Plantar Fasciitis, Plantar Heel Pain
Conditions
Keywords
pain, plantar fasciitis, plantar heel pain, ESWT, extracorporeal shock wave therapy
Brief summary
Heel pain is a problem that affects daily life activities and quality of life. Extracorporeal shock wave therapy (ESWT) is a treatment used for heel pain. However, some people do not benefit from ESWT treatment. The aim of this study is to determine the factors that affect the response to ESWT in the treatment of heel pain.
Detailed description
Plantar heel pain is one of the reasons that affect daily life activities. There are many treatment methods for this. Extracorporeal shock wave therapy (ESWT) is one of them. However, some patients do not respond to ESWT treatment. In this study, patients were divided into 2 groups as those who did not respond to ESWT treatment in terms of pain (less than 50% decrease in pain level) or those with recurrence of pain and those who responded to treatment. Patients who had passed 3-6 months after ESWT constituted the study groups. These two groups will be compared in terms of age, gender, occupation, weight, height, Body Mass Index (BMI), side: right / left / bilateral, calcaneal angle, Meary angle, presence of spur on X-ray (size in mm if present), dorsiflexion angle degree, plantar fascia thickness with ultrasonography, tibial / plantar nerve conduction study evaluated with electroneuromyography, Visual Analog Scale, Heel Sensitivity Index and Foot Function Index.
Interventions
None listed
Sponsors
Sisli Hamidiye Etfal Training and Research Hospital
Study design
Observational model
CASE_CONTROL
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* \>18 years * Unresponsive to conservative treatments (physical therapy, rest, exercises, anti-inflammatory medical treatment, insoles, etc.) * Patients who have received ESWT treatment and 3-6 months have passed since ESWT
Exclusion criteria
* History of injection therapy including steroids after ESWT treatment * Those taking NSAIDs in the last 2 weeks * Those with a history of trauma or surgery to the foot or ankle * Presence of rheumatic disease affecting the foot or ankle (e.g. spondyloarthritis, etc.) * Malignancy * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Tibial/plantar nerve conduction study with electroneuromyography | Day 1 | Nerve conductions show decreased amplitude of the compound muscle action potential (CMAP) of the tibial nerve stimulated at the ankle and recorded from the abductor hallucis and abductor digiti minimi. Sensory and mixed conduction studies are usually performed with centering techniques. |
| Calcaneal inclination angle | Day 1 | This angle is established on a weight-bearing lateral foot radiograph between the calcaneal inclination axis (i.e., the lowest portion of the calcaneus) and the supporting horizontal surface. A cut-off point of ≤19° is used to diagnose symptomatic pes planus/flatfoot. |
| Ankle dorsiflexion degree | Day 1 | The patient is in a prone position with the ankle on the test side away from the base and the leg extended. The therapist will stabilize the tibia. The normal range of ankle dorsiflexion is 20 degrees. Normal plantar flexion is 50 degrees. |
| Plantar fascia thickness | Day 1 | To be measured by ultrasound; typically shows increased fascial thickness (\>4.0 mm) and a hypoechoic fascia. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Heel Tenderness index | Day 1 | 0=no pain; 1=painful; 2=painful and whines; 3=painful, whines, and withdraws |
| Plantar calcaneal spurs | Day 1 | Classically, on plain radiography, the presence of a bony spur extending inferomedially from the calcaneus in the sagittal image will be determined, and its size in mm will be determined. |
| Meary angle | Day 1 | The Meary angle has been used to determine the apex of the deformity on lateral weight-bearing foot radiographs in patients with pes cavus and pes planus. It is the angle between a line drawn through the longitudinal axes of the talus (mid-talus axis) and the first metatarsal (first metatarsal axis). It can be used to classify the severity of the deformity; mild: \<15º, moderate: 15-30º, severe: \>30º |
| Foot Function Index | Day 1 | The FFI consists of 23 items divided into 3 subscales that quantify the impact of foot pathology on pain, disability, and activity limitation in patients. Pain, disability, and activity limitation subscale scores range from 0 to 100. |
Countries
Turkey (Türkiye)
Outcome results
None listed