Authors (including presenting author) :
Ho SH(1), Pak LY(1)
Affiliation :
Prosthetic and Orthotic Department, Pamela Youde Nethersole Eastern Hospital
Introduction :
Plantar fasciitis is a common musculoskeletal disease affecting ones’ feet and causing sharp heel pain or medial longitudinal arch pain. Mechanical stress which surpass plantar fascia may contribute to the development of the disorder (Deol & Philbin, 2012). The increased stress force may lead to microtrama of the fascia and the cumulative microtrama may finally cause inflammation of plantar fascia. The pain would be the most intense during the first step after awaking and long period of resting. It would be reduced gradually but increased again after prolonged walking and standing.
Conservative treatments are usually considered as the initial treatment. McPoli et al. (2008) pointed out that foot orthosis and stretching exercises are strongly and moderately evidence- based treatment respectively.
Objectives :
Both stretching exercises and orthotic therapy could provide short- term pain reduction. They are therefore suggested as the initial treatment (Neufeld and Cerrato, 2008). However, effectiveness of the combination of these 2 treatments is not clear. The aim of this project is to investigate the effectiveness of this combined intervention in plantar fasciitis, especially its effectiveness in patients who have symptoms for a longer duration.
Methodology :
Patients with plantar fasciitis were identified in department and hence suitable orthotic insoles were prescribed to them. It is suggested that they had to use the insoles every day. Moreover, plantar fascia stretching exercise and Achilles stretching exercise were taught to them and it is recommended that patients should perform each of the exercises at home 3 times daily for both sides, holding each for 100 seconds. The Foot Function Index (FFI) for PF was used to measure foot pain before receiving the combined treatment and also in the follow up section which was held 4 to 5 months later.
Result & Outcome :
71 patients with plantar fasciitis were recruited in the study and treated with a 4-months to 5-months orthotic treatment and stretching exercises. The mean age was 56.3 years old (SD = 11.9) and mean pain duration was 8.2 months (SD=16.9). The mean scores of pre and post treatment were 6.53 and 2.67 respectively. In further analysis, subjects were divided into three groups by pain duration, < 3 months (n=33), 3 months < x ≤ 6 months (n=22) and > 6 months (n=16). The mean percentage change of score after treatment were 59.2%, 53.7% and 64.8% respectively. Pain score was significantly reduced with the combined treatment (95% CI: 3.39-4.33; p< 0.001). However, no significant difference was shown among different pain durations. Subjects with plantar fasciitis demonstrated significant improvement in reduction of pain score after the combined treatment regardless the pain duration.
