Manual Therapy Informed by the Fascial Distortion Model for Plantar Heel Pain: Results of a Single-Arm Prospective Effectiveness Study.

Autor:	Boucher, Joshua, Mooney, Scott, Dewey, Thomas, Kirtley, Robert G., Walker, Tyler, Rabago, David
Předmět:	ULTRASONIC imaging of the foot STATISTICS STATISTICAL power analysis CLINICAL trials ANALYSIS of variance SELF-evaluation MATHEMATICAL models FASCIAE (Anatomy) TREATMENT effectiveness PRE-tests & post-tests T-test (Statistics) MANIPULATION therapy PALPATION QUESTIONNAIRES FOOT REPEATED measures design DESCRIPTIVE statistics THEORY HEEL pain DATA analysis software DATA analysis PAIN management LONGITUDINAL method EVALUATION
Zdroj:	Journal of Alternative & Complementary Medicine; Aug2021, Vol. 27 Issue 8, p697-705, 9p
Abstrakt:	Objectives: Plantar heel pain (PHP) is the most common cause of heel pain and can be debilitating; 20% of patients are refractory to standard of care. The Fascial Distortion Model (FDM), a novel manual diagnostic and treatment strategy, is purported to be effective for chronic pain; however, no rigorous studies document its effectiveness. We assessed the FDM for care of PHP. Design: Single arm prospective effectiveness study. Settings/Location: Outpatient primary care clinic; Fort Gordon, GA. Subjects: Outpatient adults. Interventions: Participants received an FDM-informed diagnostic and treatment strategy to identify fascial "distortions" at the foot based on patient-reported pain patterns and palpatory examination and then to provide distortion-specific manual therapy at baseline and 1 week. Outcome Measures: Primary outcome measure (0, 1, and 16 weeks): the Foot Pain subscale on the validated Foot Health Status Questionnaire (FHSQ; 0–100 points on each of eight separate subscales); secondary outcome measures (0, 1, and 16 weeks): the seven remaining subscales on the FHSQ, visual analog pain scale (VAS, 0–100 points), and plantar fascia thickness of the most effected foot assessed by ultrasound (0 and 16 weeks). Analysis was performed per protocol using repeated-measures analysis of variance. Results: One hundred and ninety-seven participants were screened; 33 were enrolled. Twenty-eight participants received two FDM procedures. Compared with baseline, improvement on the FHSQ Foot Pain (33.8–23.6 points) and Foot Function (23.9–19.8 points) subscales and VAS (44.7–27.7 points) at 16 weeks was statistically significant (all p's < 0.001) and clinically important representing large effect sizes. Relative to baseline, 16-week ultrasound demonstrated reduced average plantar fascia thickness (0.6–0.9 mm [p = 0.001]). Demographic characteristics were unrelated to response. Satisfaction was high. There were no serious adverse events; side effects included consistent mild-to-moderate self-limited pain. Conclusions: Participants with PHP who received FDM-informed care reported significant and sustained improvement on validated foot pain and foot function measures; additional findings included decreased plantar fascial thickness. These results require corroboration in a larger randomized controlled study. Clinical Trial Registration No: DDEAMC17005. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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