This study found widespread pressure hypersensitivity over both nerve trunks and musculoskeletal structures in individuals with unilateral chronic plantar heel pain, as a manifestation of a centrally altered central nociceptive pain processing.

Objective Pain experienced by patients with plantar heel pain has been associated with fascia thickness. It is possible that referred muscle pain may also be related to symptoms experienced by these patients. Our aim was to systematically investigate if the referred pain elicited by trigger points in the leg and foot musculature reproduces the symptoms in individuals with plantar heel pain and to determine the association of trigger points (TrPs) with pain and related disability. Methods A case–control study was conducted. Thirty-five individuals with unilateral chronic plantar heel pain and 35 matched comparable healthy controls participated. An assessor blinded to the subject’s condition explored TrPs in the flexor hallucis brevis, adductor hallucis, quadratus plantae, and internal gastrocnemius. Pain and related disability were assessed with a numerical pain rating scale (0–10), the Foot Function Index, and the Foot Health Status Questionnaire. Results The number of TrPs for each patient with plantar heel pain was 4 ± 3 (2.5 ± 2 active TrPs, 1.5 ± 1.8 latent TrPs). Healthy controls only had latent TrPs (mean = 1 ± 1). Active TrPs in the quadratus plantae (N = 20, 62.5%), and flexor hallucis brevis (N = 19, 59%) were the most prevalent in patients with plantar heel pain. A greater number of active, but not latent, TrPs was associated with higher foot pain variables (0.413 < rs < 0.561, P < 0.01), higher impact of foot pain (0.350 < rs < 0.473, P < 0.05) and worse related disability (–0.447 < rs < –0.35456, P < 0.05). Conclusions The referred pain elicited by active TrPs in the foot muscles reproduced the symptoms in patients with plantar heel pain. A greater number of active TrPs was associated with higher pain and related disability in patients with plantar heel pain.

No abstract

Objective To assess the potential relationship between demographic (age, gender, body mass index, height, weight), clinical (affected side, duration of symptoms, health-related quality of life), psychological (depressive levels) or neuro-physiological (pressure pain sensitivity and number of trigger points -TrP-) outcomes with foot function and pain intensity in patients with unilateral plantar heel pain (PHP). Methods Fifty-four patients with PHP (48% females) were recruited. Demographic data, months with pain, time in standing position, depression, pressure pain thresholds (PPTs), number of TrPs, health-related quality of life, function and pain intensity were collected. A multivariable correlation analysis was performed to determine the association between the variables and a regression analysis was conducted to explain the variance in function and pain intensity. Results Pain intensity was negatively correlated with symptoms duration and calcaneus bone PPT and positively associated with gender, time in standing position and number of TrPs. Function was negatively correlated with PPTs on calcaneus bone, flexor digitorum brevis and abductor hallucis muscle and quality of life, and positively correlated with age, gender and depressive levels. Stepwise regression analyses revealed that 60.8% of pain intensity was explained by female gender, calcaneus PPTs, time in standing position, and function. Further, gender, quality of life, age, depressive levels and calcaneus bone PPTs explained 52.4% of function variance. Conclusions This study found that demographic, clinical, psychological and neuro-physiological variables can play a mutual interaction in function and pain intensity in patients with unilateral PHP. These findings could guide clinicians into the identification, prevention and treatment of PHP risk factors.

Background: Motor imagery, which emphasizes mental rehearsal of motor skills to improve function, is frequently used in clinical practice. Because of its increasing use, reliable and valid tools are necessary to evaluate motor imagery abilities. However, there are few questionnaires translated and validated into Spanish language. Objective: To translate, transculturally adapt, and validate the Spanish version of the Movement Imagery Questionnaire-Revised Second Version (MIQ-RS). Design: A single-center observational study. Setting: University community. Participants: One hundred fifty-five healthy participants were recruited. Interventions: Not applicable. Main Outcome Measures: Spanish translation of the MIQ-RS and psychometric performances of the questionnaire were tested using concurrent-criterion and content validity, construct validity, internal consistency, and test-rest reliability. Internal consistency, concurrent-criterion validity, construct validity, and test-rest reliability were assessed with Cronbach´s alpha, Spearman´s correlation coefficient, confirmatory factor analysis, and intraclass correlation coefficient (ICC), respectively. Results: Results showed satisfactory internal consistency (Cronbach α = 0.90), test-retest reliability (ICC for visual items = 0.844 and for kinesthetic items = 0.70) and content and criterion-concurrent validity (Spearman´s correlation coefficient for visual items, 0.60 and for kinesthetic items, 0.81) of the MIQ-RS Spanish version. The two-factor structure was supported by confirmatory factor analysis. Statistically significant gender differences were observed in mean kinesthetic motor imagery scores and in mean visual motor imagery scores according to sports practice. No significant differences for gender, age, and sports, musical, and dance practice were reported. Conclusions: The Spanish version of the MIQ-RS is a valid and reliable tool to assess motor imagery abilities in healthy young people.

Objectives To assess the psychometric characteristics of the Spanish Post-COVID-19 Functional Status (PCFS) scale (web-based and paper-based forms) and the test-retest reliability of the web-based form. Study design and setting Cross-sectional study of 125 COVID-19 survivors. The test-retest reliability of the web-based form was assessed at 7 days after the first evaluation. We collected symptoms, functional status (PCFS scale), health-related quality of life (EuroQol-5D questionnaire, EQ-5D-5L), activities of daily living limitations [Barthel Index and Global Activity Limitation Index, GALI] and psychological state (Hospital Anxiety and Depression Scale, HADS). Results The paper- and web-based forms of the Spanish PCFS scale showed adequate construct validity, and the web-based form provided substantial test-retest reliability (kappa = 0.63). The percentage of agreement between the web-based and paper-based forms was high (88%). Functional status showed a high correlation with EQ-5D-5L (inverse) and GALI (direct) (both; Rho ≥ .743), a moderate correlation with HADS (Rho ≥ .409) and a low correlation with the Barthel Index (Rho < .30). The Kruskal–Wallis test showed statistically significant differences in EQ-5D-5L, GALI and HADS according to the degree of functional status. Conclusion The Spanish version of the PCFS scale (web-based and paper-based forms) showed adequate construct validity, and the web-based form provided substantial test-retest reliability in COVID-19 survivors.

Resumen El objetivo de esta revisión fue evaluar la eficacia de la terapia en espejo (TE) y terapia de observación de acciones (AOT) en estructuras y funciones corporales, actividad y participación, relacionadas con miembro superior en parálisis cerebral infantil (PCI). Se realizó una revisión sistemática de ensayos controlados aleatorizados publicados en los últimos diez años, que investigaran TE o AOT frente a otras intervenciones en PCI. La calidad metodológica de los nueve estudios incluidos se evaluó con la escala PEDro. El tratamiento con TE o AOT parece mostrar mejoras significativas en estructuras y funciones corporales, actividades y participación del miembro superior comparado con otras intervenciones en PCI. Ambas intervenciones parecen mejorar la calidad de vida al abarcar la globalidad del paciente, reducir la discapacidad y favorecer su funcionamiento. Se necesitan más estudios con mayor calidad metodológica para respaldar estas intervenciones a largo plazo.

Plantar heel pain (PHP) is one of the most common foot pain conditions in adults. Several biological and psychological factors could be involved in chronic PHP in a complex matrix. However, reciprocal interactions between these factors are unknown. The aim of the present study was to use network analysis to quantify potential multivariate relationships between pain-related, function, clinical, mechanosensitivity, psychological, and health-related variables in individuals with PHP. Demographic (age, gender), pain-related (pain intensity), function, clinical (myofascial trigger points [TrPs]), mechanosensitivity (pressure pain thresholds), psychological (Beck Depression Inventory), and health-related variables (EQ-5D-5L) were collected in 81 PHP patients. Network connectivity analysis was conducted to quantify the adjusted correlations between the modeled variables and to assess their centrality indices. The connectivity network showed local associations between pain-related variables, foot function, and mechanosensitivity. Additionally, associations between quality of life, depression, and pain-related variables were found, while TrPs was associated with quality of life and mechanosensitivity. The node with the highest strength centrality was the worst pain intensity, while mechanosensitivity and worst pain intensity showed the highest closeness and betweenness centrality. This is the first study to apply network modeling to understand the connections between pain-related, function, clinical, mechanosensitivity, psychological, and health-related variables in PHP. The role of pain severity and mechanosensitivity is highlighted and supported by the network. Thus, this study reveals potential factors that could be the target in the management of PHP, promoting a comprehensive and effective therapeutic approach.