Leg length discrepancy is not a risk factor for plantar fasciitis.

PURPOSE: Plantar fasciitis (PF) is a main source of heel pain, and only about one-third of patients have bilateral symptomatic involvement, although age, body mass index (BMI), and physical activities are known risk factors. The high prevalence of unilateral involvement is poorly understood. We aimed to assess the potential association between PF and the leg length discrepancy (LLD) in unilateral PF. METHODS: A transversal case-control study was conducted from January 2019 to December 2020, including 120 participants allocated to two groups matched by BMI and sex: cases (with a diagnosis of PF; 50 ± 13 years) and control (without foot pain; 40 ± 15 years). For both groups, a difference greater than 0.64 cm in the scanometry determined the criteria for the presence of LLD. RESULTS: The multivariate logistic regression analysis showed an independent association of PF only with age (p < 0.001), and no association with LLD. We did not observe differences in the mean discrepancy (1.37 ± 0.83 cm in the PF group in comparison with 1.13 ± 0.37 cm in the control group, [p > 0.05]) or in the prevalence of LLD between groups (48% [n = 29] in the PF group compared with 42% [n = 25] in the control group, [p > 0.05]). In the PF group, 80% of the participants reported unilateral pain. We observed a higher prevalence of pain in the shorter limb (p < 0.05). CONCLUSION: Age was the only factor associated with the diagnosis of PF when groups were matched by sex and BMI. LLD was not an independent factor associated with the diagnosis of PF. However, when PF is unilateral, the shorter limb is more affected with 70% of prevalence. LEVEL OF EVIDENCE: Level III, case-control.

The association between refractory plantar fasciitis and insertional Achilles tendinopathy and peripheral spondyloarthritis: a report of human leukocyte antigen B-27 investigation and treatment outcome.

PURPOSE: This study aimed to determine the presence of peripheral spondyloarthritis and investigate the clinical characteristics of patients with concurrent peripheral spondyloarthritis in those presenting with refractory plantar fasciitis and Achilles tendinopathy by conducting human leukocyte antigen B-27 (HLA-B27) testing. METHODS: This retrospective study aimed to investigate patients who complained of persistent pain and significant limitations in daily activities due to their respective foot pain, despite receiving conservative treatment for over one year under the diagnosis of plantar fasciitis or insertional Achilles tendinopathy. The study included 63 patients who underwent HLA-B27 testing. The patients were classified into two groups based on the presence or absence of HLA-B27 positivity. The Mann-Whitney U test assessed significant relationships between continuous variables, and the chi-square test was used to compare categorical variables. RESULTS: Among the 63 included patients, HLA-B27 positivity was confirmed in 11 patients (17.5%), which was significantly associated with a lower average age (22.8 years versus 31.7 years, P = 0.01) and a substantially lower proportion of females compared to HLA-B27-negative patients (9.1% vs. 25.0%, P = 0.001). Ten of the 11 patients initiated treatment with conventional synthetic disease-modifying antirheumatic drugs (DMARDs) combined with oral steroids as the first-line medication after being diagnosed as HLA-B27 positive. Six patients experienced pain relief with the first-line medication (60%). Four patients who did not achieve pain control with the first-line medication received tumour necrosis factor-alpha inhibitors as the second-line medication. Two patients experienced pain relief, while two experienced reduced but persistent pain. CONCLUSIONS: Among the patients with "refractory" plantar fasciitis and insertional Achilles tendinopathy, 17.5% were diagnosed with peripheral spondyloarthritis. Patients diagnosed with peripheral spondyloarthritis had a higher proportion of men and relatively younger mean age compared to those without the diagnosis. Approximately 70% of these patients achieved symptom improvement in foot and ankle joints by taking conventional synthetic DMARDs, TNF-α inhibitors, or both appropriate for spondyloarthritis.

Common Painful Foot and Ankle Conditions: A Review.

