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Objective@#To examine the clinical effect of all-inside endoscopic treatment of recalcitrant plantar fasciitis through two medial portals.@*Methods@#The recalcitrant plantar fasciitis data of 67 cases (79 feet) that underwent two medial portals all-inside endoscopic treatment at Department of Hand and Foot Microsurgery, Xuzhou Central Hospital from October 2016 to June 2018 were retrospectively analyzed.There were 24 males (30 feet) and 43 females (49 feet) aged 44.3 years old(range:24-76 years).The mean disease duration from the specialist doctor intervention to operation was (23.7±11.0) months (range: 12-60 months). All the patients were treated with the two medial portals all-inside endoscopic procedure when the 6 months conservative treatment had failed.The endoscopic procedure including debridement and partial plantar fasciotomy.The clinical results,including pain,activity,gait and foot health quality,were scored using visual analogue pain scale (VAS),American Orthopaedic Foot & Ankle Society Ankle Hindfoot Scale (AOFAS) and SF-36.@*Results@#All the patients were followed up for (15.2±6.7) months (range: 12-24 months). All cases achieved primarily healing of the wound without postoperative complications of nerve,vessel and tendon.At the last follow-up,the VAS decreased from (5.3±2.0) preoperative to 0 prooperative (t=21.60, P=0.000), AOFAS increased from (72.6±9.4) to (97.3±4.6)(t=19.43,P=0.000),SF-36 increased from (93.6±8.4) to (119.1±7.3) (t=18.78, P=0.000), non-recurrent calcaneal spur, normal foot and ankle activity was recorded.@*Conclusion@#The two medial portals all-inside endoscopic procedure is effective for the treatment of recalcitrant plantar fasciitis.
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Objective: To explore the clinical effect of ultrasound-guided dry needling of myofascial trigger points in treatment of plantar fasciitis. Methods: Totally 48 patients with plantar fasciitis were randomly divided into 2 groups. Patients in the simple treatment group (n=24) received sole non-weight-bearing plantar fascia stretching training, and the ones in the combined treatment group (n=24) received ultrasound-guided dry needling for myofascial trigger points combined with stretching training. The numeric pain-rating scale (NPRS) of the first move, American Orthopaedic Foot and Ankle Society Hindfoot Score (AOFAS), physical component summary (PCS) and mental component summary (MCS) of 36-item short-form health survey were evaluated before (T0) as well as 1 month (T1) and 3 months (T2) after treatment respectively. Results: The overall differences of NPRS, AOFAS, PCS and MCS were significant before and after treatment in both two groups (all P0.05). Conclusion: Ultrasound-guided dry needling for myofascial trigger points combined with stretching training and sole non-weight-bearing plantar fascia stretching training are both effective for treatment of plantar fasciitis, while the former is better for relieving pain and improving ankle function.
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<p><b>OBJECTIVE</b>To study the clinical effects of modified plantar fascia stretching manipulation combined with needle Dao loosing in the treatment of heel spur syndrome.</p><p><b>METHODS</b>From September 2010 to September 2015, 115 patients diagnosed as heel spur syndrome were divided into two groups: treatment group and control group. There were 58 patients in the treatment group, including 21 males and 37 females, ranging in age from 26 to 73 years old, with the course of disease from 6 to 51 months. The patients in the treatment group were treated with modified plantar fascia stretching manipulation combined with needle Dao loosing. There were 57 patients in the control group, including 22 males and 35 females, ranging in age from 31 to 75 years old, with the course of disease from 7 to 58 months. The patients in the control group were treated with traditonal stretching manipulation combined with needle Dao loosing. The NRS scores of heel pain were evaluated at the 1st week, 1 and 3 months after treatment; and the clinical effects of the two groups were evaluated with the Foot and Ankle Ability Measure(FAAM) scale evaluation system.</p><p><b>RESULTS</b>The numerical rating scale(NRS) scores were 3.89±0.96 and 2.46±0.95 in the treatment group 1 month and 3 months after treatment, which were superior to 4.52±1.21 and 4.73±1.11 in the control group; and the FAAM rates in the treatment group were (3.89±0.96)% and(2.46±0.95)% separately 1 month and 3 months after treatment, which were better than (4.52±1.21)% and (4.73±1.11)% in the control group. The total curative effects of the treatment group were better than that of the control group.</p><p><b>CONCLUSIONS</b>The modified plantar fascia stretching manipulation combined with needle Dao loosing can locate the traction point, which has a significant effect on the patients with heel spur syndrome. Compared with traditonal stretching manipulation combined with needle Dao loosing, this modified mainpulation combined with needle knife loosing has better medium to-long term effects.</p>
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<p><b>PURPOSE</b>Plantar fasciitis is the most common cause of pain on the bottom of the heel. It occurs when the strong band of the tissue supporting the arch of foot becomes irritated and inflamed. The majority of patients can be treated conservatively but some resistant cases need surgery eventually. This study aims to evaluate the outcome results of percutaneous planter fascia release under local anesthesia for chronic planter fasciitis.</p><p><b>METHODS</b>This prospective study was conducted in the Department of Orthopaedic Surgery in the School of Medical Science and Research, Sharda University, India from December 2010 to December 2013. Totally 78 patients with planter fasciitis for more than 6-12 months were recruited from the outpatient department. All patients were operated on under local anesthesia and followed up for a year.</p><p><b>RESULTS</b>The clinical results were evaluated in terms of pain, activity level and patient satisfaction. Pain relief was achieved averagely at eight weeks after surgery. The results were excellent in 88.46% (69/78) patients and good in 6.41% (9/78) patients. Neither complications of lateral column instability, sinus tarsitis and metatarsalgia nor wound-related complications were encountered. On subjective evaluations, 88.46% (69/78) patients reported full satisfaction and 6.41% (9/78) reported partial satisfaction after treatment.</p><p><b>CONCLUSION</b>Percutaneous planter fasciitis release under local anesthesia is a minimally invasive procedure that can be performed in the outpatient setting. It is easy, quick, effective and moreover with few complications.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Anesthesia, Local , Fasciitis, Plantar , General Surgery , Minimally Invasive Surgical Procedures , Patient Satisfaction , Prospective StudiesABSTRACT
Objetivo: Avaliar a efetividade da Terapia por Ondas de Choque Extracorpórea (ESWT) e do Laser na redução da dor de indivíduos com fasciíte plantar. Métodos: Foram feitas buscas de ensaios clínicos randomizados nas bases de dados MEDLINE, LILACS e Cochrane até novembro de 2016, nos idiomas inglês e português. Foram incluídos estudos que tinham como forma de tratamento as ESWT ou Laser, comparados com outros métodos, e que avaliaram a dor com a escala visual analógica. Foi utilizada a escala de PEDro para avaliação da qualidade metodológica dos estudos. Resultados: Foram encontrados 131 artigos. Destes, 106 foram excluídos após a leitura de seus títulos e resumos e 15 após sua leitura na íntegra, restando oito que tiveram como forma de tratamento as ESWT e dois o Laser. Conclusão: Dos dez artigos encontrados seis apresentaram resposta estatisticamente significativa em relação à dor, sendo dois sobre Laser e quatro sobre ESWT.
Purpose: To evaluate the effectiveness of Extracorporeal Shock Wave Therapy (ESWT) and Laser in pain reduction of individuals with plantar fasciitis. Methods: Searches were made of randomized trials in MEDLINE, LILACS and Cochrane until November 2016, in English and Portuguese. They included studies that had as a treatment ESWT or the Laser, compared with other methods, and assessed pain with a visual analogue scale. It used the PEDro scale to assess the methodological quality of the studies. Results: We found 131 articles. Of these, 106 were excluded after reading their titles and abstracts and 15 after reading in full, leaving eighy who had as a treatment the ESWT and two the Laser. Conclusion: Of the 10 articles found six showed statistically significant response in relation to pain, two on Laser and six on ESWT.
