Plantar fasciitis

Sports Clinic, University of Sydney, Camperdown, Sydney, NSW 2006, Australia.
BMJ (online) (Impact Factor: 17.45). 10/2012; 345(7878):e6603. DOI: 10.1136/bmj.e6603
Source: PubMed
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    • "Due to the multifactorial nature of PHP, many terms such as plantar fasciitis, plantar fasciopathy, and plantar fasciosis have been used to describe the condition. Furthermore, there are a number of different treatments proposed to be effective in PHP and multiple healthcare providers that offer primary care for PHP [18-20]. "
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    ABSTRACT: A significant number of individuals suffer from plantar heel pain (PHP) and many go on to have chronic symptoms and continued disability. Persistence of symptoms adds to the economic burden of PHP and cost-effective solutions are needed. Currently, there is a wide variation in treatment, cost, and outcomes of care for PHP with limited information on the cost-effectiveness and comparisons of common treatment approaches. Two practice guidelines and recent evidence of effective physical therapy intervention are available to direct treatment but the timing and influence of physical therapy intervention in the multidisciplinary management of PHP is unclear. The purpose of this investigation is to compare the outcomes and costs associated with early physical therapy intervention (ePT) following initial presentation to podiatry versus usual podiatric care (uPOD) in individuals with PHP. A parallel-group, block-randomized clinical trial will compare ePT and uPOD. Both groups will be seen initially by a podiatrist before allocation to a group that will receive physical therapy intervention consisting primarily of manual therapy, exercise, and modalities, or podiatric care consisting primarily of a stretching handout, medication, injections, and orthotics. Treatment in each group will be directed by practice guidelines and a procedural manual, yet the specific intervention for each participant will be selected by the treating provider. Between-group differences in the Foot and Ankle Ability Measure 6 months following the initial visit will be the primary outcome collected by an independent investigator. In addition, differences in the European Quality of Life -- Five Dimensions, Numeric Pain Rating Scale, Global Rating of Change (GROC), health-related costs, and cost-effectiveness at 6 weeks, 6 months, and 1 year will be compared between groups. The association between successful outcomes based on GROC score and participant expectations of recovery generally, and specific to physical therapy and podiatry treatment, will also be analyzed. This study will be the first pragmatic trial to investigate the clinical outcomes and cost-effectiveness of ePT and uPOD in individuals with PHP. The results will serve to inform clinical practice decisions and management guidelines of multiple disciplines.Trial registration: NCT01865734.
    Trials 12/2013; 14(1):414. DOI:10.1186/1745-6215-14-414 · 1.73 Impact Factor

  • BMJ (online) 10/2012; 345:e7252. DOI:10.1136/bmj.e7252 · 17.45 Impact Factor
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    ABSTRACT: This article is based on educating readers and physicians about the use of footwear and orthotics for themselves and their patients, to treat diseases and enhance functionality in sports and daily life.
    Primary care 12/2013; 40(4):1001-12. DOI:10.1016/j.pop.2013.08.013 · 0.74 Impact Factor
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