply many methods attempt to alleviate the warning signs of pain in plantar heel, as well as a variety of taping techniques for which there is slight accessible facts. METHOD Research was conducted at Outpatient Department of tertiary care hospital. INTERVENTIONS 18 contestants amid plantar heel pain were hired from the ordinary community. Participants were randomly assigned into two groups. Group A participants were treated with kinesio taping, cold pack and ultrasound. Group B participants were treated with stretching, cold pack and ultrasound. The period of record for every participant was four weeks. No participants are missing to transcribe. Outcome assesses included pain in ‘first-step’ (evaluated on a Pain Scale from 1to 10) plus the pain disability index Questionnaire. RESULTS Comprehensive information was acquired from eighteen participants. One-year record outcomes proved great improvement in every participant after application of stretching exercises of plantar fascia, with an chiefly lofty rate of upgrading in the actual group participants managed by the stretching exercises. CONCLUSION This study consists of the application of the stretching method which is the major element of management in chronic condition of plantar fasciitis. Continuing advantages of the stretching exercises include a noticeable reduction of pain and a lofty rate of achievement. These finding can give the health-care provider with an efficient, economical, and uncomplicated treatment method. KEY WORDS Plantar fasciitis, Plantar heel pain, repetitive micro trauma, plantar fascia, heel spur, nerve trapping, taping, stretching.

scholarly journals The effectiveness of combined shockwave therapy and plantar fascia stretching interventions in treating plantar heel pain

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ian Burton ◽  
Kay Cooper ◽  
Lyndsay Alexander ◽  
Paul Alan Swinton
Keyword(s):  
Plantar Fascia ◽  
Heel Pain ◽  
Shockwave Therapy ◽  
Plantar Heel Pain
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