Subject(s)
Fasciitis, Plantar/therapy , Laser Therapy , Extracorporeal Shockwave Therapy , Pain Management/instrumentationABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy of small needle scalpel under ultraosonography guidance in plantar fasciitis.</p><p><b>METHODS</b>From March 2011 to May 2015, 234 patients with plantar fasciitis were divided into ultrasound-guided group and traditional knife group. There were 117 patients in ultrasound guided group, including 54 males and 63 females, aged from 42 to 8 years old with an average of(54.36±15.04) years; the courses of disease was(15.72±9.55) months on average; treated with small needle scalpel under ultraosonography guidance. While there were 117 patients in traditional small needle scalpel group, including 52 males and 65 females, aged from 43 to 80 years old with an average of (53.6±18.14) years; the average course of disease was(16.98 ±8.99) months;treated only with needle knife. VAS score, tenderness score and AOFAS-AH score before treatment, 1 week, 1 month and 3 months after treatment were observed and compared between two groups.</p><p><b>RESULTS</b>VAS score, tenderness score in ultrasound guided group were lower than traditional needle knife group, and had significant difference between two groups at 1 week, 1 month and 3 months after treatment;while ultrasound guided group was better than traditional needle knife group in alleviating pain. AOFAS-AH score in ultrasound guided group was higher than traditional needle knife group, and had significant difference between two groups at 1 week, 1 month and 3 months after treatment. The function of foot at different time points in ultrasound guided group was better than traditional needle knife group. Wound healing between two groups were better and no complications were occurred.</p><p><b>CONCLUSIONS</b>Needle knife under ultraosonography guidance is a reliable method for the treatment of plantar fasciitis, and has advantages of rapid onset, excellent efficacy, good functional recovery.</p>
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Objective To observe the clinical efficacy of grain-sized moxibustion plus acupuncture in treating plantar fasciitis. Method Forty patients with plantar fasciitis were randomized into a treatment group and a control group, 20 in each group. The treatment group was intervened by grain-sized moxibustion plus acupuncture, while the control group was by ordinary acupuncture. Visual Analogue Scale (VAS) was used to observe the morning heel pain degree before and after the treatment, and the clinical efficacies were compared.Result The VAS scores were significantly changed after treatment in the two groups (P<0.05). After treatment, VAS score in the treatment group was significantly different from that in the control group (P<0.05). The recovery rate and total effective rate were respectively 45.0% and 95.0% in the treatment group, versus 10.0% and 90.0% in the control group, and there was a significant difference in comparing the recovery rates (P<0.01).Conclusion Grain-sized moxibustion plus acupuncture is an effective method in treating plantar fasciitis.
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A fasciíte plantar ou síndrome da dor do calcanhar é uma causa frequente de dor no calcanhar e no pé em adultos que acomete cerca de 2 milhões de americanos por ano e estima-se que cerca de 10% da população mundial já apresentou ou irá apresentar queixa de dor no pé em algum momento da vida. Objetivo: Realizar uma revisão da literatura a fim de verificar a efetividade das modalidades de tratamento fisioterapêutico em pacientes com fasciíte plantar. Método: Foi realizada uma busca eletrônica nas bases de dados Cochrane Library, Medline (via Pubmed), PEDro, LILACS, sem restrições de data e idioma. Foram incluídos, no presente estudo, os artigos que abordaram o tratamento fisioterapêutico na fasciíte plantar e excluídos os artigos que tiveram como foco o tratamento cirúrgico. Resultados: No total, 23 estudos cumpriram os critérios de inclusão. As modalidades encontradas foram: Alongamento de tríceps sural, terapia manual, bandagens, órteses/palmilhas e eletroterapia. Conclusão: Há evidência moderada de que os exercícios para alongamento do tríceps sural proporcionam benefícios aos pacientes com fasciite plantar. A evidência da aplicação de bandagens ainda é fraca, porém alguns estudos relatarem melhora da dor e função a curto prazo. Há evidência de qualidade que suporte que o uso de palmilhas customizadas proporciona melhora da dor e função a curto prazo em pacientes com fasciíte plantar. A utilização de talas noturnas apresenta resultados controversos, apesar de alguns estudos terem apresentado bons resultados.
