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The plantar heel pain is very common complaint that causes significant discomfort. Plantar fasciitis is due to degenerative change of the plantar fascia at attachment site. Corticosteroids and autologous PRP injections are effective in the treatment of plantar fasciitis. We compared the local corticosteroid (methyl prednisolone acetate) injection and platelet-richplasma in terms of patient outcome in chronic plantar fasciitis. Materials and methods: The study was conducted at Pain clinic and in Department of Orthopaedics, Government District hospital Chitradurga, Karnataka from November 2022 to October 2023. Forty patients were enrolled in this study. The patients were selected randomly and were divided in two groups of 20 patients each (PRP and Steroid groups). Follow up done at 2 weeks, 6 weeks, 3 months and 6 months. Results: Significant pain relief after 6 weeks of platelet rich plasma therapy and after at 3 months and 6 months follow up. Significant improvement in both groups with respect to AOFAS score and VAS scores. This improvement was significantly more in PRP group. Conclusion: PRP injection is more effective in resulting pain relief and function as compared to corticosteroid injection in the treatment of plantar fasciitis. [ABSTRACT FROM AUTHOR]

An ankle-foot orthosis (AFO) with plantar flexion resistance (PFR) can improve the first rocker function during gait, but the incremental changes in the resistive moment on balance and gait have not been well identified. To investigate the effect of changing the PFR moment of dynamic AFO (DAFO) on measures of the center of pressure (COP) and clinical gait outcomes in individuals with post-stroke hemiparesis. In this randomized repeated measure study of 36 stroke individuals, the customized DAFO using foot drop ankle units set in three PFR situations (low, medium, and high) was evaluated. The balance parameters for COP measures were investigated by HUMAC® Balance & Tilt System. Gait parameters and ankle kinematics were recorded using the 3D motion analysis through force platform and optoelectronic system. The comparison was made using a parametric ANOVA test and the P value was set at 0.05 for statistical significance. Significant differences were observed for COP average velocity (1.30 ± 0.64, 1.10 ± 0.05, and 1.37 ± 0.43), COP path length (43.3 ± 4.6, 33.4 ± 4.3, and 36.3 ± 5.4), walking velocity (11.0 ± 3.1, 13.2 ± 4.4, and 9.9 ± 3.5), and cadence (31.5 ± 2.0, 33.0 ± 3.1, and 29.0 ± 1.6) respectively for low, medium and high PFR settings (P < 0.05). Except for the COP path length and cadence, posthoc multiple comparisons revealed significant differences between low and medium (P < 0.05) and medium and high (P < 0.05) PFR grades. PFR with medium resistance demonstrated near-normal maximal peak ankle dorsiflexion (mean deviation of 8 degrees, P < 0.05). Medium PFR grade should be encouraged since it can enhance balance parameters like path length and average velocity of COP, increase cadence and average velocity during gait, and improve maximal peak ankle dorsiflexion. • Changes in resistive moment of plantar-flexion affects gait and balance in stroke. • The influence of PFR moment on ankle kinematics, gait and balance was examined. • Dynamic AFOs with dorsiflexion assist Klenzak joints allow for adjustable PFR. • Moderate PFR setting may improve the ankle kinematics, gait and balance parameters. • High PFR may increase non-symmetrical ankle dorsiflexion during swing. [ABSTRACT FROM AUTHOR]

Purpose: In correlation with magnetic resonance imaging (MRI), this study attempts to assess the effectiveness of the diagnostic of ultrasonography (US) features and shear wave elastography (SWE) in determining the different causes of heel pain. Materials and Methods: 55 heels with a mean age of 38.33 ± 10.8 were included in the study (10 control cases and 41 cases, 4 of which had bilateral heel pain). There were 23 female cases (56.1%) and 18 male cases (43.95%). Examinations using shear wave elastography (SWE) and ultrasound (US) were done in different positions. MRI and the obtained data were correlated. Results: When used to diagnose different heel pain causes, ultrasound demonstrated great sensitivity and specificity. SWE demonstrated a good correlation with MRI findings and enhanced the ultrasound's diagnostic precision in identifying plantar fasciitis early on (increased accuracy from 88.9 to 93.33% with 100% sensitivity and 83.3% specificity) and Achilles tendinopathy (increased accuracy from 88.9 to 97.8 with 94.7% sensitivity and 100% specificity). Conclusion: In summary, we concluded that heel pain can be efficiently examined by both ultrasound (US) and shear wave elastography (SWE) with the former being used as the primary effective tool and the latter being done to increase diagnostic accuracy. We also concluded that SWE improved the ultrasound's diagnostic precision in identifying patients with early plantar fasciitis and Achilles tendinopathy and showed a robust relationship with clinical outcomes, enhancing patient evaluation and follow-up. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the efficacy of manual physiotherapy on clinical outcomes, morphology of plantar fascia (PF), thicknesses of calcaneal fat pad (CFP) and Kager's fat pad (KFP) with ultrasound imaging in plantar fasciitis (PFS) patients. Also, to evaluate the PF thickness, pain and foot functional outcomes among PFS phases. Methods: A randomized controlled trial was conducted on 122 subjects divided into three groups: group A (40 patients with PFS) underwent manual physiotherapy, group B (42 patients with PFS) without any intervention and group C (40 healthy subjects) were matched by age, gender and BMI with each patient in group A and B. The following outcomes were evaluated at baseline and one-month of follow-ups: morphology of PF and thicknesses of CFP and KFP, pain, foot functional limitation. Results: PF thickness was significantly thickened in group A and B compared to group C (P < 0.001). A significant decrease in incidence of PF echogenicity and CFP thickness were found in group A and B compared to group C. Moreover, significant improvement was observed in PF thickness (P < 0.001), PF echogenicity (P < 0.001) and CFP thickness (P = 0.002) in group A at one-month after the treatment. Furthermore, pain intensity and foot functional limitation was significantly improved within group A after receiving the treatment. Significant improvement was noted in PF thickness, pain intensity and foot functional limitation among patients with acute phase. Conclusion: The manual physiotherapy is effective in treatment of PF thickening, hypoechogenicity, pain intensity and activity limitations, particularly in patients associated with acute PFS. [ABSTRACT FROM AUTHOR]

A flat foot is one of the most common skeletal disorders that affect the function of the foot. The aim of this study was to compare the effect of two types of corrective exercise programs with a comprehensive and localized approach in correcting flat foot deformities in adolescents. The statistical population consisted of adolescent male students in Mashhad. Using cluster sampling, 75 students aged 11 to 12 years, who had simultaneously flat feet, crossed knees, and internal rotation of the knee was purposefully selected. They were randomly divided into three experimental groups: local exercises (n=25), comprehensive (n=25), and control (n=25). The severity of flat feet was measured by the navicular bone loss test (pre-test). The experimental groups performed local and comprehensive correction programs for 6 weeks. The results showed that local corrective exercises and comprehensive corrective exercises have a significant effect on correcting flat foot deformities. There was also a significant difference between the effect of local and comprehensive exercises in correcting flat foot deformities and the effect of comprehensive exercises was greater. It is concluded that for the treatment of plantar fasciitis, both local corrective exercises and comprehensive corrective exercises can be used as effective training methods and comprehensive corrective exercises have an advantage over local corrective exercises. [ABSTRACT FROM AUTHOR]