Importance: Morton neuroma, plantar fasciitis, and Achilles tendinopathy are foot and ankle conditions that are associated with pain and disability, but they can respond to nonoperative treatment. Observations: Morton neuroma, consisting of interdigital neuronal thickening and fibrosis, is characterized by burning pain in the ball of the foot and numbness or burning pain that may radiate to the affected toes (commonly the third and fourth toes). First-line nonoperative therapy consists of reducing activities that cause pain, orthotics, and interdigital corticosteroid injection; however, approximately 30% of patients may not respond to conservative treatment. Plantar fasciitis accounts for more than 1 million patient visits per year in the US and typically presents with plantar heel pain. Fifteen years after diagnosis, approximately 44% of patients continue to have pain. First-line nonoperative therapy includes stretching of the plantar fascia and foot orthotics, followed by extracorporeal shockwave therapy, corticosteroid injection, or platelet-rich plasma injection. Midportion Achilles tendinopathy presents with pain approximately 2 to 6 cm proximal to the Achilles insertion on the heel. The primary nonoperative treatment involves eccentric strengthening exercises, but extracorporeal shockwave therapy may be used. Conclusions and Relevance: Morton neuroma, plantar fasciitis, and Achilles tendinopathy are painful foot and ankle conditions. First-line therapies are activity restriction, orthotics, and corticosteroid injection for Morton neuroma; stretching and foot orthotics for plantar fasciitis; and eccentric strengthening exercises for Achilles tendinopathy.

Arabic translation, cross cultural adaptation, and validation of Foot Health Status Questionnaire among Saudi individuals with plantar fasciitis.

BACKGROUND: Measuring quality of life (QoL) plays an essential role in enabling meaningful cross-cultural comparisons. The Foot Health Status Questionnaire (FHSQ) is a valid tool for assessing both foot-specific and general health-related quality of life (HrQoL), making it suitable for evaluating Plantar Fasciitis (PF) patients. METHODOLOGY: The aim of this study is to translate the FHSQ into Arabic following methodological assessments of the translation procedure. The translation was done using forward and back translation. A pre-test questionnaire was distributed among 50 patients, resulting in the final FHSQ-Ar version, which then underwent various psychometric evaluations among 87 persons with PF, including internal consistency, dimensionality, reliability, interpretability, and construct validity against the 100-mm Visual Analogue Scale (VAS). RESULTS: Internal consistency was adequate, ranging from 0.70 to 0.92. Reliability values ranged from 0.69 to 0.80, with a poor standard error of measurement (individual) but an acceptable standard error of measurement (group). Two domains exhibited floor effects, while one domain showed a ceiling effect. Regarding validity, three out of four hypothesized correlations with VAS scores were confirmed. Factor analysis revealed four dimensions, and confirmatory factor analysis demonstrated good fit (comparative fit index = 0.98, standardized root mean square = 0.06). CONCLUSION: The psychometric properties of the FHSQ-Ar were satisfactory. Further validation for other diseases may be warranted.

Plantar Fasciitis or Flexor Digitorum Brevis Myositis.

BACKGROUND: As common as plantar fasciitis is, there's a lack of evidence regarding the true pathophysiologic process causing plantar fasciitis and plantar heel pain in general. This may partially explain the high variability and outcomes with current treatment of recalcitrant plantar fasciitis. Although Lemont reported myxoid degeneration of plantar fascia with histologic analysis of patients with fasciitis, muscle biopsy results were not reported. So far it appears we have not focused on the muscular component that may be present with plantar heel pain in general and in patients we diagnose with plantar fasciitis in particular. METHODS: In this article we performed a retrospective analysis of biopsy results from five patients with the diagnosis of recalcitrant plantar fasciitis to determine whether this diagnosis was correct or whether other component pathologies contribute to the chronicity of symptoms or to the failure of treatment. RESULTS: Three of the five pathology reports included specific mention of inflammation, degeneration and atrophy of the intrinsic musculature consistent with myositis. Two of these showed lymphocytic infiltration in the muscle consistent with inflammation, with no signs of inflammation in the fascia. One showed inflammation of the fascia without signs of inflammation of the muscle. CONCLUSIONS: This small study introduces the idea that intrinsic myositis may contribute to, or be responsible for some cases of plantar heel pain and plantar fasciitis. This may be important in changing the way we deal with plantar heel pain in the future.

INCIDENTAL INTRAOSSEOUS CALCANEAL LIPOMA IN A PATIENT SUFFERING FROM PLANTARFASZIITIS.

Intraosseous calcaneal lipoma is a rare benign bone tumor. The incidence of intraosseous lipoma involving the calcaneus has been noted to account for fewer than 8-15% of all intraosseous lipoma. The etiology of the lesion is unknown. A post-traumatic secondary bone reaction, healing bone infarct, and benign neoplasm have been discussed. The symptoms can be nonspecific, varying from dull, intermittent pain to activity-related plantar pain. This pain can predictably be misdiagnosed as plantar fasciitis. We present the case of a 49-year-old male patient suffering from plantar fasciitis for three months and incidental asymptomatic intraosseous calcaneal lipoma, which was diagnosed by x-ray and CT scan. As the patient was out of complaints, the typical CT findings we saw no indication for biopsy but recommended regular CT and MRI controls.;

Immunopathogenesis, early Detection, current therapies and prevention of plantar Fasciitis: A concise review.

Plantar fasciitis or the inflammation of the fascial lining on the plantar aspect of the foot continues to be the leading cause of heel pain for many Americans. Common causes can range from anatomical deformities such as pes planus or flat foot, biomechanical etiology such as excessive pronation of the subtalar joint, or chronic diseases such as obesity and diabetes mellitus. The pathophysiology of plantar fasciitis can be either inflammatory due to vasodilation and immune system activation or non-inflammatory involving fibroblastic hypertrophy. Worsening pain of the inferior and medial heel after periods of prolonged rest and late in the day after hours of ambulation and weight-bearing activities is the most common symptom of plantar fasciitis. Common treatments for plantar fasciitis include plantar fascia stretching, physical therapy, orthotics, corticosteroid injections, and even surgery. Despite these treatment strategies, fasciitis remains a clinical problem and better treatment modalities are warranted. Late diagnosis is a common issue for prolonged and equivocal treatment and early diagnostic measures might be beneficial. In this concise review, we discussed the etiology, immunopathogenesis, current treatments of plantar fasciitis and potentially preventative measures prior to the onset of chronic treatment resistant condition.

Case report: Baxter's nerve radiofrequency in patient with plantar fasciitis nonresponsive to conventional treatment.

Plantar fasciitis is recognized as the leading cause of talalgia worldwide. In the vast majority of cases it can be controlled with the use of appropriate footwear, stretching exercises and changes in the sport activity, while a few cases require infiltrations or surgical interventions. The latter puts the patient at greater risk, and is reserved for the most severe cases. We propose using pulsed radiofrequency ablation of Baxter's nerve to treat this painful symptom in patients who do not respond adequately to conventional treatment. We present the case of a patient with refractory plantar fasciitis in whom surgery had been ruled out. The patient underwent pulsed radiofrequency treatment with satisfactory results in the short and medium term.

Is there a relation between plantar fasciitis and total cholesterol levels?

BACKGROUND: The main objective of this study is to investigate the relationship between hypercholesterolemia and Plantar Fasciitis (PF). METHODS: The study includes patients who presented to the orthopedics outpatient clinic with heel pain and were diagnosed with PF. The control group was composed of patients who came to the orthopedics outpatient clinic, with complaints other than heel pain. The two groups were compared in terms of epidemiological data, total cholesterol (TC) levels, and hypercholesterolemia prevalence. We also performed an in-group analysis of PF patients in terms of age, sex, body mass index, and duration of symptoms. RESULTS: There were 238 patients (mean age, 46.7) in the PF group and 240 patients (mean age, 47.9) in the control group. There was a significant difference between the PF group and the control group in TC levels (207.6 ± 47.5 versus 195.1 ± 30.1, p = 0.001). Hypercholesterolemia (TC level > 240 mg/dL) was found in 22.7% (n = 54) of the patients in the PF group whereas in the control group this rate was 10.8% (n = 26) (p < 0.001). It was seen that the TC levels were significantly higher in patients over the age of 45 in the PF group (p = 0.038). We also found that TC levels were higher in PF patients with symptoms for longer than a year (p = 0.026). CONCLUSION: Significantly higher TC levels were found in PF patients in comparison with other orthopedic outpatients. Besides, being over the age of 45 and having a duration of symptoms longer than a year is associated with higher cholesterol levels for PF patients. LEVEL OF CLINICAL EVIDENCE: 4.

Plantar Fasciitis/Fasciosis.

Many randomized controlled trials demonstrate the effectiveness of conservative treatment of plantar fasciitis. Patients with acute plantar fasciitis generally respond to treatment more rapidly and more predictably than patients with chronic plantar fasciitis. If conservative treatment fails, endoscopic plantar fasciotomy offers patients a more prompt return to activity compared with open procedures.

Common Complaints of the Hands and Feet.

Primary care providers frequently care for complaints of the hands and feet. Here, the author describes the typical presentations of hand osteoarthritis, carpal tunnel syndrome, ganglion cysts, plantar fasciitis, onychomycosis, and Morton neuroma. Useful physical examination techniques are described. The history and physical examination are usually sufficient to diagnose these conditions without the need for more advanced testing. All of these conditions have evidence-based therapy that can be initiated by the primary care provider. These treatments as well as reasons to refer to a specialist are reviewed.

