Individuals with Plantar Heel Pain Demonstrate Altered Foot Posture, Plantar Fascia Thickness, and Plantar Cutaneous Sensation

Title

Individuals with Plantar Heel Pain Demonstrate Altered Foot Posture, Plantar Fascia Thickness, and Plantar Cutaneous Sensation

College

College of Health Sciences

Program

Ph.D. Kinesiology & Rehabilitation

Publication Date

3-28-2019

Abstract

Plantar heel pain (PHP) is a common injury in physically active individuals that decreases the ability to participate in physical activity and quality of life. The symptoms of plantar fasciitis are well known, however, there has been inconsistent evidence to explain the multifaceted etiology of this condition. The purpose of the study was to compare foot posture, plantar sensation, plantar fascia thickness and abductor hallucis morphology in individuals with and without PHP. Sixteen individuals with PHP and sixteen matched healthy participants volunteered to participate. Foot posture, plantar sensation, plantar fascia thickness, and abductor hallucis cross-sectional area (CSA) were evaluated in each participant. Foot posture was assessed with the Foot Posture Index-6 (FPI-6). Plantar fascia thickness and abductor hallucis CSA were measured utilizing diagnostic ultrasound. Abductor hallicus CSA was measured while participants performed a short foot exercise. Plantar fascia thickness was measured at three sites from the medial calcaneal tubercle to the second toe. Plantar foot sensation was assessed using Semmes-Weinstein Monofilaments. Sensation thresholds were tested at two aspects on the plantar aspect of the foot. Between group differences were evaluated using independent t-tests for all outcome measures (Alpha ≤0.05). Individuals with PHP exhibited a more pronated foot posture (PHP=6.7±3.4; healthy=3.0±3.6, p=0.01) and displayed greater plantar fascia thickness at the proximal insertion (PHP=0.32±0.09cm; healthy=0.25±0.04cm, p=0.02) compared to healthy controls. Plantar sensation thresholds were higher in the PHP group compared to healthy controls at the head of the first metatarsal (PHP=3.85±0.72; healthy=3.22±0.39, p=0.01) and medial longitudinal arch (PHP=3.91±0.42; healthy=3.62±0.38, p=0.04). There was no difference in abductor hallucis CSA between groups (PHP=2.15±0.53; healthy=1.99±0.57, p=0.41). Individuals with PHP exhibited a more pronated foot posture, thicker plantar fascia, and diminished plantar tactile sensation. Cumulatively, these findings provide evidence that PHP is associated with both mechanical and sensorimotor deficits in the foot.

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Individuals with Plantar Heel Pain Demonstrate Altered Foot Posture, Plantar Fascia Thickness, and Plantar Cutaneous Sensation


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