Plantar fasciitis or heel pain syndrome is a common cause of heel and foot pain in adults that affects about 2 million Americans a year and it is estimated that about 10% of the world's population have presented or will present foot pain at some time in their life. Objective: To review the literature in order to verify the effectiveness of the modalities of physical therapy in patients with plantar fasciitis. Method: An electronic search was conducted in the databases of the Cochrane Library, Medline (via Pubmed), PEDro, and LILACS, with no date or language restrictions. In the present study, articles about the physical therapy for plantar fasciitis and those that have focused on the surgical treatment were included. Results: In total, 23 studies met the inclusion criteria. The procedures were: Stretching sural triceps, manual therapy, bandaging, orthotics/insoles and electrotherapy. Conclusions: There is moderate evidence that stretching exercises for the triceps surae provide benefits to patients with plantar fasciitis. The evidence of the application of bandages is still weak, but some studies have reported improvement in pain and function in the short term. There is good quality evidence supporting the use of custom insoles that can provide short-term improvement in pain and function in patients with plantar fasciitis. The use of night splints presents controversial results, although some studies have shown good results.
Subject(s)
Humans , Pain , Exercise , Physical Therapy Modalities/instrumentation , Fasciitis, Plantar/rehabilitationABSTRACT
A fasciíte plantar é causa frequente de dor no calcanhar e no pé que afeta cerca de 2 milhõesde americanos por ano. A fisioterapia é o tratamento inicialmente prescrito, e o sucesso dotratamento depende da adesão dos pacientes. Objetivo: Elaborar um manual de orientaçõese exercícios para pacientes com fasciíte plantar, analisar a clareza, nível de compreensão e asatisfação dos pacientes leigos e fisioterapeutas acerca do manual. Método: Foram selecionados30 fisioterapeutas e 30 pacientes que não fossem analfabetos e que não apresentassem nenhumdéficit cognitivo. Foi aplicado um manual contendo 10 exercícios e orientações para pacientescom fasciíte plantar. Resultados: Todos os exercícios e orientações tiveram alto índice decompreensão (acima de 90%). O manual foi considerado excelente pelos leigos e ótimo pelosfisioterapeutas. Conclusão: O manual apresentou um nível relevante de compreensão tanto entreos fisioterapeutas como entre os leigos, além de alto índice de satisfação entre as populaçõesabordadas. Portanto, o manual pode servir de ferramenta complementar no tratamento dospacientes com fasciíte plantar.
Plantar fasciitis is a common cause of heel and foot pain. It affects approximately 2 million Americansannually. Physiotherapy is the first treatment prescribed, and its success depends on the patient?sadherence to treatment. Objective: This study aimed to develop a manual with orientations andexercises for patients with plantar fasciitis and to assess its clarity, level of understanding, andsatisfaction among patients and physiotherapists. Method: Thirty physiotherapists and thirtypatients, who were literate and showed no cognitive deficit, participated in this study. Theyanalyzed a manual that consists of 10 exercises and orientations for patients with plantar fasciitis.Results: All exercises and orientations were well understood (above 90%). The manual wasconsidered excellent by the patients and great by physiotherapists. Conclusion: Demonstrating arelevant level of understanding and satisfaction among therapists and patients, the manual provedto be a supplementary tool in the treatment of patients with plantar fasciitis.
Subject(s)
Humans , Physical Therapy Modalities/instrumentation , Fasciitis, Plantar/therapy , Exercise Therapy/instrumentation , Cross-Sectional StudiesABSTRACT
Objective: This paper has the purpose to analyze prospectively the treatment results in patients with chronic plantar fasciitis resistant to conservative treatment who underwent extracorporeal shock wave therapy (ESWT). Methods: We evaluated 30 patients (36 feet); 16 (53.3%) patients were male and 14 (47.7%) female with mean age of 48.7 y.o., varying from 33 to 78 y.o.; 16 (53.3%) present the problem on the left side, 14 (46.7%) on the right ones and 6 (20%) bilateral; the symptomatology varied from 6 to 60 months, with the average of 13.58 months. These patients were submitted to a weekly ESWT session for 4 consecutive weeks. We measured the plantar fascia thickness millimeters with ultrasound and we applied American Orthopaedic Foot and Ankle Society (AOFAS) scale for ankle and hindfoot, and Roles & Maudsley scales in pre ESWT, after one, three and six months after and decrease in the plantar fascia thickness by the ultrasound (p = 0.011) along the different moments studied. Results: We observed improvement of the evaluated criteria (p < 0.001) and plantar fascia thickness by ultrasound (p = 0.011) at different time points studied. Conclusion: The ESWT can be considered an important tool in the primary or adjuvant treatment of the chronic plantar fasciitis when associated with conventional therapies. This methodology is safe, non-invasive and provides precocious rehabilitation and return to regular activities considering the results of the statistical analysis. This resource provides decrease in the thickness of the plantar fascia. .
Objetivo: Este trabalho teve como objetivo analisar prospectivamente os resultados do tratamento com terapia de ondas de choque (TOC) em pacientes portadores de fasciíte plantar crônica resistente ao tratamento conservador. Métodos: Obtivemos 30 pacientes (36 pés), 16 (53,3%) do sexo masculino e 14 (47,7%) do feminino, cuja idade, em média, foi de 48,37 anos, com variação de 33 a 78 anos; 16 (53,3%) apresentavam a afecção no pé esquerdo, 14 (46,7%) no direito e seis (20%) bilateralmente; a sintomatologia variou de seis a 60 meses, com média de 13,58 meses. Os pacientes foram submetidos a uma sessão semanal de TOC por quatro semanas consecutivas. Mensuramos a espessura da fáscia plantar em milímetros pelo ultrassom e usamos a escala da American Orthopaedic Foot and Ankle Society (AOFAS) para tornozelo e retropé e a escala de Roles & Maudsley nos momentos pré-TOC, após o primeiro, o terceiroeosexto meses após a aplicação. Resultados: Observamos melhoria dos critérios avaliados (p < 0,001) e da espessura da fáscia plantar pelo ultrassom (p = 0,011) nos diferentes momentos estudados. Conclusão: A TOC pode ser considerada importante instrumento no tratamento primário ou adjuvante da fasciíte plantar crônica, quando aliada às terapias convencionais. Essa metodologia é segura, não invasiva e promove reabilitação e retorno precoces às atividades habituais pelos resultados das análises estatísticas. Proporciona também redução da espessura da fáscia plantar. .
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Fasciitis, Plantar , High-Energy Shock Waves/therapeutic use , UltrasonographyABSTRACT
Objective To identify the exact origin and insertion of plantar aponeurosis and the anatomic relationship of calcaneal spur to plantar aponeurosis. Methods Fourteen specimen of feet were dissected and radiographed. Three fetus feet were observed histologically. Sonographic evaluation was carried out on 20 normal adults and 52 patients with plantar fasciitis. Results (1) Anatomic observation found that plantar aponeurosis was located under the medial process of caleaneus but not attached to it, and proximally attached to the plantar aspect of calcaneal tuborosity. The insertion (origin) of plantar aponeurosis was not a point but a face. Posteriorly the plantar aponeurosis and fascia of Archlles heel were fused or transmigrated together,entirely covered and attached very coherently to the plantar and posterior aspect of calcaneal tuborosity. (2) Histological observation of heel of fetuses found plantar aponeurosis and fascia of Arehlles heel were eosinophil band-like structure. Both continued at the plantar and posterior aspect of calcaneus and attached closely to bone at this area. There were no significant demarcation between them. (3) Sonographic evaluation:normal plantar aponeurosis showed a thin band-like echo, its orgin attached to entire plantar aspect of calcaneal tuberosity and continued with fascia coming posteriorly from Archlles heel. No distinct boundary existed between these two fascias. When plantar fasciitis occurred, the orgin of plantar aponeurosis thickened significantly,this phenomenon could be detected in wholly plantar aspect of calcaneal tuberrosity. The heel spur didn't located within plantar aponeurosis. Conclusions Plantar aponeurosis orginates from entire plantar aspect of cancaneal tuberosity. Heel spur oeeures in the orgin of the intrinsic musculature, such as flexor digitorum brevis,and doesn't locate within plantar aponeurosis.