Background: Plantar fasciitis, a common musculoskeletal disorder, is characterized by inflammation of the plantar fascia, a thick band of tissue that connects the heel bone to the toes. The plantar fascia plays a crucial role in supporting the arch of the foot and absorbing shock during movement. Factors such as excessive physical activity, improper footwear, and biomechanical abnormalities are recognized contributors to the development of plantar fasciitis. However, the prevalence and underlying causes may vary across different demographic groups, necessitating targeted investigations. Objective: This study aims to investigate the prevalence, causes and treatment of plantar fasciitis in young female students (18–30) of a medical college in Pakistan and explore potential associations with high-heel footwear. Methodology: In this study, a cross-sectional survey was carried out, engaging 100 young females from a medical college. Employing a structured questionnaire, we assessed a spectrum of parameters, including heel pain symptoms, footwear habits, and available treatment options. The diagnostic precision of the Windlass test, specific to plantar fasciitis, was incorporated. Rigorous data analysis, utilizing SPSS, centered on discerning associations between the nuances of high-heel wear (considering types and duration) and the reported symptoms. This methodological framework ensures a comprehensive and precise exploration of the prevalence, causes, and treatment of plantar fasciitis in our targeted demographic. Results: All the participants were female, and the total number was 100, of which 66% felt pain in the heel when they wore high heels. Out of this 66%, only 6% are diagnosed with plantar fasciitis. The rest of the 60% have pain in the heel due to different causes such as heel spurs, stress fractures, etc. 2% of people receive treatment with steroid injections, and 12% are treated with ice. Conclusion: We conclude that the prevalence of plantar fasciitis is high in females wearing high heels. This study reveals that an increase in the total duration of wearing high heels with hard soles increases the symptoms of plantar fasciitis. Plantar fasciitis can be prevented by education and applying ergonomics and could be treated by steroids and the ice method, according to medical practitioners. [ABSTRACT FROM AUTHOR]

Background/Objectives: Plantar fasciitis (PF) is a common condition that causes heel pain. While various conservative treatment modalities for PF exist, no previous studies have investigated the effectiveness of shoe rotation (ShR) in patients with PF pain. This study aimed to compare the therapeutic effectiveness of ShR with that of two conventional treatments for PF—namely, foot orthosis (FO) and physical therapy (PT). Methods: Charts of 42 patients with heel pain were retrospectively reviewed. Participants were allocated to one of three treatment groups: the ShR group, the customized FO group, and the PT group. Pain and functional outcomes were assessed using the Visual Analog Scale (VAS), Digital Pain Scale (DPS), Foot Function Index (FFI), Foot Pain and Function Scale (FPFS), and American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS-AHS) at baseline and at 4 and 12 weeks after the intervention. Results: The ShR, FO, and PT groups all showed improvements, with statistically significant decreases in VAS, DPS, and FFI scores and significant increases in FPFS and AOFAS-AHS scores over time (p < 0.05). All three interventions resulted in significant improvements from baseline to 4 weeks and further to 12 weeks (p < 0.05). The ShR group exhibited a slightly larger effect on all measurements than the other groups. Conclusions: ShR, FO, and PT contributed to pain reduction and functional improvement, and alternating the shoes alleviated PF pain. These results suggest a new approach to managing PF and serve as a basis for providing convenient treatment for patients with PF. [ABSTRACT FROM AUTHOR]

Objective Ultrasound-guided tibial nerve pulsed radiofrequency (US-guided TN PRF) and fluoroscopy-guided intralesional radiofrequency thermocoagulation (FL-guided intralesional RFT) adjacent to the painful calcaneal spur are two interventions for pain management in painful calcaneal spur and plantar fasciitis. This study aimed to compare the effectiveness of the two procedures. Design A prospective, randomized, single-blind study. Setting Single-center pain clinic. Subjects Forty-nine patients who met the inclusion criteria were randomized into two groups. Methods Group U (25 patients) received US-guided TN PRF at 42°C for 240 s, whereas Group F (24 patients) received FL-guided intralesional RFT at 80°C for 90 s. The most severe numeric rating scale (NRS) score during the first morning steps and the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores were used to evaluate the effectiveness of the procedures. The study's primary outcome assessed treatment effectiveness via the NRS, whereas the secondary outcomes included changes in the AOFAS score and the incidence of procedure-related mild adverse events. Results NRS and AOFAS scores significantly improved in Groups U and F at 1 and 3 months compared with baseline (P  < .05), and there was no significant difference between the groups. At month 1, 50% or greater pain relief was achieved in 72% of patients in Group U and 75% of patients in Group F. No significant difference was observed in the incidence of mild adverse events between the groups. Conclusions US-guided TN PRF and FL-guided intralesional RFT have shown significant effectiveness in the treatment of painful calcaneal spur and plantar fasciitis. Larger randomized controlled trials are needed. Clinical Trial Number NCT06240507. [ABSTRACT FROM AUTHOR]

In this randomized clinical trial, we compared the early effects of polyethylene (PE), polyurethane (PU), and Carbon Fiber insoles in the treatment of PF using a set of patient-reported outcomes. Patients were randomly allocated one of the three prefabricated insoles – Carbon Fiber (n = 14), PU (n = 14), or PE (n = 17) for regular use. Their response was recorded using PROMIS 3a (for pain intensity), PROMIS 4a (for pain interference), FAOS (Foot and Ankle Outcome Score), and VAS for pain at baseline, two, six, and twelve weeks. The PROMIS pain intensity scores improved in both the Carbon Fiber and the PE groups starting at the 6th week (p = 0.04) and 2nd week (p = 0.002), respectively. PROMIS pain interference scores also showed positive trends in these two groups (p = 0.02, p = 0.004, respectively). Prefabricated Carbon Fiber and PE insoles showed significant pain-reducing effects in patients with PF. Level I, Randomized controlled trial. [ABSTRACT FROM AUTHOR]

