Efficacy of taping for the treatment of plantar fasciosis: a systematic review of controlled trials

Sonographic and clinical effects of manual physical therapy for plantar fasciitis: randomized prospective controlled trial

OBJECTIVE

This study aimed to evaluate the efficacy of manual physiotherapy on clinical outcomes, morphology of plantar fascia (PF), thicknesses of calcaneal fat pad (CFP) and Kager's fat pad (KFP) with ultrasound imaging in plantar fasciitis (PFS) patients. Also, to evaluate the PF thickness, pain and foot functional outcomes among PFS phases.

METHODS

A randomized controlled trial was conducted on 122 subjects divided into three groups: group A (40 patients with PFS) underwent manual physiotherapy, group B (42 patients with PFS) without any intervention and group C (40 healthy subjects) were matched by age, gender and BMI with each patient in group A and B. The following outcomes were evaluated at baseline and one-month of follow-ups: morphology of PF and thicknesses of CFP and KFP, pain, foot functional limitation.

RESULTS

PF thickness was significantly thickened in group A and B compared to group C (P < 0.001). A significant decrease in incidence of PF echogenicity and CFP thickness were found in group A and B compared to group C. Moreover, significant improvement was observed in PF thickness (P < 0.001), PF echogenicity (P < 0.001) and CFP thickness (P = 0.002) in group A at one-month after the treatment. Furthermore, pain intensity and foot functional limitation was significantly improved within group A after receiving the treatment. Significant improvement was noted in PF thickness, pain intensity and foot functional limitation among patients with acute phase.

CONCLUSION

The manual physiotherapy is effective in treatment of PF thickening, hypoechogenicity, pain intensity and activity limitations, particularly in patients associated with acute PFS.

A Systematic Review of Systematic Reviews on the Epidemiology, Evaluation, and Treatment of Plantar Fasciitis

The number of systematic review and meta-analyses on plantar fasciitis is expanding. The purpose of this review was to provide a comprehensive summary of reviews on the topic pertaining to plantar fasciitis, identify any conflicting and inconsistent results, and propose future research direction. A qualitative review of all systematic reviews and meta-analyses related to plantar fasciitis up to February 2021 was performed using PubMed, Embase, Web of Science, and the Cochrane Database. A total of 1052 articles were initially identified and 96 met the inclusion criteria. Included articles were summarized and divided into the following topics: epidemiology, diagnosis, and treatment. While the majority of reviews had high level of heterogeneity and included a small number of studies, there was general consensus on certain topics, such as BMI as a risk factor for plantar fasciitis and extracorporeal shockwave therapy as an effective mode of therapy. A qualitative summary of systematic reviews and meta-analyses published on plantar fasciitis provides a single source of updated information for clinicians. Evidence on topics such as the epidemiology, exercise therapy, or cost-effectiveness of treatment options for plantar fasciitis are lacking and warrant future research.

Taping for conditions of the musculoskeletal system: an evidence map review

Background

Taping is a common treatment modality used by many rehabilitation providers. Several types of tapes and taping methods are used in the treatment of musculoskeletal dysfunction and pain.

Purpose

To summarize and map the evidence related to taping methods used for various joints and conditions of the musculoskeletal system, and to provide clinicians and researchers with a user-friendly reference with organized evidence tables.

Data sources

The PEDro, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Central Register for Controlled Trials, PubMed, and PROSPERO databases were searched from inception through October 31, 2019.

Study selection

Eligible studies were selected by two independent reviewers and included either systematic reviews (SRs) or randomized controlled trials (RCTs) and included a musculoskeletal complaint using a clinical outcome measure.

Data extraction

Data was extracted by two investigators independently. Risk of bias and quality were assessed using A MeaSurement Tool to Assess systematic Reviews (AMSTAR) for SRs or the Physiotherapy Evidence Database (PEDro) scale for RCTs. The protocol was registered with PROSPERO (CRD42019122857).

Data synthesis

Twenty-five musculoskeletal conditions were summarized from forty-one SRs and 127 RCTs. There were 6 SRs and 49 RCTs for spinal conditions. Kinesio tape was the most common type of tape considered. Four evidence tables representing the synthesized SRs and RCTs were produced and organized by body region per condition.

Limitations

Inclusion of only English language studies. Also, the heterogeneous nature of the included studies prevented a meta-analysis.

Conclusions

There is mixed quality evidence of effectiveness for the different types of taping methods for different body regions and conditions. All of the SRs and RCTs found during our search of the taping literature have been organized into a series of appendices. A synthesis of the results have been placed in evidence tables that may serve as a useful guide to clinicians and researchers.

Effectiveness of Mechanical Treatment for Plantar Fasciitis: A Systematic Review

CONTEXT

Plantar fasciitis is one of the most common foot injuries. Several mechanical treatment options, including shoe inserts, ankle-foot orthoses, tape, and shoes are used to relieve the symptoms of plantar fasciitis.

OBJECTIVES

To investigate the effectiveness of mechanical treatment in the management of plantar fasciitis.

EVIDENCE ACQUISITION

The review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. A systematic search was performed in PubMed, CINAHL, Embase, and Cochrane up to March 8, 2018. Two independent reviewers screened eligible articles and assessed risk of bias using the Cochrane Collaboration's risk of bias tool.

EVIDENCE SYNTHESIS

A total of 43 articles were included in the study, evaluating 2837 patients. Comparisons were made between no treatment and treatment with insoles, tape, ankle-foot orthoses including night splints and shoes. Tape, ankle-foot orthoses, and shoes were also compared with insoles. Follow-up ranged from 3 to 5 days to 12 months. Cointerventions were present in 26 studies.

CONCLUSIONS

Mechanical treatment can be beneficial in relieving symptoms related to plantar fasciitis. Contoured full-length insoles are more effective in relieving symptoms related to plantar fasciitis than heel cups. Combining night splints or rocker shoes with insoles enhances improvement in pain relief and function compared with rocker shoes, night splints, or insoles alone. Taping is an effective short-term treatment. Future studies should aim to improve methodological quality using blinding, allocation concealment, avoid cointerventions, and use biomechanical measures of treatment effects.

Prediction on the plantar fascia strain offload upon Fascia taping and Low-Dye taping during running

Background

Taping is commonly prescribed to treat plantar fasciitis for runners by virtue of its alleged ability to offload the plantar fascia and facilitate positive injury prognosis. Our study aimed to investigate how different taping methods could change the loading on the plantar fascia during running using computational simulations.

Methods

A finite element foot model was modified from a previous version to fit the study's purpose. The model featured twenty bones, bulk soft tissue, foot muscles, ligaments/tendons, and a solid part representing the plantar fascia. A runner performed several running trials under one untaped condition and two taped conditions—Low-Dye taping and Fascia taping, which were implemented by a physiotherapist using the Kinesio tapes. The captured motion data were processed to drive a scaled musculoskeletal model and calculate segmental kinematics, foot muscle force, and joint reaction force. These variables were then input as the boundary/loading conditions for finite element analyses of running. The principal tensile strain on the plantar fascia, subtalar eversion, and navicular height during the stance phase were averaged across five trials of each condition and compared using Friedman's test.

Results

Maximal subtalar eversion did not differ among conditions (p = 0.449). Fascia taping significantly reduced maximal strains on the fascia band (p = 0.034, Kendall's W = 0.64–0.76) and increased the navicular height (p = 0.013, Kendall's W = 0.84) compared with nontaping. There were no significant differences in all outcome variables between Low-Dye taping and nontaping (p = 0.173–0.618).

Conclusion

From a mechanical point of view, our study provided quantitative evidence to support the application of taping treatments for overstrained plantar fascia. The untensed fascia band by Fascia taping could be a potential indicator of pain relief for the runners. However, a prospective study targeting the patient population would be needed to address the point.

The Translational Potential of this Article

The study quantified the loading status of the plantar fascia during running and provided mechanical evidence to support the usage of taping as a mean to reduce fascial strain, thus possibly controlling injury risks for the runners. The results of the study also highlighted the importance of selecting specific taping methods based on individuals' needs.

