Gulle Halime, Morrissey Dylan, Tayfur Abdulhamit, Coskunsu Dilber Karagozoglu, Miller Stuart, Birn-Jeffery Aleksandra V, Prior Trevor
School of Physical Therapy and Rehabilitation Science, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Sports and Exercise Medicine, William Harvey Research Institute, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, London, UK.
J Foot Ankle Res. 2024 Dec;17(4):e70022. doi: 10.1002/jfa2.70022.
Plantar Heel Pain (PHP) can be a debilitating musculoskeletal condition from which only 50% recover within a year due to poor understanding of the mechanisms explaining severity and predicting outcomes specific to PHP.
To explore associations between biopsychosocial variables and the severity of people with PHP. Secondly, to determine what combination of self-reported factors distinguishes people with PHP from other foot pain (OFP).
We collected data from 235 participants, including 135 (%57) PHP (age 44 ± 12 years, 66% female) and 99 OFP (%43) (age 38 ± 11 years, 57% female) using 5 demographic, 13 biomedical, 8 psychological, 3 social and 8 activity-related factors. These were tested in linear and logistic regression models.
Quality of life (QoL) (β = 0.35; p < 0.001), education (β = -0.22; p = 0.003), gender (β = -0.20; p = 0.007), morning pain duration (β = -0.18; p = 0.01) and disease duration (β = -0.15; p = 0.040) were significantly associated with severity of PHP. The second model, without QoL, showed that having sensitisation (β = -0.18; p = 0.002) and a higher level of morning pain (β = -0.20; p = 0.01) are associated with severity. The logistic regression results revealed that people with PHP tend to have a systemic disease (OR = 3.34; 1.53-7.76), express more kinesiophobia (OR = 1.02; 1.01-1.14), are less likely to have previous injuries (OR = 0.40; 0.19-0.81), worse morning pain (OR = 1.02; 1.01-1.03) and standing pain (OR = 2.60; 1.39-4.87) compared to people with OFP.
People with PHP have higher associated levels of a range of psychological, social and activity related factors than people with OFP. The findings highlight the importance of considering psychosocial assessments alongside physical examination.
足底足跟痛（PHP）可能是一种使人衰弱的肌肉骨骼疾病，由于对解释其严重程度和预测特定于PHP的结果的机制了解不足，一年内只有50%的患者能够康复。
探讨生物心理社会变量与PHP患者严重程度之间的关联。其次，确定自我报告因素的何种组合能够区分PHP患者与其他足部疼痛（OFP）患者。
我们收集了235名参与者的数据，其中包括135名（57%）PHP患者（年龄44±12岁，66%为女性）和99名OFP患者（43%）（年龄38±11岁，57%为女性），涉及5个人口统计学因素、13个生物医学因素、8个心理因素、3个社会因素和8个与活动相关的因素。这些因素在线性和逻辑回归模型中进行了测试。
生活质量（QoL）（β = 0.35；p < 0.001）、教育程度（β = -0.22；p = 0.003）、性别（β = -0.20；p = 0.007）、晨起疼痛持续时间（β = -0.18；p = 0.01）和疾病持续时间（β = -0.15；p = 0.040）与PHP的严重程度显著相关。在不包括QoL的第二个模型中，显示有敏化反应（β = -0.18；p = 0.002）和较高水平的晨起疼痛（β = -0.20；p = 0.01）与严重程度相关。逻辑回归结果显示，与OFP患者相比，PHP患者更容易患有全身性疾病（OR = 3.34；1.53 - 7.76），表现出更多的运动恐惧症（OR = 1.02；1.01 - 1.14），既往受伤的可能性较小（OR = 0.40；0.19 - 0.81），晨起疼痛更严重（OR = 1.02；1.01 - 1.03）和站立疼痛更严重（OR = 2.60；1.39 - 4.87）。
与OFP患者相比，PHP患者在一系列心理、社会和与活动相关的因素方面具有更高的关联水平。研究结果强调了在体格检查的同时考虑心理社会评估的重要性。