[Purpose] The purpose of this study was to compare the effectiveness of the Structural Diagnosis and Management (SDM) approach with Myofascial Release (MFR) in improving plantar heel pain, ankle range of motion, and disability. [Subjects] Sixty-four subjects, aged 30–60 years, with a diagnosis of plantar heel pain, plantar fasciitis, or calcaneal spur by a physician according to ICD-10, were equally allocated to the MFR (n = 32) and SDM (n = 32) groups by hospital randomization and concealed allocation. [Methods] In this assessor-blinded randomized clinical trial, the control group performed MFR to the plantar surface of the foot, triceps surae, and deep posterior compartment calf muscles, while the experimental group performed a multimodal approach utilizing the SDM concept for 12 sessions over 4 weeks. Both groups also received strengthening exercises, ice compression, and ultrasound therapy. Pain, activity limitations and disability were assessed as primary outcomes using the Foot Function Index (FFI) and Range of motion (ROM) assessment of the ankle dorsiflexors and plantar flexors using a universal goniometer. Secondary outcomes were measured using the Foot Ankle Disability Index (FADI) and a 10-point manual muscle testing process for the ankle dorsiflexors and plantar flexors. [Results] Both MFR and SDM groups exhibited significant improvements from baseline in all outcome variables, including pain, activity level, disability, range of motion, and function after the 12-week intervention period (p <.05). The SDM group showed more improvements than MFR for FFI pain (p <.01), FFI activity (p <.01), FFI (p <.01) and FADI (p = <.01). [Conclusion] Both MFR and SDM approaches are effective in reducing pain, improving function, ankle range of motion, and reducing disability in plantar heel pain, however, the SDM approach may be a preferred treatment option. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of extracorporeal shock waves versus corticosteroids injections on pain, thickness of plantar fascia and foot function in patients with plantar fasciitis. Secondarily, to assess the efficacy of radial and focused extracorporeal shock waves and the most appropriated intensity (high, medium or low). Data sources: PubMed, SCOPUS, CINAHL and PEDro, until April 2024, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Review methods: Randomized controlled trials comparing the efficacy of extracorporeal shock waves versus corticosteroids injections on pain intensity and sensitivity, thickness of plantar fascia and foot function in patients with plantar fasciitis. Methodological quality and risk of bias were assessed using PEDro Scale and Cochrane Risk of Bias Tool. Pooled effect was calculated using the standardized mean difference (SMD) and its 95% confidence interval (95%CI). Results: Sixteen studies involving 1121 patients, showing a mean of 6 points in PEDro scale, were included. At three months, extracorporeal shock waves were better than corticosteroids injections in reducing pain (SMD −0.6; 95%CI −1.1 to −0.11) and thickness of the plantar fascia (SMD −0.4; 95%CI −0.8 to −0.01) and increasing foot function (SMD 0.27; 95%CI 0.12–0.44). At six months, extracorporeal shock waves are more effective in reducing pain (SMD −0.81; 95%CI −1.6 to −0.06) and increasing foot function (SMD 0.67; 95%CI 0.45–0.89). Local pain and slight erythema were the most frequent adverse events. Conclusions: Extracorporeal shock waves are a safe therapy, presenting more efficacy than corticosteroids injections in improving pain, thickness of plantar fascia and foot function at mid-term. [ABSTRACT FROM AUTHOR]

Baxter's neuropathy is one of the overlooked causes of chronic heel pain. Diagnosing neuropathy in Baxter's can be challenging due to its potential occurrence as a secondary condition to other common syndromes that cause heel pain, such as plantar fasciitis, calcaneal spur, hypertrophic muscle, tenosynovitis, space-occupying lesions or trauma. Ultrasound is a reliable and easily accessible device that guides injections for the treatment of Baxter's neuropathy. We have written this letter as a guide, especially for beginner and professional pain specialists. [ABSTRACT FROM AUTHOR]

Plantar fasciitis is one of the most common causes of foot pain; in 35% of cases, it is also associated with bone edema of the heel. The aim of this study was to investigate the relationship between bone edema and the outcomes of temperature-controlled high-energy adjustable multi-mode emission laser (THEAL) and/or exercises in patients with plantar fasciitis. A prospective randomized clinical trial was designed, in which 48 patients suffering from plantar fasciitis, with or without bone edema, were treated with temperature-controlled high-energy adjustable multi-mode emission laser and exercises (the laser group) or with exercises only (the control group). The patients were evaluated at recruitment (T0) and at 2 (T1) and 6 months (T2), monitoring pain (with the Visual Analogue Scale), functionality (with the Foot Function Index), perception of improvement (with the Roles and Maudsley Score), and fascia thickness (with ultrasound examination). In both groups, there was a significant improvement in pain, functional recovery, perception of remission, and a reduction in plantar fascia thickness at T1 and T2. The laser group presented statistically better values at T2 for the Roles and Maudsley Score (z: 2.21; 0.027). The regression analysis showed that a greater reduction in fascia thickness occurred in the laser group (p-value: 0.047). In conclusion, the two conservative treatments were effective in patients suffering from plantar fasciitis, even in the presence of bone edema, but with lesser results. [ABSTRACT FROM AUTHOR]

Plantar fasciitis is the most common cause of heel pain in adults with an overall prevalence of 0.85% in the adult population of the US, affecting over 2 million adults annually. Most current treatment modalities are not supported by sufficient evidence to recommend one particular strategy over another. Topical application of analgesics for soft tissue pain is well established, however the plantar fascia presents challenges in this regard due to thick skin, fibrotic tissue, and an often thickened fat pad. Sixty-two patients with plantar fasciitis were randomized to a placebo controlled trial testing the efficacy of a topical solution of plant terpenes containing camphor, menthol, eugenol, eucalyptol, and vanillin. Skin permeation of the mixture was enhanced with 15% dimethylsulfoxide (DMSO), 1% limonene, and rosemary oil. One ml of solution was applied topically twice daily, and pain scores evaluated on Day 0, Day 1, Day 3, and Day 10. Using the validated foot function index 78.1% of patients reported an 85% or greater decrease in their total pain score by day 10 while placebo treatment was without effect (One Way ANOVA, P < 0.01). This study adapts the treatment modality of topical analgesia for soft tissue pain to a problematic area of the body and shows therapeutic promise. ClinicalTrials.gov Identifier: NCT05467631 [ABSTRACT FROM AUTHOR]

Background: Corticosteroid injections are commonly used for the treatment of plantar fasciitis. In recent years, ultrasound-guided multipuncture treatment of the fascia has been described in the literature. Our study aimed to compare the effectiveness of these two techniques in the treatment of plantar fasciitis. Methods: The outcomes achieved over 120 days following the use of these techniques to treat plantar fasciitis were examined. A total of 81 patients were randomly selected for the study; 41 were treated with ultrasound-guided multipuncture and 40 with ultrasound-guided corticosteroid injection. Clinical examinations and ultrasound assessments were performed before treatment and at 30, 60 and 120 days post-treatment. Clinical assessments included the use of a visual analog scale (VAS) to record pain and the Foot Function Index (FFI) to evaluate function. Ultrasound was used to measure the thickness of the plantar fascia. Results: Both the ultrasound-guided multipuncture and corticosteroid injection techniques were associated with significant functional and echographic improvements at 4 months post-treatment (P < 0.001). Pain did not improve significantly after 120 days with ultrasound-guided corticosteroid injection, whereas significant pain reduction was observed with ultrasound-guided multipuncture. Conclusion: Corticosteroid injection provides better short-term results in terms of VAS pain and FFI scores. However, ultrasound-guided multipuncture shows superior outcomes in VAS pain and FFI scores at 120 days. [ABSTRACT FROM AUTHOR]

