Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, 3086, Australia.
La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, 3086, Australia.
J Foot Ankle Res. 2020 Sep 29;13(1):60. doi: 10.1186/s13047-020-00428-6.
BACKGROUND: Foot orthoses and corticosteroid injection are common interventions used for plantar heel pain, however few studies have investigated the variables that predict response to these interventions. METHODS: Baseline variables (age, weight, height, body mass index (BMI), sex, education, foot pain, foot function, fear-avoidance beliefs and feelings, foot posture, weightbearing ankle dorsiflexion, plantar fascia thickness, and treatment preference) from a randomised trial in which participants received either foot orthoses or corticosteroid injection were used to predict change in the Foot Health Status Questionnaire foot pain and foot function subscales, and first-step pain measured using a visual analogue scale. Multivariable linear regression models were generated for different dependent variables (i.e. foot pain, foot function and first-step pain), for each intervention (i.e. foot orthoses and corticosteroid injection), and at different timepoints (i.e. weeks 4 and 12). RESULTS: For foot orthoses at week 4, greater ankle dorsiflexion with the knee extended predicted reduction in foot pain (adjusted R = 0.16, p = 0.034), and lower fear-avoidance beliefs and feelings predicted improvement in foot function (adjusted R = 0.43, p = 0.001). At week 12, lower BMI predicted reduction in foot pain (adjusted R = 0.33, p < 0.001), improvement in foot function (adjusted R = 0.37, p < 0.001) and reduction in first-step pain (adjusted R 0.19, p = 0.011). For corticosteroid injection at week 4, there were no significant predictors for change in foot pain or foot function. At week 12, less weightbearing hours predicted reduction in foot pain (adjusted R = 0.25, p = 0.004) and lower baseline foot pain predicted improvement in foot function (adjusted R = 0.38, p < 0.001). CONCLUSIONS: People with plantar heel pain who use foot orthoses experience reduced foot pain if they have greater ankle dorsiflexion and lower BMI, while they experience improved foot function if they have lower fear-avoidance beliefs and lower BMI. People who receive a corticosteroid injection experience reduced foot pain if they weightbear for fewer hours, while they experience improved foot function if they have less baseline foot pain.
背景：足部矫形器和皮质类固醇注射是治疗足底足跟痛的常用方法，但很少有研究调查这些干预措施的反应预测变量。
方法：从一项参与者接受足部矫形器或皮质类固醇注射的随机试验中，使用基线变量（年龄、体重、身高、体重指数（BMI）、性别、教育程度、足部疼痛、足部功能、恐惧回避信念和感觉、足部姿势、负重踝关节背屈、足底筋膜厚度和治疗偏好）来预测足底健康状况问卷足部疼痛和足部功能子量表的变化，以及使用视觉模拟量表测量的第一步疼痛。为不同的因变量（即足部疼痛、足部功能和第一步疼痛）、每种干预措施（即足部矫形器和皮质类固醇注射）和不同的时间点（即第 4 周和第 12 周）生成多变量线性回归模型。
结果：在第 4 周使用足部矫形器时，膝关节伸展时更大的踝关节背屈预示着足部疼痛的减轻（调整后的 R=0.16，p=0.034），而较低的恐惧回避信念和感觉预示着足部功能的改善（调整后的 R=0.43，p=0.001）。在第 12 周时，较低的 BMI 预示着足部疼痛的减轻（调整后的 R=0.33，p<0.001），足部功能的改善（调整后的 R=0.37，p<0.001）和第一步疼痛的减轻（调整后的 R=0.19，p=0.011）。在第 4 周接受皮质类固醇注射时，足部疼痛或足部功能的变化没有显著的预测因素。在第 12 周时，更少的负重时间预示着足部疼痛的减轻（调整后的 R=0.25，p=0.004），而较低的基线足部疼痛预示着足部功能的改善（调整后的 R=0.38，p<0.001）。
结论：患有足底足跟痛的人使用足部矫形器，如果踝关节背屈更大，BMI 更低，他们的足部疼痛会减轻，如果他们的恐惧回避信念和 BMI 更低，他们的足部功能会改善。接受皮质类固醇注射的人，如果负重时间更少，他们的足部疼痛会减轻，如果他们的基线足部疼痛更小，他们的足部功能会改善。
J Foot Ankle Res. 2020-9-29
J Orthop Sports Phys Ther. 2019-5-26
BMC Musculoskelet Disord. 2019-8-17
BMC Musculoskelet Disord. 2018-7-18
J Am Podiatr Med Assoc. 2015-7
J Orthop Sports Phys Ther. 2016-8
BMC Musculoskelet Disord. 2024-12-20
Anesth Pain Med. 2023-1-13
J Foot Ankle Res. 2020-3-6
J Orthop Sports Phys Ther. 2019-5-26
Contemp Clin Trials Commun. 2016-11-23
J Orthop Sports Phys Ther. 2014-11
Foot Ankle Int. 2015-1
Zotero 插件