Extracorporeal Shockwave Therapy Plus Rehabilitation for Patients With Chronic Plantar Fasciitis Might Reduce Pain and Improve Function but Still Not Lead to Increased Activity: A Case-Series Study With Multiple Outcome Measures

Plantar fasciitis is a common cause of plantar-aspect heel pain. Although many patients will improve, a proportion will have ongoing and sometimes debilitating symptoms. Evidence from randomized controlled trials has shown that extracorporeal shockwave therapy (ESWT) results in benefits in treating pain. However, uncertainties remain whether these benefits translate to improvements in overall function. The present prospective case series examined the results from 35 patients with chronic plantar fasciitis who had undergone a course of ESWT in addition to a graded rehabilitation program. Of the 35 subjects, 34% were male, and the median age was 50.9 years. The duration of symptoms before ESWT was 24 months. The results of the present case series demonstrated statistically significant improvements in measures of self-reported "average pain" from a median of 7.0 of 10 at baseline to 5.0 of 10 at 3 months (p < .001) and of "worst pain" from 9.0 of 10 at baseline to 7.0 of 10 at 3 months (p < .001). In addition, significant improvements were found in several validated patient-rated outcome measures of local foot/ankle function but not in overall markers of health, anxiety/depression scores, or activity levels, despite the improvements in pain. No statistically significant correlations were found between gender, age, or chronicity of symptoms and the improvements seen. No significant side effects occurred in the present study. The results of our series support the use of ESWT for patients with chronic plantar fasciitis for local pain symptoms; however, uncertainties remain regarding global benefits to health.

American College of Foot and Ankle Surgeons Clinical Consensus Statement: Diagnosis and Treatment of Adult Acquired Infracalcaneal Heel Pain

Adult acquired inferior calcaneal heel pain is a common pathology seen in a foot and ankle practice. A literature review and expert panel discussion of the most common findings and treatment options are presented. Various diagnostic and treatment modalities are available to the practitioner. It is prudent to combine appropriate history and physical examination findings with patient-specific treatment modalities for optimum success. We present the most common diagnostic tools and treatment options, followed by a discussion of the appropriateness of each based on the published data and experience of the expert panel.

The effect of kinesiotaping on hand function in stroke patients: A pilot study

Upper extremity motor impairment is one of the most prevalent problems following stroke. Considering the functional importance of the upper extremity in the daily life, the purpose of this study was to investigate the effect of kinesiotaping (KT) on hand function and spasticity in individuals following a stroke. Eight individuals who had experienced a stroke, with their age ranging from 47 to 66, participated in this pretest-posttest clinical study. An I- strip of tape was placed on the extensor muscles of the forearm. Primary outcome measures were the Modified Modified Ashwoth Scale, Box and Block test, and Nine Hole Peg test. At the immediate assessment, there were significant differences between two hand function tests scores. Secondary assessment was done after one week and the results showed significant differences between two hand function test scores. There was no significant change in flexor muscles spasticity after the intervention. This pilot study indicated that KT in the direction of the extensor muscles could result in better hand function in stroke patients.

Development of a clinical prediction rule to identify patients with plantar heel pain likely to benefit from biomechanical anti-pronation taping: A prospective cohort study

OBJECTIVES

To develop a clinical prediction rule (CPR) to identify patients with plantar heel pain (PHP) likely to benefit from biomechanical anti-pronation taping (BAPT).

DESIGN

A prospective cohort study.

SETTING

An outpatient rehabilitation department in a general hospital.

PARTICIPANTS

Seventy-five patients with PHP.

MAIN OUTCOME MEASURES

After completing a series of physical examinations, all patients received BAPT and were evaluated with a numeric rating scale for pain intensity, the patient-specific functional scale and foot function index (FFI) for function, and the global rating of change for perceived improvement.

RESULTS

Twenty-eight patients achieved a successful outcome. A CPR with 6 significant variables was identified by a multivariate logistic regression: FFI score less than 33.3, hip adduction angle of the most affected side was greater than the contralateral side, ankle plantarflexors and hip abductors on the most affected side were not weaker than those on the contralateral side, ankle invertors on the most affected side were weaker than the contralateral side, and having more than 2 painful sites in the low back and lower extremity regions. If 5 or more of the 6 predictors were presented, the probability of success increased from 37% to 80%.

CONCLUSIONS

A CPR has been developed to identify patients with PHP likely to benefit from BAPT.

The addition of a tension night splint to a structured home rehabilitation programme in patients with chronic plantar fasciitis does not lead to significant additional benefits in either pain, function or flexibility: a single-blinded randomised controlled trial

Objective

To identify any improvements in pain or function in patients with chronic plantar fasciitis following the use of a tension night splint (TNS).

Methods

Single-blinded randomised controlled trial, with participants split evenly between intervention group (TNS + home exercise programme/HEP) and control group (HEP only). Follow-up at 3 months, with interim data at 6 weeks.

Results

40 patients recruited. Mean age 52.1 years, 33% male, mean body mass index 30.8 kg/m², mean duration of symptoms of 25 months. Improvement in self-reported ‘average pain' in the intervention group from 6.8/10 at baseline to 5.6/10 at 6 weeks, and 5.3/10 at 3 months (both clinically and statistically significant at both time points), compared with control group of 7.1/10 at baseline to 6.2/10 at 6 weeks and 5.6/10 at 3 months (significant only at 3 months). Improvements in self-reported ‘worst pain', ‘pain walking' and ‘pain first thing in the morning' in both groups at all time periods. Improvements were seen in revised Foot Function Index at all time points in both groups, but limited changes seen in flexibility and no significant changes in anxiety or depression Hospital Anxiety and Depression Scale domains or sleep quality in either group. However, no differences were seen between the outcomes seen in the two groups for the majority of the measures studied.

Conclusions

Improvements in pain and some functional measures seen in both groups, with few, if any, differences seen in outcomes between the intervention group compared with the control group. However, ongoing pain symptoms were reported in both groups, suggesting that ‘help' rather than ‘cure' was obtained for the majority. There is a possibility of earlier benefit seen in the intervention group compared with the control group, but data are unclear and further work may be needed.

Trial registration number

ClinicalTrials.gov: NCT02546115; results.

Multidimensional impact of low-Dye taping on low-load hopping in individuals with and without plantar fasciitis

OBJECTIVES

Evaluate the acute effect of low-Dye, placebo and no tape on motor behaviour in individuals with plantar fasciitis (PF).

DESIGN

Prospective, experimental.

SETTING

Motion analysis laboratory.

PARTICIPANTS

Ten participants with PF and ten matched controls.

MAIN OUTCOME MEASURES

Hopping behaviour (lower-limb stiffness and ankle angle at peak loading) were evaluated during low-load sleigh hopping, during three taping conditions. Stiffness and ankle angle were determined using three-dimensional motion analysis. Pain during submaximal loading was assessed with a numeric pain rating scale.

RESULTS

The lower-limb stiffness response to therapeutic taping was modulated by the presence of PF (interaction, F = 4.48, p = 0.018). Matched controls demonstrated a significant increase in stiffness post application of low-Dye taping (p = 0.001), stiffness was unchanged in the PF group. In the PF group, low-Dye taping decreased hopping pain in comparison to placebo (p = 0.037) and no-tape (p = 0.024). There was no difference in ankle angle at peak loading between the groups or across taping conditions.

CONCLUSIONS

Low-Dye taping reduces nociceptive inputs more than placebo in the presence of PF pain. Low-Dye tape alters stiffness in the control group but not the PF group. The motor behavioural outputs such as stiffness, during low-load hopping is modulated by both pathology and therapeutic taping.

Efficacy of adhesive taping as an adjunt to physical rehabilitation to influence outcomes post-stroke: a systematic review

BACKGROUND

Adhesive taping as a therapeutic modality post-stroke has been investigated for two decades. No systematic review of the evidence to inform clinical practice exists.

OBJECTIVE

To systematically review the efficacy of adhesive taping as an adjunct to physical rehabilitation on outcomes related to body function and structure, activity, and participation post-stroke.

METHODS

The databases of PubMed, CINAHL, EMBASE, and Web of Science from 1966 through December 2013 were searched. Full-text articles in English from peer-reviewed journals reporting original research on the use of adhesive taping post-stroke were included. Two reviewers independently searched and then rated the quality of evidence using the PEDro evidence rating system. Randomized controlled trials were further assessed using the Consolidated Standards of Reporting Trials (CONSORT) guidelines.

RESULTS

Fifteen studies met the inclusion criteria. Two used elastic tape and 13 used rigid tape. The evidence quality ranged from poor to good, and included seven shoulder, one wrist, two hip, one knee, and four ankle studies. There were four good-quality studies.

CONCLUSIONS

Preliminary evidence in the domain of body function and structure suggests that use of rigid adhesive tape as an adjunct may increase the number of pain-free days at the shoulder. Evidence for the improvement of pain intensity, range of motion, muscle tone, strength, or function with taping is inconclusive. The evidence related to activity and participation is insufficient. The use of adhesive taping post-stroke needs further and more rigorous research to compare the types, methods and dosage of taping.

Heel pain-plantar fasciitis: revision 2014

The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The purpose of these revised clinical practice guidelines is to review recent peer-reviewed literature and make recommendations related to nonarthritic heel pain.

Surgery for Patients With Recalcitrant Plantar Fasciitis: Good Results at Short-, Medium-, and Long-term Follow-up

BACKGROUND

Plantar fasciitis is a common cause of foot pain, and although many episodes are self-limiting with short duration, 10% leave chronic symptoms. Recalcitrant cases can be managed surgically, with studies demonstrating good results in the short term but uncertainties over longer term outcomes.

PURPOSE

To assess the outcome following surgical intervention for patients with plantar fasciitis.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

Seventy-nine patients were identified from operative diaries undergoing plantar fasciotomy surgery between 1993 and 2009. They were contacted to investigate long-term results using self-reported outcome measures.

RESULTS

Sixty-eight responses were received (86% response rate), with an average of 7 years (range, 1-15 years) of follow-up. Patients reported an average reduction in pain by visual analog scale of 79%, and 84% of patients were happy with the surgical results. Greater success was achieved in patients with shorter duration of symptoms preoperatively. No deterioration in success was seen over time.

CONCLUSION

Plantar fasciotomy surgery for plantar fasciitis remains controversial, with biomechanical arguments against surgery; however, this article reports good success following surgery over a long follow-up period. The results of current operative techniques need to be fully investigated for longer term success, as do the outcomes of newer nonoperative management strategies.

A biomechanical analysis of the effects of low-Dye taping on arch deformation during gait

BACKGROUND

The low-Dye technique serves to limit hindfoot pronation and medial arch collapse. Few studies exist that investigate the effects on medial arch deformation from a biomechanical perspective.

METHODS

Kinematic data was collected using a Motion Analysis System. Foot function of 21 healthy adults was assessed during the stance phase of gait. Subjects were evaluated prior to and immediately following the low-Dye tape application, as well as at 48 h. Foot deformation was assessed during the stance phase of gait using the calcaneus, navicular and 1st metatarsal head markers to calculate the medial longitudinal arch angle (MLA) and the dynamic arch height index (dAHI). Paired t-tests were used to assess low-Dye tape effectiveness.

RESULTS

There was a significant 19.3% reduction in MLA immediately after application of the tape. However only 4.01% reduction remained in deformation after 48 h. The MLA deformation findings were consistent with the AHI change, showing a significant change in the arch deformation between Pre and Post0 low-Dye taping. The effects were short-lived.

CONCLUSIONS

There are measurable changes to medial arch height and amount of arch height deformation during gait following low-Dye taping. Although changes were present immediately after application, results were diminished 48 h after application.