Article

Plantar heel pain is a common condition that reduces health-related
quality of life. Recovery usually occurs within 12 months; however, up to 20% of
people remain symptomatic beyond this time frame. The level of pain and function
in this chronic heel pain group is not well described.
OBJECTIVE: To identify
clinical and functional characteristics associated with chronic plantar heel pain
compared with heel pain of recent onset. DESIGN: Cross-sectional study. SETTING:
University research laboratory and private physiotherapy clinic. PARTICIPANTS: A
total of 71 people with plantar heel pain for longer than 12 months and 64 people
with plantar heel pain for less than 6 months were recruited from the general
public. METHODS: Functional characteristics of participants in both heel pain
groups were assessed with a variety of clinical measures and the Foot Health
Status Questionnaire. Clinical measures included body mass index, foot and ankle
muscle strength using hand-held dynamometry, as well as ankle and first
metatarsophalangeal joint range of motion. The Foot Health Status Questionnaire
was used to collect self-reported measures of foot pain severity, foot function
and physical activity. MAIN OUTCOME MEASUREMENTS: Univariate analyses of variance
were performed to detect differences between the 2 groups for each of the
variables measured. RESULTS: The chronic heel pain group exhibited reduced ankle
dorsiflexor and toe flexor strength yet better self-reported foot function. There
was no difference between groups for body mass index, ankle and first
metatarsophalangeal joint range of motion, inversion strength, eversion strength,
calf endurance, self-reported foot pain, and physical activity. CONCLUSIONS:
Chronic plantar heel pain is associated with selective weakness of foot and ankle
muscle groups but less affected foot function compared with heel pain of recent
onset. Those with chronic symptoms may moderate or make adaptations to their
daily activities, or simply accept their condition, enabling more effective
coping. Strength deficits, although possibly a cause or consequence of chronic
symptoms, suggest a need to include resistance exercise in the management of
plantar heel pain. LEVEL OF EVIDENCE: IV.
CI - Copyright (c) 2017 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS