title: A combined treatment approach emphasizing impairment-based manual physical therapy for plantar heel pain: a case series.
abstract: METHODS
  Case series.
  
  
  OBJECTIVE
  To describe an impairment-based physical therapy treatment approach for 4 patients with plantar heel pain.
  
  
  BACKGROUND
  There is limited evidence from clinical trials on which to base treatment decision making for plantar heel pain.
  
  
  METHODS
  Four patients completed a course of physical therapy based on an impairment-based model. All patients received manual physical therapy and stretching. Two patients were also treated with custom orthoses, and 1 patient received an additional strengthening program. Outcome measures included a numeric pain rating scale (NPRS) and self-reported functional status.
  
  
  RESULTS
  Symptom duration ranged from 6 to 52 weeks (mean duration+/-SD, 33+/-19 weeks). Treatment duration ranged from 8 to 49 days (mean duration+/-SD, 23+/-18 days), with number of treatment sessions ranging from 2 to 7 (mode, 3). All 4 patients reported a decrease in NPRS scores from an average (+/-SD) of 5.8+/-2.2 to 0 (out of 10) during previously painful activities. Additionally, all patients returned to prior activity levels.
  
  
  CONCLUSIONS
  In this case series, patients with plantar heel pain treated with an impairment-based physical therapy approach emphasizing manual therapy demonstrated complete pain relief and full return to activities. Further research is necessary to determine the effectiveness of impairment-based physical therapy interventions for patients with plantar heel pain/plantar fasciitis.
authors.affiliation: Physical Therapy Department, Wilford Hall Medical Center, Lackland Air Force Base, TX, USA. brian.young@lackland.af.mil
authors.forename: Brian
authors.initials: B
authors.lastname: Young
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Walker
authors.forename: Joseph
authors.initials: J
authors.lastname: Strunce
authors.forename: Robert
authors.initials: R
authors.lastname: Boyles
mesh_terms: D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000503:physiopathology; D036981:Fasciitis, Plantar / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000379:methods*; D009989:Orthotic Devices; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology; D016474:Weight-Bearing / Q000502:physiology