Cross-Cultural Adaptation and Validation of the Pain Scale for Plantar Fasciitis to Spanish.

The aim of this study was the validation and transcultural adaptation of the Pain Scale for Plantar Fasciitis to Spanish, following the steps defined by "Guidelines for the process of cross-cultural adaptation of self-report measures." A cross-sectional study was driven in 153 patients with unilateral plantar fasciitis diagnosis. Statistical analysis measured the internal consistency, the test-retest reliability, the construct validity with the Spanish version of Foot and Function Index, and a factorial analysis. The questionnaire Pain Scale for Plantar Fasciitis was also given to a group of 10 people who received a physiotherapy treatment based on manual therapy, therapeutic exercise, and health education, which aim was to determine the questionnaire's sensitivity to changes. The questionnaire showed high internal consistency and test-retest reliability (Cronbach's α = 0.99, intraclass correlation coefficient = 0.98 [0.97-0.98]), good convergent validity with a moderate correlation with the Foot and Function Index (rho = 0.677, p < .0001) and no floor or ceiling effects were detected. The factorial analysis revealed that the first 3 factors showed 42.47% of variance, finding only 1 latent feature. Statistically significant differences were found in those patients who received physiotherapy treatment after 1 month, revealing that the questionnaire was sensitive to changes in the symptoms of subjects with plantar fasciitis. The Spanish version of Pain Scale for Plantar Fasciitis has proved to be a valid, reliable, and change-sensitive tool for patients with plantar fasciitis.

The Impact of Extracorporeal Shock Wave Therapy and Dry Needling Combination on Pain and Functionality in the Patients Diagnosed with Plantar Fasciitis.

This study aimed to evaluate the efficiency of extracorporeal shock wave therapy (ESWT) and dry needling (DN) combination on pain and functionality in plantar fasciitis. Forty patients who were clinically diagnosed with plantar fasciitis were included in the study. The patients were randomly divided into 2 groups. The ESWT-DN group was applied 3 sessions of ESWT to plantar fascia and DN to the trigger points in the gastrosoleus muscles. The ESWT group was applied only ESWT treatment to plantar fascia. We used visual analog scale (VAS) for pain and a pressure algometer for pressure pain threshold. The functionality of the patients was evaluated with Foot Function Index (FFI). Also, maximum painless standing time and maximum painless walking distance were recorded. All assessments were repeated twice; first, pretreatment and second 1 month after the treatment. In both groups, there were statistically significant improvements in VAS, pressure pain threshold, maximum painless standing time, maximum painless walking distance, and FFI's pain, disability, and activity limitation subscales scores (p ≤ .001). In intergroup comparison; it was showed that VAS scores, maximum painless standing time (p = .002), maximum painless walking distance (p ≤ .001), and FFI pain subscale scores (p = .034) were statistically superior in the ESWT-DN group. There was no statistically difference between the groups in pressure pain threshold (p = .132), FFI disability (p = .081), and FFI activity limitation subscale (p = .226) scores. ESWT and DN combination therapy in plantar fasciitis was seen to be superior in the pain scores. Further studies with larger patients' groups and longer term results of this combination are needed for a better comparison.

Comparison of the therapeutic outcomes between open plantar fascia release and percutaneous radiofrequency ablation in the treatment of intractable plantar fasciitis.

BACKGROUND: Heel pain is one of the most common complaints in foot and ankle clinic, and one of the leading causes of heel pain is plantar fasciitis. METHODS: A retrospective analysis was carried out in 31 cases (39 feet) of patients with intractable plantar fasciitis. In the enrolled 26 cases, 16 patients (19 feet) received open plantar fascia release, and the other 15 patients (20 feet) received percutaneous radiofrequency ablation. The surgical results were assessed by visual analog scale (VAS) and American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS-AH) before and after surgery in all patients. RESULTS: All 31 patients were followed up successfully, with a mean follow-up time of 58.77 months. There were no differences of patient's demographics and characteristics information between the two groups. The average operative time of the feet in the open plantar fascia release is longer than that in the percutaneous radiofrequency ablation. Furthermore, the percutaneous radiofrequency ablation group had a shorter recovery time to normal activity than the open plantar fascia release group. There were no differences of postoperative VAS scores and the AOFAS-AH scores between the two groups. All patients reported satisfaction after either operation. CONCLUSION: The symptoms of pain and limb function were significantly improved in patients both of the partial plantar fascia release treated group and the percutaneous radiofrequency ablation treated group. The two types of surgical procedures shared the same long-term curative effects. However, percutaneous radiofrequency ablation was a better technique from the point of shorter operative time and postoperative recovery time. TRIAL REGISTRATION: Retrospectively registered.

