Plantar fasciopathy treated with dynamic splinting: a randomized controlled trial.
BACKGROUND
Plantar fasciopathy (or plantar fasciitis) is considered to be one of the most common foot abnormalities, affecting up to 2 million Americans each year, and the chief complaint is acute heel pain. Therapeutic protocols for this condition have included stretching exercises, corticosteroid injections, physical therapy, and foot orthoses, but a single modality has not been found to be universally effective. We sought to determine the efficacy of stretching with dynamic splinting for the treatment of plantar fasciitis.


METHODS
Sixty patients (76 feet) were enrolled in this 12-week study from four different clinics across the United States. Patients were randomly categorized into experimental and control groups. All of the patients received nonsteroidal anti-inflammatory drugs, orthoses, and corticosteroid injections if needed. Thirty experimental patients also received dynamic splinting for nightly wear to obtain a low-load, prolonged-duration stretch with dynamic tension. The dependent variable was change from baseline in Plantar Fasciopathy Pain/Disability Scale score, and the independent variable was group (experimental versus control).


RESULTS
Two-sample t tests were calculated, and there was a significant difference in the mean change scores of experimental versus control patients (-33 versus -2 points, P < .0001).


CONCLUSIONS
Dynamic splinting was effective for reducing the pain of plantar fasciopathy, and this modality should be included in the standard of care for treating plantar fasciopathy.
Sheridan
Larry
L
Musculoskeletal Services, Kaiser Permanente, Sacramento, CA, USA.
Lopez
Angel
A
Perez
Andres
A
John
Mathew M
MM
Willis
F Buck
FB
Shanmugam
Ramalingam
R
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D036981:Fasciitis, Plantar / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000295:instrumentation*; D009989:Orthotic Devices; D010147:Pain Measurement; D016059:Range of Motion, Articular; D013165:Splints; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids