Discrepancies in Pedobarography between Affected and Unaffected Sides in Patients with Plantar Fasciitis

Abstract

Category: Other; Basic Sciences/Biologics Introduction/Purpose: Plantar fasciitis is one of the most common causes of chronic heel pain. Typically, conservative treatment involves stretching exercises and the use of orthosis such as heel cups. To prescribe the appropriate orthosis, a fundamental understanding of plantar pressure distribution is essential. We evaluated the plantar pressure distribution of patients with unilateral plantar fasciitis by comparing it with contralateral unaffected sides. Methods: We prospectively recruited 20 participants who were diagnosed with unilateral plantar fasciitis and had been complaining of heel pain for at least 6 months. The emed ® system was used to measure the plantar pressure of both feet during gait. We measured the pedobarographic parameters, such as contact area, maximum force, peak pressure, force time integrals, and pressure time integrals. The analysis was performed using a 4-mask configuration (hindfoot, midfoot, forefoot, and toes). In addition, we measured radiographic parameters that could potentially affect plantar pressure in simple foot and ankle radiographs. Results: Both sides showed no significant difference in radiographic parameters. The affected side showed significantly higher contact area (28.9±10.3 vs. 26.3±8.2, p=0.007), maximum force (27.3±12.9 vs. 24.4±11.9, p=0.048), and force time integrals (0.6±0.3 vs. 0.5±0.2, p=0.044) in the midfoot. However, the unaffected side demonstrated significantly higher maximum force (67.5±11.4 vs. 60.1±8.4, p=0.030) and force time integrals (1.4±0.2 vs. 1.2±0.2, p=0.038) in the hindfoot. Conclusion: The increase in the contact area and maximum force in the midfoot on the side with plantar fasciitis can be interpreted as a result of weight transfer from the hindfoot to the midfoot due to heel pain. It can be suggested that Achilles tendon and plantar fascia stretching exercise is necessary to prevent weight transfer from the original hindfoot to the midfoot or forefoot. Moreover, the findings of this study could be helpful in prescribing appropriate orthosis for patients effectively.