Effectiveness of Manual Therapy, Customised Foot Orthoses and Combined Therapy in the Management of Plantar Fasciitis-a RCT

Casper Grim, Ruth Kramer, Martin Engelhardt, Swen Malte John, Thilo Hotfiel, Matthias Wilhelm Hoppe, Casper Grim, Ruth Kramer, Martin Engelhardt, Swen Malte John, Thilo Hotfiel, Matthias Wilhelm Hoppe

Abstract

Background: Plantar fasciitis (PF) is one of the most common causes of plantar heel pain.

Objective: To evaluate the effectiveness of three different treatment approaches in the management of PF.

Methods: Sixty-three patients (44 female, 19 men; 48.4 ± 9.8 years) were randomly assigned into a manual therapy (MT), customised foot orthosis (FO) and a combined therapy (combined) group. The primary outcomes of pain and function were evaluated using the American Orthopaedic Foot and Ankle Society-Ankle Hindfoot Scale (AOFAS-AHS) and the patient reported outcome measure (PROM) Foot Pain and Function Scale (FPFS). Data were evaluated at baseline (T0) and at follow-up sessions after 1 month, 2 months and 3 months (T1-T3).

Results: All three treatments showed statistically significant (p < 0.01) improvements in both scales from T0 to T1. However, the MT group showed greater improvements than both other groups (p < 0.01).

Conclusion: Manual therapy, customised foot orthoses and combined treatments of PF all reduced pain and function, with the greatest benefits shown by isolated manual therapy.

Keywords: back pain; customised orthoses; heel pain; insoles; joint mobilization; manual therapy; plantar fasciitis.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow-diagram of patient recruitment. Abbreviations: MT, manual therapy; FO, foot orthoses; ITT, Intention to treat; T0, baseline; T1–T3, follow-up sessions after 1–3 months.
Figure 2
Figure 2
Customised foot orthoses.
Figure 2
Figure 2
Customised foot orthoses.
Figure 3
Figure 3
Changes in American Orthopaedic Foot and Ankle Score-Ankle Hindfoot Scale (AOFAS-AHS) for the three groups from T0–T3. Abbreviations: MT, manual therapy; FO, foot orthoses; T0, baseline; T1–T3, follow-up sessions after 1–3 months.
Figure 4
Figure 4
Changes in Foot Pain and Function Scale (FPFS) for the three groups from T0–T3. Abbreviations: MT, manual therapy; FO, foot orthoses; T0, baseline; T1–T3, follow-up sessions after 1–3 months.