Plantar fasciopathy is a very common musculoskeletal complaint that leads to reduced physical activity and undermines the quality of life of patients. It is associated with changes in plantar fascia structure and biomechanics which are most often observed between the tissue's middle portion and the calcaneal insertion. Sonographic measurements of thickness and shear wave (SW) elastography are useful tools for detecting such changes and guide clinical decision making. However, their accuracy can be compromised by variability in the tissue's loading history. This study investigates the effect of loading history on plantar fascia measurements to conclude whether mitigation measures are needed for more accurate diagnosis. The plantar fasciae of 29 healthy participants were imaged at baseline and after different clinically relevant loading scenarios. The average (±standard deviation) SW velocity was 6.5 m/s (±1.5 m/s) and it significantly increased with loading. Indicatively, five minutes walking increased SW velocity by 14% (95% CI: −1.192, −0.298, t(27), p = 0.005). Thickness between the calcaneal insertion and the middle of the plantar fascia did not change with the tissues' loading history. These findings suggest that preconditioning protocols are crucial for accurate SW elastography assessments of plantar fasciae and have wider implications for the diagnosis and management of plantar fasciopathy. [ABSTRACT FROM AUTHOR]

This document is a correction notice for an article titled "Evaluation of the efficacy of trigger points combined with extracorporeal shock waves in the treatment of plantar fasciitis: heel temperature and plantar pressure." The authors made a mistake in using the incorrect symbol "T" instead of "t" in certain tables, and the corrected tables are provided in the document. The tables present data on NRS scores and heel temperatures in both the control and test groups. The corrected tables show significant differences in NRS scores and heel temperatures between the two groups. The document also includes a table summarizing the plantar pressure measurements in both groups. The study found that the treatment had a significant impact on plantar pressure in both groups, with the test group showing greater improvements compared to the control group. The results were statistically significant, with p-values indicating a high level of confidence in the findings. [Extracted from the article]

Objective: To evaluate the long-termefficacy and safety of an ultrasonic fasciotomy for plantar fasciopathy.Design: Prospective observational study. Setting: Tertiary care academic medical center. Participants: Patients with chronic plantar fasciopathy refractory to standard, conservative treatments were included in this study. Interventions: Patients underwent ultrasonic fas- ciotomy of the plantar fascia.MainOutcomeMeasures: The primary outcomemeasures were change in visual analog scale at 12 and 52 weeks post-procedure compared with baseline as well as patients' self-reported satisfaction with the procedure. Results: Sixty-seven patients were included. There was a significant improvement in visual analog scale at all follow-up time points, with an average overall improvement of 5.87 (P < 0.0001). 94% of patients reported satisfaction with the outcomes of their procedure at 12 and 52 weeks. No procedural complications were seen. Conclusions: This study demonstrates that an ultrasonic fasciotomy is a safe and effective treatment option for chronic plantar fasciopathy, with continued symptomimprovement and a high degree of patient satisfaction up to 52 weeks post-procedure. Clinical Relevance: These findings suggest that an ultrasonic fasciotomy should be considered for patients with chronic plantar fasciopathy refractory to conservative treatments. [ABSTRACT FROM AUTHOR]

Background: Platelet-rich plasma (PRP) helps in the treatment of various insertion tendinitis, and the recurrence rate will be low. In this study, we used intralesional injections of autologous PRP for the treatment of insertion tendinitis. Aims and Objectives: Assessment of pain relief following PRP treatment for insertion tendinitis and ascertaining the efficacy of PRP as a treatment option for insertion tendinitis. Materials and Methods: The study was done at Maharani Laxmi Bai Medical College, Jhansi, between January 2021 and June 2022, including 100 patients were applied for the treatment of PRP. We assessed patients before treatment and at three follow-up time points: 2, 4, and 6 months after the end of treatment. During each evaluation, three parameters were noted: Victorian Institute of Sports AssessmentAchilles (VISA-A) score, the Visual Analog Scale, and patient satisfaction according to the roles and Maudsley score. Results: This was a prospective trial by study design conducted on 100 patients, which included 44 patients with plantar fasciitis and 56 patients with tennis elbow. The response to PRP injection in patients with plantar fasciitis was assessed by the VISA-A score. The pre-injection VISA-A score of patients with plantar fasciitis was 56.82 (mean with SD of 18.015), which improved to 65.45 in the 2nd month (mean with SD −18.857), 4th month with 69.77 (mean with SD–19.823), and at 6 months 71.82 (mean with SD–20.829). Statistical analysis with an analysis of variance test gave a P=0.001. In our study, the patients had gradual sequential improvement in VISA-A score throughout the follow-up, with maximum improvement from the pre-injection score were observed in 2 months (65.45 with SD 18.85). Conclusion: Autologous PRP injection is a safe and useful modality of treatment in the treatment of insertion tendinitis. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the effects of dry needling (DN) and extracorporeal shock wave therapy (ESWT) in the treatment of plantar fasciitis (PF). The study included 55 patients with PF. The patients were randomly divided into 2 groups. The DN group applied 3 sessions of DN to the myofascial trigger points in the lower limb muscles. The ESWT group applied 3 sessions of ESWT to the plantar fascia. For clinical evaluation, we used a visual analog scale (VAS) (first step, rest, activity) and Foot Function Index (FFI) (pain, disability, activity). Assessments were done baseline, post-treatment first week, and fourth week. Maximum pain-free standing time (Max PfST) and maximum pain-free walking distance (Max PfWD) were recorded at baseline and post-treatment fourth week. In this study, we found significant improvement in VAS, FFI, Max PfST, and Max PfWD in both groups (p <.01). VAS-activity baseline-forth week change was significantly superior in the DN group compared to the ESWT group (p =.023). FFI-disability baseline-fourth week change was significantly superior in the DN group compared to the ESWT group (p =.048). There was no significant difference in other treatment-related changes between the groups (p >.05). However, VAS-rest baseline-fourth week change and FFI-pain baseline-fourth week change trended towards statistical significance between groups ((p =.056), (p =.052) respectively). This study showed that DN may be a good alternative treatment for patients with PF, with effects similar to or even superior to ESWT. [ABSTRACT FROM AUTHOR]

Plantar fasciitis is a relatively common cause of heel pain which can be greatly debilitating for the patient and frustrating to the practitioner treating the complaint. The aetiology is still largely subject to debate although mechanical forces are clearly involved but the plethora of available treatment modalities suggests that the aetiology is multifactorial. Kenzora (1987) suggested that up to 90% of patients can be treated successfully. This pilot study examines the current literature and assesses the effect of 0.5% bupivacaine infiltrations into the heel under tibial nerve block weekly, over a period of five weeks, in patients suffering from chronic plantar fasciitis (CPF). Twenty-five patients, all suffering from recalcitrant cases of CPF were treated, and the average reduction in pain was 78%. Forty-four per cent of patients achieved total resolution of symptoms. A significant overall reduction in pain levels of 5.58cm. on a visual analogue scale was noted (P<0.110) and a mean percentage reduction of 76.8%. [ABSTRACT FROM AUTHOR]

Background: Plantar fasciitis (PF) is a common foot disorder with variability in treatment strategy. Two effective management techniques include platelet-rich plasma (PRP) injections and extracorporeal shock wave therapy (ESWT). The purpose of this meta-analysis is to compare the effectiveness of PRP vs ESWT in the management of PF. Methods: A systematic search was performed of PubMed, Cochrane, and Google Scholar for randomized controlled trials comparing PRP to ESWT. Studies met inclusion criteria if mean and SDs for visual analog scale (VAS) pain scores and plantar fascia thickness (PFT) were reported. Mean differences were used to compare VAS pain score and PFT between PRP and ESWT. Results: Six randomized controlled trials, comparing a total of 214 subjects in the PRP group and 218 subjects in the ESWT group, were analyzed. A significantly greater statistical improvement was seen in the PRP group in VAS pain (mean difference = −0.67 [95% CI −1.16, −0.18], P =.007) and plantar fascia thickness (PFT) (mean difference = −0.56 [95% CI −0.77, −0.35], P <.001). Conclusion: PRP had a statistically higher pain reduction than ESWT, but the difference does not reach clinical significance in this meta-analysis. [ABSTRACT FROM AUTHOR]

Objective: to consider, based on the analysis of domestic and foreign sources, the main issues of epidemiology, pathogenesis, diagnosis, and treatment of plantar fasciitis in athletes.Materials and methods: an analysis of data from electronic portals such as PubMed-NCBI, Scopus, Google Scholar, Cochrane Library, and “Scientific Electronic Library eLIBRARY.RU” was conducted by request: “plantar fasciitis sport”, “plantar fasciitis in athletes”, “plantar fasciitis physical therapy”. The review analyzed 103 publications, of which 16 are devoted to the problems of plantar fasciitis in sports; 34 meta-analyses, 39 reviews, 11 randomized clinical trials and 19 other studies based on the principles of good clinical practice were included.Results: the prevalence of plantar fasciitis among athletes was evaluated, ranging from 5.2 to 17.5%. It has been demonstrated that the leading morphological change is the degeneration of connective tissue, which, in combination with repetitive microtrauma, can cause pain. In athletes, plantar fasciitis is often accompanied by various biomechanical disorders and is frequently associated with flat feet. It has been noted that ultrasound and magnetic resonance imaging, which allow for the detection of thickening of the plantar fascia and signs of its degenerative changes, as well as X-ray examination of the feet, are considered as additional diagnostic tools. A wide range of approaches to the treatment of plantar fasciitis has been described: pharmacological methods of intervention, physical and rehabilitation medicine, as well as surgical intervention, which have varying degrees of proven efficacy.Conclusion: since plantar fasciitis in athletes is characterized by a high prevalence and resistance to ongoing therapeutic measures, which is reflected in limited studies, the development of pathogenic justified measures for timely diagnosis and treatment of this condition, primarily focusing on biomechanics, will contribute to the athlete’s prompt resumption of full training and competitive activities. Directions for further research on the issue of foot pain occurrence in athletes have been proposed.

Abstract Background Corticosteroid injections are commonly used for the treatment of plantar fasciitis. In recent years, ultrasound-guided multipuncture treatment of the fascia has been described in the literature. Our study aimed to compare the effectiveness of these two techniques in the treatment of plantar fasciitis. Methods The outcomes achieved over 120 days following the use of these techniques to treat plantar fasciitis were examined. A total of 81 patients were randomly selected for the study; 41 were treated with ultrasound-guided multipuncture and 40 with ultrasound-guided corticosteroid injection. Clinical examinations and ultrasound assessments were performed before treatment and at 30, 60 and 120 days post-treatment. Clinical assessments included the use of a visual analog scale (VAS) to record pain and the Foot Function Index (FFI) to evaluate function. Ultrasound was used to measure the thickness of the plantar fascia. Results Both the ultrasound-guided multipuncture and corticosteroid injection techniques were associated with significant functional and echographic improvements at 4 months post-treatment (P

Objective The most common causes of plantar and heel pain are plantar fasciitis and calcaneal spurs, and they often co‐exist. Surgery is a recognized treatment for refractory plantar fasciitis. However, few studies have proposed treatment options for patients with metatarsophalangeal fasciitis with bone spurs. Accordingly, this study's purpose was to propose a four‐step surgical regimen, and to improve the surgical outcome of plantar fasciitis with osteophytes and to establish a procedure for surgical treatment. Methods Retrospective analysis of 45 patients suffering from plantar fasciitis with bone spurs from 2020 to 2023. All patients underwent a four‐step procedure, including plantar fascia release, calcaneal spur grinding, inflammatory tissue removal, and calcaneal burr decompression. The imaging parameters and functional scores were recorded before and after the operation. The objective evaluation included the measurement of calcaneal spur length on radiographs. Clinical evaluation included the American Orthopaedic Foot and Ankle Society (AOFAS), the Visual Analog Scale (VAS), and the Foot and Ankle Outcome Scale (FAOS). Measurement data that conformed to normal distribution were expressed as (x2 ± s), and pre‐and postoperative AOFAS, FAOS, and VAS scores were compared using repeated‐measures ANOVA, and preoperative and postoperative spur lengths were compared using paired t‐tests. Results The 45 patients were followed up for 3 to 30 months, (17.72 ± 8.53) months, at final follow‐up, the patient's AOFAS score improved from preoperative (74.93 ± 5.56) to (94.78 ± 3.98), FAOS score increased from preoperative (76.42 ± 3.37) to (96.16 ± 2.74), the VAS score decreased from (3.18 ± 0.54) to (1.07 ± 1.20) (p

Background. Heel discomfort is caused by plantar fasciitis in both active and sedentary people of all ages. Obese people and people who spend most of their time on their feet are more susceptible to this disease. Most of the interventions used to treat plantar fasciitis have not been adequately studied. Purpose: to prove the effectiveness of the impact of shock wave therapy and stretching of the calf muscles on plantar fasciitis. Methods. Extracorporeal shock wave therapy as the sole treatment and in combination with calf stretching exercises on a stair treadmill; assessment of the level of pain according to the VAS and AOFAS scales, the method of statistical analysis. Results. Statistically significant differences in the assessments of the level of pain according to the VAS and AOFAS scales were obtained in the treatment of heel pain in plantar fasciitis. At the same time, pain assessment on the AOFAS scale reflected a statistically significantly more pronounced effect of treatment when combined with extracorporeal shock wave therapy in combination with a set of exercises for stretching the calf muscles. Conclusion. Extracorporeal shock wave therapy can be effectively used for chronic pain localized in the calcaneus and caused by plantar fasciitis. The greatest effect is observed in patients receiving ESWT and exercises for stretching the calf muscles in the complex.

Objective: Plantar fasciitis, commonly found in orthopaedic practice, may restrict daily life activities and lead to loss of workforce. We aimed to evaluate the short- and medium-term outcomes of radiofrequency ablation (RFA) and steroid injection treatments in patients with plantar fasciitis who did not benefit from conservative therapies through pain and function scores. Material and Method: Patients studied at the Hakkari State Hospital for at least six months of conservative treatment due to plantar fasciitis between 01.07.2021-01.01.2023. The patients were divided into two groups: those who received RFA and those who were given steroid injections. Demographic information of the patients, the Visual Analog Scale (VAS) and the American Orthopedic Foot Ankle Society (AOFAS) score were studied, and both gups were compared. Results: No significant difference was observed when comparing preop VAS and AOFAS values for both groups (p=0.469 p=0.244). No significant difference was observed when comparing the VAS and AOFAS values of the two groups for the first month (p=0.764 p=0.466 respectively). A significant difference was observed when comparing the VAS and AOFAS values in the post-6 month (p=0,001 p=0.001). Significant differences were observed between VAS and AOFAS values in patients receiving RFA in preop and 6 months (p=0.001 p=0.001). No significant difference was observed in preop and 6 month VAS and AOFAS values in steroid injections (p=0.512 p=0.844 respectively).No complications were observed in both groups during the follow-up period. Conclusion: In patients who have received conservative treatment but have not benefited, radiofrequency ablation has been found to be an effective, safe and minimally invasive method of reducing the severity of pain in the short to medium term and improving daily activities.

Background. Various methods have been proposed to treat plantar fasciitis. Among these, autologous blood transfusion has been discussed and investigated in the past few years, the findings indicate its effects in the medium term, and in some studies, better results were observed compared to corticosteroids. This study was conducted with the aim of comparing the effect of two therapeutic methods of local injection of autologous blood and corticosteroid with the control group in the treatment of plantar fasciitis. Methods. In this prospective study that took place in Shahid Beheshti Hospital, Babol, during 2020–2021, 90 plantar fasciitis patients were examined in two treatment groups by corticosteroid injection or autologous blood. Their levels of pain and satisfaction were recorded during three and six months by the visual analog scale (VAS) and the Roles and Maudsley Scale (RMS). The data were described and analyzed by SPSS-22 using descriptive indices and statistical analysis tests at a significance level of 0.05. Results. There was no significant difference in pain and satisfaction during the third month of steroid and autologous blood transfusions. However, in the sixth month, the patients in the autologous blood group had significantly less pain than those in the steroid group (P= 0.001), and their level of satisfaction was significantly higher than that of patients in the steroid injection group (P= 0.018). The mean pain intensity based on VAS in six months was 5.40 ± 1.37 and 3.76 ± 1.87 in the steroid and autologous blood groups, respectively (P< 0.001). Based on the Wilcoxon test, the VAS score increased significantly in the steroid group in the sixth month compared to the third month (P= 0.011), while it decreased in the autologous blood group (P< 0.001). Conclusion. Based on the findings, autologous blood injection in plantar fasciitis over six months had significant pain-reducing effects and satisfaction versus corticosteroid injection. However, after three months, these effects were not significant compared to corticosteroids. Practical Implications. Based on the findings, autologous blood injection in plantar fasciitis over six months had significant pain-reducing effects and satisfaction versus corticosteroid injection. However, after three months, these effects were not significant compared to corticosteroids.

Background/Objectives: This study aimed to investigate the relationship between posterior tibial artery blood flow velocity and plantar heel pain (PHP). Methods: The PHP group comprised patients diagnosed with plantar fasciitis with plantar heel pain during gait, and the control group comprised healthy participants without plantar heel pain. The peak systolic velocity of the posterior tibial artery was measured using ultrasonography; it was measured three times on each side, and the mean value was calculated. Receiver operating characteristic curve analysis was performed to calculate the peak systolic velocity cutoff value for plantar heel pain. Results: 23 patients (age 58.0 ± 16.5 years; 13 males and 10 females) and 23 healthy participants (age 51.3 ± 17.3 years; 10 males and 13 females) formed the PHP and control groups, respectively. Peak systolic velocity on the affected side was significantly greater in the PHP group (44.1 ± 13.1 cm/s) than in the control group (32.7 ± 5.9 cm/s). No significant difference was observed between the left and right sides in the PHP (7.1 ± 9.8 cm/s) and control (3.7 ± 3.0 cm/s) groups. A cutoff value of 38.2 cm/s was observed on the affected side. Conclusions: We quantified the increase in posterior tibial artery blood flow velocity in patients with plantar heel pain. Peak systolic velocity measurements can aid in quantitatively evaluating these patients. This study was registered as a clinical trial (UMIN000046875) on 1 October 2021. [ABSTRACT FROM AUTHOR]

Objective: The most common causes of plantar and heel pain are plantar fasciitis and calcaneal spurs, and they often co‐exist. Surgery is a recognized treatment for refractory plantar fasciitis. However, few studies have proposed treatment options for patients with metatarsophalangeal fasciitis with bone spurs. Accordingly, this study's purpose was to propose a four‐step surgical regimen, and to improve the surgical outcome of plantar fasciitis with osteophytes and to establish a procedure for surgical treatment. Methods: Retrospective analysis of 45 patients suffering from plantar fasciitis with bone spurs from 2020 to 2023. All patients underwent a four‐step procedure, including plantar fascia release, calcaneal spur grinding, inflammatory tissue removal, and calcaneal burr decompression. The imaging parameters and functional scores were recorded before and after the operation. The objective evaluation included the measurement of calcaneal spur length on radiographs. Clinical evaluation included the American Orthopaedic Foot and Ankle Society (AOFAS), the Visual Analog Scale (VAS), and the Foot and Ankle Outcome Scale (FAOS). Measurement data that conformed to normal distribution were expressed as (x2 ± s), and pre‐and postoperative AOFAS, FAOS, and VAS scores were compared using repeated‐measures ANOVA, and preoperative and postoperative spur lengths were compared using paired t‐tests. Results: The 45 patients were followed up for 3 to 30 months, (17.72 ± 8.53) months, at final follow‐up, the patient's AOFAS score improved from preoperative (74.93 ± 5.56) to (94.78 ± 3.98), FAOS score increased from preoperative (76.42 ± 3.37) to (96.16 ± 2.74), the VAS score decreased from (3.18 ± 0.54) to (1.07 ± 1.20) (p < 0.05), the length of spur decreased from (0.72 ± 1.81) cm to (0.23 ± 1.19) cm, and there were significant differences before and after operation (p < 0.05). Conclusion: The four‐step surgical regimen is an appropriate and effective surgical procedure to treat plantar fasciitis with bone spurs. [ABSTRACT FROM AUTHOR]

