Predicting the outcome of plantar heel pain

NewsBot · May 13, 2023

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Predicting the outcome of plantar heel pain in adults: a systematic review of prognostic factors
Halime Gulle, Dylan Morrissey, Xiang Li Tan, Matthew Cotchett, Stuart Charles Miller, Aleksandra Birn Jeffrey & Trevor Prior
Journal of Foot and Ankle Research volume 16, Article number: 28 (2023)

Background
Plantar Heel Pain (PHP) is a common disorder with many treatment pathways and is not self-limiting, hence prognostic information concerning recovery or recalcitrance is needed to guide practice. In this systematic review, we investigate which prognostic factors are associated with favourable or unfavourable PHP outcomes.

Methods
MEDLINE, Web of Science, EMBASE, Scopus and PubMed electronic bibliographic databases were searched for studies evaluating baseline patient characteristics associated with outcomes in prospective longitudinal cohorts or after specific interventions. Cohort, clinical prediction rule derivation and single arms of randomised controlled trials were included. Risk of bias was evaluated with method-specific tools and evidence certainty with GRADE.

Results
The review included five studies which evaluated 98 variables in 811 participants. Prognostic factors could be categorised as demographics, pain, physical and activity-related. Three factors including sex and bilateral symptoms (HR: 0.49[0.30–0.80], 0.33[0.15–0.72], respectively) were associated with a poor outcome in a single cohort study. The remaining four studies reported twenty factors associated with a favourable outcome following shockwave therapy, anti-pronation taping and orthoses. Heel spur (AUC = 0.88[0.82–0.93]), ankle plantar-flexor strength (Likelihood ratio (LR): 2.17[1.20–3.95]) and response to taping (LR = 2.17[1.19–3.90]) were the strongest factors predicting medium-term improvement. Overall, the study quality was low. A gap map analysis revealed an absence of research that included psychosocial factors.

Conclusions
A limited number of biomedical factors predict favourable or unfavourable PHP outcomes. High quality, adequately powered, prospective studies are required to better understand PHP recovery and should evaluate the prognostic value of a wide range of variables, including psychosocial factors.
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NewsBot · Oct 26, 2023

Responsiveness of specific and generic patient-reported outcome measures in
patients with plantar fasciopathy
Marte Heide et al
Source

Purpose: To evaluate and compare responsiveness characteristics for the Foot Function Index revised
short form (FFI-RS), RAND-12 Health Status Inventory (RAND-12), and Numeric Rating Scale (NRS), in
patients with plantar fasciopathy receiving non-surgical treatment.
Materials and methods: This study was conducted on a sub-group of patients from an ongoing
randomised controlled trial. One-hundred fifteen patients were included. The patient-reported outcome
measures (PROMs) were applied at baseline and after 6months. Responsiveness was calculated using
standardised response mean and area under the receiver operating characteristic (ROC) curve. ROC
curves were used to compute the minimal important change (MIC) for the outcome measures.
Results: The region specific FFI-RS had best responsiveness and the NRS at rest had lowest
responsiveness.
Conclusion: FFI-RS were marginally more responsive than the other PROMs. Responsiveness and MIC
estimates should be regarded as indicative rather than fixed estimates.
hIMPLICATIONS FOR REHABILITATION
• The region-specific Foot Function Index Revised Short Form could, based on responsiveness
perspectives, be recommended as an outcome measurement for patients with plantar fasciopathy.
• Responsiveness and minimal important change estimates are indicative and should be interpreted
with caution.
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