Fascitis plantar. Criterios y experiencias sobre la infiltración con anestésicos locales y corticoesteroides / Plantar fasciitis Criteria and experiences on infiltration with local anesthetics and corticosteroids

Introducción: Dentro del grupo de las enfermedades del sistema osteomioarticular la fascitis plantar (FP) es una de las causas más frecuente de dolor crónico del pie. Objetivo: aportar criterios sobre el empleo de la infiltración de anestésicos locales y corticoesteroides para el tratamiento de la fascitis plantar. Desarrollo: se seleccionaron las infiltraciones de corticoesteroides y de anestésicos locales que se realizan con mayor frecuencia en la práctica clínica, se analizó su efectividad según la evidencia en la literatura internacional y a partir de ahí se contrastaron los resultados encontrados con los criterios y experiencias de los autores de este trabajo. Conclusiones: Las consideraciones realizadas en este estudio apuntan a que el uso de los corticoides mediante infiltraciones en patologías ortopédicas es un medio valioso para mejorar la inflamación de los tejidos y para el alivio de los dolores, tanto cuando se emplea en las articulaciones como en las partes blandas(AU)

Introduction: within the group of diseases of the osteomioarticular system, plantar fasciitis (FP) is one of the most frequent causes of chronic foot pain. Objective: to provide criteria on the use of infiltration of local anesthetics and corticosteroids for the treatment of plantar fasciitis. Development: the infiltrations of corticosteroids and local anesthetics that are performed more frequently in clinical practice were selected, their effectiveness was analyzed according to the evidence in the international literature and from there the results were contrasted with the criteria and experiences of the patients authors of this work. Conclusions: the considerations made in this study suggest that the use of corticosteroids through infiltrations in orthopedic pathologies is a valuable means to improve inflammation of the tissues and for the relief of pain, both when used in the joints and in the joints and soft parts(AU)

Elastosonographic evaluation after extracorporeal shockwave treatment in plantar fasciopathy.

AIM: To assess the ultrasound features in patients with plantar fasciopathy before and after extracorporeal shock waves therapy (ESWT), using conventional grey-scale imaging and both strain (SE) and shear wave (SWE) elastosonographic evaluation. MATERIAL AND METHOD: Consecutive patients of both sexes attending our outpatient's clinic, with diagnosis of unilateral plantar fasciopathy, were enrolled. Patients were treated with 3 sessions of ESWT once a week, and underwent clinical and ultrasound evaluation at baseline and at one and three months after treatment. Roles and Maudsley score (RM), visual analog scale (VAS) and 17-Italian Foot Function Index (FFI), were used to assess pain and functional improvement. RESULTS: Twenty patients (11 female and 9 male) were enrolled in the study. Contralateral asymptomatic healthy plantar fascia was used as a control. At baseline, SWE velocity (SWEv) showed statistically significant difference between affected 3.8 (1.5; 5.1) m/s and healthy side 4.7 (4.07; 7.04) m/s, (p=0.006); no significant difference was found for strain ratio values (p=0.656). SWEv post hoc test results showed a significant difference from baseline 3.8 (1.5-5.1) m/s and three month 5.23 (4.55-6.74) m/s follow up visit (p=0.003). Significant statistical negative correlation was found between the SWEv and VAS (p=0.001) and positive correlation between the SWEv and FFI (p=0.012). CONCLUSION: SWE was effective in assessing plantar fascia elasticity and its alteration in fasciopathy. Furthermore, on the basis of the correlation with pain and functional scales, this technique appears to be a useful additional technique to conventional ultrasound for monitoring the efficacy of treatment.

Preliminary Report on the Role of Dry Needling Versus Corticosteroid Injection, an Effective Treatment Method for Plantar Fasciitis: A Randomized Controlled Trial.

