Physiotherapy for Plantar Fasciitis

NewsBot · Feb 13, 2016

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Physiotherapy for plantar fasciitis: A UK-wide survey of current practice
Rob Grieve, PhD, Shea Palmer, PhD
Physiotherapy; Article in Press

Objectives
To identify how United Kingdom (UK) physiotherapists currently diagnose, assess and manage plantar fasciitis in routine practice

Design
Online questionnaire survey

Participants
Practising physiotherapists across the UK who treat patients with plantar fasciitis.

Methods
Physiotherapists were approached via ́interactive Chartered Society of Physiotherapy (CSP)́ online networks and an email database of clinical educators in South West England. An online questionnaire was developed by reviewing similar existing physiotherapy surveys and consultation with experienced musculoskeletal researchers/clinicians. Descriptive statistics were used to analyse the data.

Results
285 physiotherapists responded, with 257 complete survey responses. Pain on palpation and early morning pain were the most common diagnostic criteria, with some physiotherapists using no formal test criteria. Advice (237/257,92%), plantar fasciitis pathology education (207/257,81%) and general stretching exercises (189/257, 74%) were most routinely used. Prefabricated orthotics, custom made orthotics and night splints were seldom used. For the manual therapy approach, the most frequently used modalities were massage, myofascial release, specific soft tissue mobilisations and myofascial trigger point therapy. Commonly used outcome measures were pain assessment, functional tests and range of movement.

Conclusions
Physiotherapists appeared to follow most of the established diagnostic criteria for PF, but have not followed established outcome measure guidelines. Advice and education with an emphasis on self-management including calf/hamstring stretching was the most commonly reported treatment approach. There is uncertainty whether this approach accurately reflects clinical practice used throughout the UK, due to potential response bias/unknown response rate and the low number of patients with PF treated by the respondents.
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NewsBot · Feb 1, 2017

Utilization of Physical Therapy Intervention Among Patients With Plantar Fasciitis in the United States
John J. Fraser, PT, MS, OCS, Neal R. Glaviano, PhD, ATC, Jay Hertel, PhD, ATC
Journal of Orthopaedic & Sports Physical Therapy, 2017 Volume:47 Issue:2 Pages:49–55 DOI: 10.2519/jospt.2017.6999

Study Design
Retrospective observational study.

Background
Plantar fasciitis is responsible for 1 million ambulatory patient care visits annually in the United States. Few studies have investigated practice patterns in the treatment of patients with plantar fasciitis.

Objective
To assess physical therapist utilization and employment of manual therapy and supervised rehabilitation in the treatment of patients with plantar fasciitis.

Methods
A retrospective review of the PearlDiver patient record database was used to evaluate physical therapist utilization and use of manual therapy and supervised rehabilitation in patients with plantar fasciitis between 2007 and 2011. An International Classification of Diseases code (728.71) was used to identify plantar fasciitis, and Current Procedural Terminology codes were used to identify evaluations (97001), manual therapy (97140), and rehabilitation services (97110, 97530, 97112).

Results
A total of 819 963 unique patients diagnosed with plantar fasciitis accounted for 5 739 737 visits from 2007 to 2011, comprising 2.7% of all patients in the database. Only 7.1% (95% confidence interval: 7.0%, 7.1%) of patients received a physical therapist evaluation. Of the 57 800 patients evaluated by a physical therapist (59.8% female), 50 382 (87.2% ± 0.4%) received manual therapy, with significant increases in utilization per annum. A large proportion (89.5% ± 0.4%) received rehabilitation following physical therapist evaluation.

Conclusion
Despite plantar fasciitis being a frequently occurring musculoskeletal condition, a small proportion of patients with plantar fasciitis were seen by physical therapists. Most patients who were evaluated by a physical therapist received manual therapy and a course of supervised rehabilitation as part of their plan of care.
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NewsBot · Sep 2, 2017

The symptomatic and functional effects of manual physical therapy on plantar heel pain: a systematic review.
Mischke JJ et al
J Man Manip Ther. 2017 Feb;25(1):3-10. doi: 10.1080/10669817.2015.1106818.

OBJECTIVES:
Plantar heel pain is common and can be severely disabling. Unfortunately, a gap in the literature exists regarding the optimal intervention for this painful condition. Consequently, a systematic review of the current literature regarding manual therapy for the treatment of plantar heel pain was performed.
METHODS:
A computer-assisted literature search for randomized controlled trials in MEDLINE, EMBASE, Cochrane, CINAHL, and Rehabilitation & Sports Medicine Source, was concluded on 7 January 2014. After identification of titles, three independent reviewers selected abstracts and then full-text articles for review.
RESULTS:
Eight articles were selected for the final review and underwent PEDro scale assessment for quality. Heterogeneity of the articles did not allow for quantitative analysis. Only two studies scored ≥7/10 on the PEDro scale and included joint, soft tissue, and neural mobilization techniques. These two studies showed statistically greater symptomatic and functional outcomes in the manual therapy group.
DISCUSSION:
This review suggests that manual therapy is effective in the treatment of plantar heel pain; however, further research is needed to validate these findings given the preponderance of low quality studies.
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