Department of Physiotherapy and Rehabilitation, Yeditepe University, Istanbul, Atasehir, Turkey.
Division of Orthopedics and Traumatology, Yeditepe University, Istanbul, Turkey.
Foot Ankle Int. 2019 Nov;40(11):1295-1303. doi: 10.1177/1071100719865302. Epub 2019 Aug 6.
We compared the effectiveness of stretching and strengthening exercises combined with myofascial releasing and mobilization techniques to a stretching and strengthening only home program in plantar fasciitis (PF) management.
The study included 53 feet of 47 patients with plantar fasciitis (35 women / 12 men; mean age 48.9±11.2 years). Pain, disability, and activity restrictions were assessed by Foot Function Index (FFI), and first step pain was graded by visual analog scale (VAS). Ankle range of motion (ROM), gastrocnemius-soleus flexibility, proprioception, dynamic balance, and foot sensation were also considered. The patients were randomly divided into outpatient clinic treatment (Outpatient, n = 27 feet) and home rehabilitation groups (Home, n = 26 feet). Patient education was routine for all at the beginning of the management programs. In the Outpatient group, the foot-ankle-hip exercise program, myofascial releasing, and joint and soft tissue mobilization techniques were "hands on" at a clinic (twice a week for 8 weeks), whereas the Home group completed their home rehabilitation program on their own (8 weeks' duration with follow-ups every week).
VAS, FFI, ROM, balance, proprioception, foot sense, and flexibility improved at the eighth week in both groups according to intragroup comparison ( < .05). When the 2 groups were compared, the results of plantar flexion range, balance, proprioception, foot sensation, flexibility, FFI, and VAS showed significant improvements in the Outpatient vs the Home group ( < .05). Also, the FFI and VAS scores at the sixth month were superior in the Outpatient group ( < .05).
A combined supervised management protocol had superior clinical results in plantar fasciitis management.
Level II, comparative study.
我们比较了伸展和强化锻炼结合肌筋膜松解和动员技术与仅伸展和强化的家庭方案在足底筋膜炎（PF）管理中的效果。
该研究包括 53 只脚的 47 名足底筋膜炎患者（35 名女性/12 名男性；平均年龄 48.9±11.2 岁）。通过足部功能指数（FFI）评估疼痛、残疾和活动受限程度，通过视觉模拟量表（VAS）评估第一步疼痛程度。还考虑了踝关节活动度（ROM）、比目鱼肌-跟腱柔韧性、本体感觉、动态平衡和足部感觉。患者随机分为门诊治疗（门诊，n=27 只脚）和家庭康复组（家庭，n=26 只脚）。在管理方案开始时，所有患者都接受了常规的患者教育。在门诊组，足部-踝-髋运动方案、肌筋膜松解和关节及软组织动员技术在诊所进行“手工”治疗（每周两次，持续 8 周），而家庭组则自行完成家庭康复方案（持续 8 周，每周进行一次随访）。
根据组内比较，两组在第八周时 VAS、FFI、ROM、平衡、本体感觉、足部感觉和柔韧性均有所改善（<0.05）。当比较两组时，门诊组在跖屈 ROM、平衡、本体感觉、足部感觉、柔韧性、FFI 和 VAS 方面的结果明显优于家庭组（<0.05）。此外，门诊组在第六个月时的 FFI 和 VAS 评分更优（<0.05）。
联合监督管理方案在足底筋膜炎管理中具有更好的临床效果。
二级，比较研究。
