title: Higher body mass index is associated with plantar fasciopathy/'plantar fasciitis': systematic review and meta-analysis of various clinical and imaging risk factors.
abstract: OBJECTIVE
  What (risk) factors are associated with plantar fasciopathy (PF)?
  
  
  METHODS
  Systematic review with meta-analyses.
  
  
  METHODS
  Patients with PF.
  
  
  METHODS
  All factors described in prospective, case-control or cross-sectional observational studies.
  
  
  RESULTS
  51 included studies (1 prospective, 46 case-control and 4 cross-sectional studies) evaluated a total of 104 variables. Pooling was possible for 12 variables. Higher body mass index (BMI) (BMI>27, OR 3.7 (95% CI 2.93 to 5.62)) in patients with PF was the only significant clinical association, and its effect was the strongest in the non-athletic subgroup. In people with PF compared to controls, pooled imaging data demonstrated a significantly thicker, hypoechogenic plantar fascia with increased vascular signal and perifascial fluid collection. In addition, people with PF were more likely to have a thicker loaded and unloaded heel fat pat, and bone findings, including a subcalcaneal spur and increased Tc-99 uptake. No significant difference was found in the extension of the first metatarsophalangeal joint.
  
  
  CONCLUSIONS
  We found a consistent clinical association between higher BMI and plantar fasciopathy. This association may differ between athletic and non-athletic subgroups. While consistent evidence supports a range of bone and soft tissue abnormalities, there is lack of evidence for the dogma of clinical and mechanical measures of foot and ankle function. Clinicians can use this information in shared decision-making.
authors.affiliation: Department of General Practice, Erasmus MC University Medical Center Rotterdam, The Netherlands.
authors.forename: K D B
authors.initials: KD
authors.lastname: van Leeuwen
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Rogers
authors.affiliation: Faculty of Health, Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: T
authors.initials: T
authors.lastname: Winzenberg
authors.affiliation: Department of General Practice, Erasmus MC University Medical Center Rotterdam, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: van Middelkoop
mesh_terms: D000328:Adult; D000843:Ankle Joint / Q000502:physiology; D001696:Biomechanical Phenomena / Q000502:physiology; D015992:Body Mass Index; D002111:Calcaneus / Q000502:physiology; D004812:Epidemiologic Methods; D015444:Exercise / Q000502:physiology; D036981:Fasciitis, Plantar / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D000070633:Hamstring Muscles / Q000502:physiology; D006365:Heel / Q000502:physiology; D006801:Humans; D008683:Metatarsophalangeal Joint / Q000502:physiology; D053580:Muscle Strength / Q000502:physiology; D011187:Posture / Q000502:physiology; D011379:Prognosis; D012775:Shoes
keywords: Epidemiology; Foot; Review