Background: Plantar fasciitis is a painful tendinous condition (tendinopathy) with a high prevalence in athletes. While a healthy tendon has limited blood flow, ultrasound has indicated elevated blood flow in tendinopathy, but it is unknown if this is related to a de facto increase in the tendon vasculature. Likewise, an accumulation of glycosaminoglycans (GAGs) is observed in tendinopathy, but its relationship to clinical pain is unknown. Purpose: To explore to what extent vascularization, inflammation, and fat infiltration were present in patients with plantar fasciitis and if they were related to clinical symptoms. Study Design: Descriptive laboratory study. Methods: Biopsy specimens from tendinopathic plantar fascia tissue were obtained per-operatively from both the primary site of tendon pain and tissue swelling ("proximal") and a region that appeared macroscopically healthy at 1 to 2 cm away from the primary site ("distal") in 22 patients. Biopsy specimens were examined with immunofluorescence for markers of blood vessels, tissue cell density, fat infiltration, and macrophage level. In addition, pain during the first step in the morning (registered during an earlier study) was correlated with the content of collagen and GAGs in tissue. Results: High vascularization (and cellularity) was present in both the proximal (0.89%) and the distal (0.96%) plantar fascia samples, whereas inconsistent but not significantly different fat infiltration and macrophage levels were observed. The collagen content was similar in the 2 plantar fascia regions, whereas the GAG content was higher in the proximal region (3.2% in proximal and 2.8% in distal; P =.027). The GAG content in the proximal region was positively correlated with the subjective morning pain score in the patients with tendinopathy (n = 17). Conclusion: In patients with plantar fasciitis, marked tissue vascularization was present in both the painful focal region and a neighboring nonsymptomatic area. In contrast, the accumulation of hydrophilic GAGs was greater in the symptomatic region and was positively correlated with increased clinical pain levels in daily life. Clinical Relevance: The accumulation of GAGs in tissue rather than the extent of vascularization appears to be linked with the clinical degree of pain symptoms of the disease. [ABSTRACT FROM AUTHOR]

Plantar fasciitis (PF) is the most common cause of heel pain in adults. There are numerous non-operative treatments available including platelet rich plasma (PRP) injections. PPR has demonstrated effectiveness for a range of musculoskeletal conditions including plantar fasciitis. To compare the effectiveness of PRP to other conservative treatment options for the management of PF. A systematic search of PubMed and Google Scholar was performed for randomized control trials (RCT) comparing PRP to other treatment modalities. Studies met inclusion criteria if mean and standard deviations for visual analog scale (VAS) pain scores, plantar fascia thickness (PFT), Foot Function Index (FFI), or American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score were reported. Mean differences (MD) were used to compare VAS pain, PFT, FFI, and AOFAS between PRP and other treatments. Twenty-one RCTs which altogether included 1356 patients were included in the meta-analysis. PRP demonstrated significantly greater improvements in VAS pain scores compared to extracorporeal shock wave therapy (ESWT) (SMD: 0.86; CI: [0.30, 1.41]; p = 0.002), corticosteroid injections (CSI) (SMD: 1.08; CI: [0.05, 2.11]; p = 0.04), and placebo (SMD: 3.42; CI: [2.53, 4.31]; p < 0.00001). In terms of FFI, no significant differences existed among PRP, ESWT, CSI, dextrose prolotherapy (DPT), and meridian trigger points (MTP) in enhancing foot functionality. However, PRP demonstrated a marked advantage over phonophoresis, showing a substantial improvement in FFI scores (SMD: 3.07, 95% CI: 2.34–3.81). PRP did not demonstrate superiority over ESWT, CSI, or MTP for improving PFT, but it was notably more effective than phonophoresis (SMD: 3.18, 95% CI: 2.43–3.94). PRP demonstrated significantly greater improvements in AOFAS scores over CSI (SMD: 3.31, CI: [1.35, 5.27], p = 0.0009) and placebo (SMD: 3.75; CI: [2.81, 4.70]; p < 0.00001). PRP is more effective than CSI, ESWT, and placebo in reducing VAS and more effective than CSI and placebo in improving AOFAS. PRP did not demonstrate a consistent advantage across all outcome measures, such as PFT and FFI. These findings underscore the complexity of PF treatment and call for a more standardized approach to PRP preparation and outcome measurement. Level I Meta-Analysis [ABSTRACT FROM AUTHOR]

Background: In India, the most typical form of heel pain is plantar, which results in inflammation of plantar fascia sometimes and can be seen in every age group. This condition mainly includes inflammation of plantar fascia and can be treated conservatively. It may cause many secondary symptoms along with it, and pain in back region is one of them. The purpose of this study is to discover how prevalent low back pain was in individuals who had plantar fasciitis. Objectives: Objectives are to evaluate the pain associated with plantar fasciitis, assess the low back pain and lastly check the prevalence of low back pain in plantar fasciitis patients by using different methods. Method: A convenience sampling method consisted of 65 participants were selected in relation with inclusion and exclusion criteria. The information collected, which comprises questionnaires and demographic data. Two standardised questionnaires were used, i.e., one to check the ability of an individual on the basis of plantar fasciitis and another to check the back pain especially in lower region. Both scales were given to 65 individuals one by one. First the foot’s capability calculated, and then pain in lower back region was checked. The prevalence was calculated on the basis of both scale responses with the help of statistical analysis. Results: The outcomes of the statistical study indicated that, the incidence of low back pain is prevalent of individual’s foot disability in plantar fasciitis patients. Conclusion: Findings show that the prevalence of low back pain is higher if plantar fasciitis has become chronic in the patient, and if the foot’s ability is maximal, low back pain is minimal, and vice versa. [ABSTRACT FROM AUTHOR]

Corticosteroid injections have been typically used for the management of plantar fasciitis with apparently good clinical outcomes; however, there is no information of the effect of corticosteroids on the thickness of the plantar fascia which is typically altered in this pathology. We aimed determine whether treatment with corticosteroid injections induces plantar fascia thickness changes in plantar fasciitis MEDLINE, Embase, Web of Science, and Scopus databases were searched for randomized controlled trials (RCT) reporting the use of corticosteroid injection to treat plantar fasciitis to July 2022. Studies must have reported plantar fascia thickness measurement. The risk of bias in all studies was assessed with the Cochrane Risk of Bias 2.0 tool. Meta-analysis was conducted using a random-effects model and the generic inverse variance method. Data from 17 RCT (including 1109 subjects) were collected. The follow-up period ranged from one to six months. Most studies measured the thickness of the plantar fascia at the insertion into the calcaneus using ultrasound. Pooled analysis revealed that corticosteroid injections had no significant effect on plantar fascia thickness (weighted mean differences [WMD], 0.06 mm [95% CI: −0.17, 0.29]; p = 0.61) or pain relief (WMD, 0.12 cm [95% CI: −0.36, 0.61]; p = 0.62) above active controls. Corticosteroid injections do not perform better than other common interventions in terms of a decrease of plantar fascia thickness and pain relief for plantar fasciitis. [ABSTRACT FROM AUTHOR]

We evaluated the effectiveness of plasma-rich protein injections (PRP) in terms of pain, patient-reported outcomes and function in degenerative joint disease and tendinopathy. The search strategies were ran in Ovid Medline and Ovid Embase in October 2023 by a clinical librarian. Results were limited to the last 10 years. The search terms used were 'platelet rich plasma' and 'orthopaedics'. After screening and the eligibility process this resulted in 18 randomized control trials (RCTs). We analysed 18 level 1 RCTs in regard to gluteal tendinopathy, hip osteoarthritis, patella tendinopathy, knee osteoarthritis, Achilles tendinopathy, plantar fasciitis, rotator cuff tendinopathy and elbow tendinopathy. Further research, such as meta-analyses and double-blinded trials with more patients, longer follow-up and with a placebo group, is needed to better elucidate the safety and efficacy of PRP injections. [ABSTRACT FROM AUTHOR]

Objectives: This pilot study primarily aimed to detect the adherence as well as the effect size required to estimate the actual sample size needed for a larger scale study to compare and evaluate the effectiveness of two extracorporeal shock wave therapy (ESWT) protocols along, with a physical therapy program in reducing pain and improving function among patients suffering from plantar fasciitis. The study also aimed to report the effects of the ESWT protocols used on pain and function. Methods: A total of 26 participants took part in the study, including 17 females and 9 males. The average age of the participants was 34 years with a body mass index (BMI) of 23 kg/m2. Participants were divided into three equal groups; Group A received ESWT at a frequency of 15 Hz and intensity of 3, Group B received ESWT at a frequency of 10 Hz and intensity of 4, while Group C underwent the selected physical therapy program along with sham shock wave therapy as a control. Pain levels were assessed using the Visual Analog Scale (VAS) while functional improvements were evaluated using the Foot Function Index (FFI). Data was collected prior to treatment, after three sessions and at the end of six weeks (after six sessions). Results: The three groups were well matched, and the results revealed high adherence rates (90%, 90% and 80% respectively). Results also indicated reductions in pain levels and improvements in function for both intervention groups when compared to the control group. Group A demonstrated better outcomes compared to Group B while Group C showed relatively less improvement. Conclusion: The study concluded a high adherence rate for the three groups as well as a small effect size detected of 0.282 that would suggest a total of 123 participants to be required to replicate the study on a larger scale. With regards to the findings of this pilot, the combination of ESWT and a targeted physical therapy program revealed a possible effective therapeutic approach for plantar fasciitis, with a higher frequency potentially yielding more favourable results. [ABSTRACT FROM AUTHOR]

Objectives: Plantar fasciitis (PF), which accounts for approximately 80% of heel pain, is a common condition affecting adults' quality of life. There are many different treatment modalities used in the treatment of PF. In this study, we compared the clinical and functional outcomes of patients diagnosed with chronic PF in our clinic who underwent USG-guided PRP (platelet-rich plasma) injection and patients who underwent RFNA (radiofrequency nerve ablation) treatment. Methods: Ultrasound-guided PRP injection or RFNA was performed on 95 patients who were diagnosed with chronic PF and met the inclusion criteria. This group of patients was followed for at least one year (October 2021-October 2023), and the clinical and functional results of the patients were compared. Results: The mean pre-treatment Visual Analog Scale (VAS), Foot Function Index (FFI), and American Orthopaedic Foot and Ankle Society (AOFAS) posterior-ankle scores were similar, and no significant difference was found (P>0.05). A significant improvement was observed in the groups' FFI, VAS, and AFOAS scores after treatment (P<0.05). However, no significant difference was found in treatment modalities (P>0.05). Conclusions: As a result of the study, it was concluded that PRP injection and RFNA are effective treatment methods in patients diagnosed with chronic plantar fasciitis without response to other conservative treatment methods, but these two methods are not superior to each other. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study aimed to evaluate the efficacy of application-linked stretching ball instruments that record the rolling time and force of patients compared with a traditional simple stretching ball. Methods: Fourteen participants with plantar fasciitis were divided into a simple massage ball group (group A, n = 8) and an application-linked massage ball group (group B, n = 6). The application-linked massage ball sends information regarding the massages, such as the frequency and force of the massage on the foot, to the application on the patient's smartphone. All clinical outcomes were evaluated at the beginning of the study and 1-, 2-, and 3-month follow-up. The primary outcome measure was the Manchester–Oxford Foot Questionnaire (MOXFQ) score. Results: At the beginning of the study, the initial MOXFQ score was not significantly different between the two groups (p = 0.948). At each time point, the MOXFQ score of the whole population did not improve significantly compared to that of the initial state (p = 0.131). Generalized estimating equation modeling demonstrated that there was no significant difference in the improvement of the MOXFQ score between groups A and B during follow-up (p = 0.826). In addition, no group-by-time interactions were observed (p = 0.457). Conclusions: The efficacy of an application-linked massage ball for the treatment of plantar fasciitis was not as definite as that of a traditional simple stretching ball in patients whose symptoms persisted for at least six months. Future studies that include patients with acute plantar fasciitis are required. [ABSTRACT FROM AUTHOR]

Objective: To analyze the short-term effects of medium-intensity radial shock wave therapy on plantar fasciitis at different energy flux densities. Method: A retrospective analysis was performed on the clinical data of 213 patients with plantar fasciitis treated with medium-intensity radial shockwaves from January 2017 to October 2021: 73 cases were divided in 0.12mJ/ mm² ( A group); 71 cases in 0.14mJ/mm² ( B group); and 69 cases in 0.16mJ/mm² ( C group). The evaluation index were changes in the visual analogue scale(VAS)and the-hindfoot function score of the American Orthopedic Foot and Ankle Society Score(AOFAS)in the 4th week post-treatment compared to pre-treatment. The difference in efficacy between groups was evaluated by the difference between groups before and after treatment with AOFAS score. A regression model was established to explore the relevant factors of good therapeutic outcomes. Result: There were no significant statistical differences in gender, age, unilateral or bilateral condition, duration of illness and BMI among the three groups. All patients had no adverse effects after treatment. The VAS and AOFAS scores in all the three groups improved significantly before and after treatment (P<0.001). There was a statistically significant difference in AOFAS scores between groups (P<0.05). Logistic regression showed that age (OR=0.946, P<0.05), unilateral and bilateral sides of the affected foot (OR=0.102, P<0.05) may be risk factors affecting the therapeutic outcome. Conclusion: Medium-intensity radial shock wave therapy can achieve good short-term efficacy in treating planter fasciitis. However, the energy flow density (0.12—0.16mJ/mm² ) may not be a key factor in determining the therapeutic outcome. [ABSTRACT FROM AUTHOR]