References

    1. Cleland J.A., Abbott J.H., Kidd M.O., Stockwell S., Cheney S., Gerrard D.F., Flynn T.W. Manual physical therapy and exercise versus electrophysical agents and exercise in the management of plantar heel pain: A multicenter randomized clinical trial. J. Orthop. Sports Phys. Ther. 2009;39:573–585. doi: 10.2519/jospt.2009.3036.
    1. Landorf K.B. Plantar heel pain and plantar fasciitis. BMJ Clin. Evid. 2015;2015:1–46.
    1. McMillan A.M., Landorf K.B., Barrett J.T., Menz H.B., Bird A.R. Diagnostic imaging for chronic plantar heel pain: A systematic review and meta-analysis. J. Foot. Ankle Res. 2009;2:32. doi: 10.1186/1757-1146-2-32.
    1. Mischke J.J., Jayaseelan D.J., Sault J.D., Emerson Kavchak A.J. The symptomatic and functional effects of manual physical therapy on plantar heel pain: A systematic review. J. Man. Manip. Ther. 2017;25:3–10. doi: 10.1080/10669817.2015.1106818.
    1. Pollack Y., Shashua A., Kalichman L. Manual therapy for plantar heel pain. Foot. 2018;34:11–16. doi: 10.1016/j.foot.2017.08.001.
    1. Whittaker G.A., Munteanu S.E., Menz H.B., Tan J.M., Rabusin C.L., Landorf K.B. Foot orthoses for plantar heel pain: A systematic review and meta-analysis. Br. J. Sports Med. 2018;52:322–328. doi: 10.1136/bjsports-2016-097355.
    1. Ajimsha M.S., Binsu D., Chithra S. Effectiveness of myofascial release in the management of plantar heel pain: A randomized controlled trial. Foot. 2014;24:66–71. doi: 10.1016/j.foot.2014.03.005.
    1. Renan-Ordine R., Alburquerque-Sendin F., de Souza D.P., Cleland J.A., Fernandez-de-Las-Penas C. Effectiveness of myofascial trigger point manual therapy combined with a self-stretching protocol for the management of plantar heel pain: A randomized controlled trial. J. Orthop. Sports Phys. Ther. 2011;41:43–50. doi: 10.2519/jospt.2011.3504.
    1. Hansen L., Krogh T.P., Ellingsen T., Bolvig L., Fredberg U. Long-term prognosis of plantar fasciitis: A 5- to 15-year follow-up study of 174 patients with ultrasound examination. Orthop. J. Sports Med. 2018;6:2325967118757983. doi: 10.1177/2325967118757983.
    1. Goff J.D., Crawford R. Diagnosis and treatment of plantar fasciitis. Am. Fam. Physician. 2011;84:676–682.
    1. Van Leeuwen K.D., Rogers J., Winzenberg T., van Middelkoop M. Higher body mass index is associated with plantar fasciopathy/‘plantar fasciitis’: Systematic review and meta-analysis of various clinical and imaging risk factors. Br. J. Sports Med. 2016;50:972–981. doi: 10.1136/bjsports-2015-094695.
    1. McClinton S., Collazo C., Vincent E., Vardaxis V. Impaired foot plantar flexor muscle performance in individuals with plantar heel pain and association with foot orthosis use. J. Orthop. Sports Phys. Ther. 2016;46:681–688. doi: 10.2519/jospt.2016.6482.
    1. Martin R.L., Davenport T.E., Reischl S.F., McPoil T.G., Matheson J.W., Wukich D.K., McDonough C.M., American Physical Therapy Association Heel pain-plantar fasciitis: Revision 2014. J. Orthop. Sports Phys. Ther. 2014;44:1–33. doi: 10.2519/jospt.2014.0303.
    1. Huffer D., Hing W., Newton R., Clair M. Strength training for plantar fasciitis and the intrinsic foot musculature: A systematic review. Phys. Ther. Sport. 2017;24:44–52. doi: 10.1016/j.ptsp.2016.08.008.
    1. Hotfiel T., Hotfiel K.H., Gelse K., Engelhardt M., Freiwald J. Einlagenversorgung im leistungssport – indikationen, wirkungsweise, sportspezifische versorgungsstrategien [The use of insoles in competitive sports – Indications, effectiveness, sport specific treatment strategies] Sports Orthop. Traumatol. 2016;32:250–257. doi: 10.1016/j.orthtr.2016.06.003.
    1. Whittaker G.A., Munteanu S.E., Menz H.B., Landorf K.B. Should foot orthoses be used for plantar heel pain? Br. J. Sports Med. 2018;52:1224–1225. doi: 10.1136/bjsports-2018-099426.
    1. Hawke F., Burns J., Radford J.A., du Toit V. Custom-made foot orthoses for the treatment of foot pain. Cochrane Database Syst. Rev. 2008;16:1–131. doi: 10.1002/14651858.CD006801.pub2.
    1. Brantingham J.W., Bonnefin D., Perle S.M., Cassa T.K., Globe G., Pribicevic M., Hicks M., Korporaal C. Manipulative therapy for lower extremity conditions: Update of a literature review. J. Manipul. Physiol. Ther. 2012;35:127–166. doi: 10.1016/j.jmpt.2012.01.001.
    1. Brantingham J.W., Globe G., Pollard H., Hicks M., Korporaal C., Hoskins W. Manipulative therapy for lower extremity conditions: Expansion of literature review. J. Manipul. Physiol. Ther. 2009;32:53–71. doi: 10.1016/j.jmpt.2008.09.013.
    1. Fraser J.J., Glaviano N.R., Hertel J. Utilization of physical therapy intervention among patients with plantar fasciitis in the united states. J. Orthop. Sports Phys. Ther. 2017;47:49–55. doi: 10.2519/jospt.2017.6999.
    1. Shashua A., Flechter S., Avidan L., Ofir D., Melayev A., Kalichman L. The effect of additional ankle and midfoot mobilizations on plantar fasciitis: A randomized controlled trial. J. Orthop. Sports Phys. Ther. 2015;45:265–272. doi: 10.2519/jospt.2015.5155.
    1. Wynne M.M., Burns J.M., Eland D.C., Conatser R.R., Howell J.N. Effect of counterstrain on stretch reflexes, hoffmann reflexes, and clinical outcomes in subjects with plantar fasciitis. J. Am. Osteopath. Assoc. 2006;106:547–556.