Plantar fasciopathy (PF) is a common disorder for which there is no consensus regarding an optimal treatment strategy. We hypothesized that dry needling would be as effective as the use of corticosteroid injections for treating PF while avoiding the potential adverse effects of corticosteroids. After approval was received from the institutional review board, patients diagnosed with PF were prescribed a 3-week nonoperative treatment regimen. In addition to using oral and topical antiinflammatory drugs, patients engaged in plantar fascia and gastrocnemius stretching exercises. A study population of 98 patients was planned. An appointment was made in the third week of first-line treatment. Patients whose pain did not abate and who required further treatment were included in the study. One week later, we randomly divided patients into 2 groups using an online random number generator. Group 1 underwent dry needling, and group 2 underwent corticosteroid injection. All dry needling was performed by a single physiotherapist, and all corticosteroid injections were performed by the second author. Patients were assessed in the third week and sixth month by a single investigator using the foot function index. In terms of foot function index scores, dry needling caused significant decrease in the third week and also in the sixth month. However, although corticosteroid use led to a significant decrease at the third week, it lost efficacy in the sixth month (p < .001). In conclusion, dry needling seems to be a reliable procedure for treating PF, with better outcomes than corticosteroid injection.

Comparing two dry needling interventions for plantar heel pain: a protocol for a randomized controlled trial.

BACKGROUND: Both manual therapy techniques and dry needling have shown to be effective treatment options for the treatment of plantar heel pain; however, in recent years, other techniques based on dry needling (DN), such as percutaneous needle electrolysis (PNE), have also emerged. Currently, PNE is being used in clinical practice to manage myofascial trigger points, despite the lack of studies comparing the effects of this technique over dry needling. Therefore, the aim of this randomized controlled study is to compare the effectiveness of DN versus PNE for improving the level of pain experienced by patients suffering from plantar heel pain provoked by myofascial trigger points. METHODS: A randomized controlled trial will be conducted with blinded participants and outcome assessors. A sample of 94 patients with a medical diagnosis of plantar heel pain will be recruited and divided into two treatment groups. Eligible participants will be randomly allocated to either (a) treatment group with DN and a self-stretching home program or (b) treatment group with PNE and a self-stretching home program. Each group will receive one treatment session per week over a period of 4 weeks. The primary outcome measure will be the pain subscale of the Foot Health Status Questionnaire. The secondary outcome measures will be a visual analogue scale for pain (average and highest level of pain experienced during the previous 48 h; level of pain immediately after the treatment session) and health-related quality of life (assessed using the EuroQoL-5 dimensions). Cost-effectiveness data will be extracted based on the EuroQoL-5 dimensions. Follow-up measurements will take place at baseline and at 4, 8, 12, 26, and 52 weeks. DISCUSSION: The justification for this trial is the need to improve current understanding regarding the effectiveness of treatments targeting the rehabilitation of plantar heel pain. This study will be the first randomized controlled trial to directly compare the effectiveness of DN and PNE combined with a specific stretching program for the treatment of plantar heel pain provoked by myofascial trigger points. TRIAL REGISTRATION: Clinical Trials NCT03236779. Registered at clinicaltrials.gov 2 August 2017.

Obesity-Related Foot Pain: Diagnosis and Surgical Planning.

Obese patients are at higher risk for surgical complications and consist of a large portion of podiatric patients. Obese patients are additionally at increased risk of developing specific podiatric conditions, and it is important to be able to identify and appropriately treat these conditions accordingly. Initially, conservative treatment is adequate for a variety of pathologic conditions related to obesity. Occasionally surgical intervention is warranted depending on the severity and lack of response to conservative measures. Arthrodesis-type procedures are often preferable and may be necessary, as opposed to periarticular osteotomy, in obese patients even if the deformity is flexible.

Should I Stay or Should I Go? A Prospective, Blinded Study Comparing the Diagnostic Capability of Dynamic and Stationary Pedobarography in Plantar Fasciitis.

The aim of this study was to determine the diagnostic capability of a dynamic gait analysis insole and compare its ability to detect clinical correlations to a common stationary analysis tool. Twenty-five patients with chronic plantar fasciitis were included in this prospective, blinded, diagnostic study. Conventional, stationary gait analysis on a force plate on an even surface and continuous dynamic pedobarography on a standardized course consisting of different gait tasks were performed and correlated to the disease severity. Mean patient age was 53.6 (range 41 to 68) years, with a mean pain level of 6.1 (range 4 to 10) on the Visual Analogue Scale and a calcaneodynia score of 48.7 (range 33 to 66). Significant correlations were seen between several dynamic gait values and clinical scoring: cadence (rs = 0.56, p = .004), stance time (rs = -0.6, p = .002), center-of-pressure velocity (rs = 0.44, p = .046), and double support time (rs = 0.42, p = .042). No significant correlations were seen between any force plate gait analysis values and clinical scoring. In this study setting, dynamic gait analysis was able to identify clinically relevant correlations to plantar fasciitis disease severity that standard force plate measurements could not.