    1. Saban B., Deutscher D., Ziv T. Deep massage to posterior calf muscles in combination with neural mobilization exercises as a treatment for heel pain: A pilot randomized clinical trial. Man. Ther. 2014;19:102–108. doi: 10.1016/j.math.2013.08.001.
    1. Burmeister S. Master’s Thesis. Donau Universität Krems; Krems, Germany: 2012. Osteopathie und ihr Effektivität bei Fasciitis Plantaris.
    1. McClinton S., Weber C.F., Heiderscheit B. Low back pain and disability in individuals with plantar heel pain. Foot. 2018;34:18–22. doi: 10.1016/j.foot.2017.09.003.
    1. Armijo-Olivo S., Warren S., Magee D. Intention to treat analysis, compliance, drop-outs and how to deal with missing data in clinical research: A review. Phys. Ther. Rev. 2009;14:36–45. doi: 10.1179/174328809X405928.
    1. Gupta S.K. Intention-to-treat concept: A review. Perspect. Clin. Res. 2011;2:109–112. doi: 10.4103/2229-3485.83221.
    1. Kitaoka H.B., Alexander I.J., Adelaar R.S., Nunley J.A., Myerson M.S., Sanders M. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994;15:349–353. doi: 10.1177/107110079401500701.
    1. Madeley N.J., Wing K.J., Topliss C., Penner M.J., Glazebrook M.A., Younger A.S. Responsiveness and validity of the sf-36, ankle osteoarthritis scale, aofas ankle hindfoot score, and foot function index in end stage ankle arthritis. Foot Ankle Int. 2012;33:57–63. doi: 10.3113/FAI.2012.0057.
    1. Kostuj T., Schaper K., Baums M.H., Lieske S. Eine Validierung des aofas-ankle-hindfoot-scale für den deutschen Sprachraum [German Validation of the AOFAS ankle hindfoot scale] Foot Ankle. 2014;12:100–106.
    1. Richter M., Zech S., Geerling J., Frink M., Knobloch K., Krettek C. A new foot and ankle outcome score: Questionaire based, subjective, visual-analogue-scale, validated and computerized. Foot Ankle Surg. 2006;12:191–199. doi: 10.1016/j.fas.2006.04.001.
    1. Ibrahim T., Beiri A., Azzabi M., Best A.J., Taylor G.J., Menon D.K. Reliability and validity of the subjective component of the american orthopaedic foot and ankle society clinical rating scales. J. Foot Ankle Surg. 2007;46:65–74. doi: 10.1053/j.jfas.2006.12.002.
    1. Chan H.Y., Chen J.Y., Zainul-Abidin S., Ying H., Koo K., Rikhraj I.S. Minimal clinically important differences for american orthopaedic foot & ankle society score in hallux valgus surgery. Foot Ankle Int. 2017;38:551–557.
    1. Dawson J., Doll H., Coffey J., Jenkinson C. Responsiveness and minimally important change for the manchester-oxford foot questionnaire (moxfq) compared with aofas and sf-36 assessments following surgery for hallux valgus. Osteoarthr. Cartil. 2007;15:918–931. doi: 10.1016/j.joca.2007.02.003.
    1. Katz J., Melzack R. Measurement of pain. Surg. Clin. North Am. 1999;79:231–252. doi: 10.1016/S0039-6109(05)70381-9.
    1. Olsen M.F., Bjerre E., Hansen M.D., Hilden J., Landler N.E., Tendal B., Hrobjartsson A. Pain relief that matters to patients: Systematic review of empirical studies assessing the minimum clinically important difference in acute pain. BMC Med. 2017;15:35. doi: 10.1186/s12916-016-0775-3.
    1. Farrar J.T., Young J.P., Jr., LaMoreaux L., Werth J.L., Poole R.M. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001;94:149–158. doi: 10.1016/S0304-3959(01)00349-9.
    1. Hawker G.A., Mian S., Kendzerska T., French M. Measures of adult pain: Visual analog scale for pain (vas pain), numeric rating scale for pain (nrs pain), mcgill pain questionnaire (mpq), short-form mcgill pain questionnaire (sf-mpq), chronic pain grade scale (cpgs), short form-36 bodily pain scale (sf-36 bps), and measure of intermittent and constant osteoarthritis pain (icoap) Arthrit. Care Res. 2011;63(Suppl. 11):S240–S252.
    1. Katz N.P., Paillard F.C., Ekman E. Determining the clinical importance of treatment benefits for interventions for painful orthopedic conditions. J. Orthop. Surg. Res. 2015;10:24. doi: 10.1186/s13018-014-0144-x.
    1. Dimou E., Brantingham J., Wood T. A randomized, controlled trial (with blinded observer) of chiropractic manipulation and achilles stretching vs orthotics for the treatment of plantar fasciitis. J. Am. Chiropr. Assoc. 2004;41:32–42.
    1. Stecco C., Corradin M., Macchi V., Morra A., Porzionato A., Biz C., De Caro R. Plantar fascia anatomy and its relationship with achilles tendon and paratenon. J. Anat. 2013;223:665–676. doi: 10.1111/joa.12111.
    1. Childs J.D., Piva S.R., Fritz J.M. Responsiveness of the numeric pain rating scale in patients with low back pain. Spine. 2005;30:1331–1334. doi: 10.1097/01.brs.0000164099.92112.29.
    1. Michener L.A., Snyder A.R., Leggin B.G. Responsiveness of the numeric pain rating scale in patients with shoulder pain and the effect of surgical status. J. Sport Rehabil. 2011;20:115–128. doi: 10.1123/jsr.20.1.115.
    1. Garrison C., Cook C. Clinimetrics corner: The global rating of change score (groc) poorly correlates with functional measures and is not temporally stable. J. Man. Manip. Ther. 2012;20:178–181. doi: 10.1179/1066981712Z.00000000022.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe