Efficacy of EZStep in the Management of Plantar Fasciitis

Abstract

Plantar fasciitis is one of the most common causes of heel pain. Despite extensive efforts foot surgeons continue to debate the best modality of treatment. Analgesics, shoe inserts, stretching exercises, steroid injection, night splints, and extracorporeal shock wave therapy have proved effective in one group but fail in others. This study evaluated the efficacy of EZStep, a new foot brace for the management of plantar fasciitis. A total of 198 patients were randomized in 2 groups; group 1 (study group) received nonsteroidal anti-inflammatory drugs (NSAIDs; 4-6 weeks) and EZStep whereas group 2 (control group) received either NSAID and physiotherapy alone (2A) or NSAID, physiotherapy, and local steroid injection (2B). None of the patients received over-the-counter insoles or strapping of plantar arch to avoid any bias in randomization. Evaluations included measurement of weight and height, visual analog scale (VAS) for pain, and Short-Form McGill Pain Questionnaire (SFMPQ). After 8 weeks, patients were reevaluated, and assessment for the VAS and SFMPQ with treatment outcome was performed. Patients with VAS scores ≤3 were considered as excellent, ≥4 as good, and ≥7 as poor. The posttreatment evaluation showed that VAS scores were in the range from 2.97 ± 1.06 to 7.64 ± 2.9 (2A), P = .001, 95% confidence interval (CI) <-4.104; for 2B P = .001, CI <-2.44, and SFMPQ was 21.7 ± 4.5 and 69.2 ± 5.8 (group 2A; P = .001, 95% CI <-46.44). Compared with group 2B the SFMPQ was 66.5 ± 4.3 (P = .001, 95% CI <-30.720). In group 1 as per VAS, 86 (73.5%) were evaluated as excellent, 15 (12.8%) as good, and 16 (13.6%) as poor. Our study shows that the regular use of EZStep with short course of NSAIDs (4-6 weeks) was effective in ameliorating symptoms in more than 85% of patients suffering from plantar fasciitis.

Efficacy of foot orthoses for the treatment of plantar heel pain: a systematic review and meta-analysis

“…The effect of EZStep was compared with physiotherapy alone and with physiotherapy and injection in one study with a high risk of bias 26. At midterm, a significantly lower VAS score was seen in the EZStep group compared with the physiotherapy group (MD −4.63 (scale 0–10) (95% CI −5.65 to –3.61)) and with the physiotherapy and injection group (MD −2.83 (scale 0–10) (95% CI −3.45 to –0.55)).…”

“…A total of 20 articles studied the effect of eight different types of orthoses, that is, custom-made orthosis,15 16 19–21 25 28 32 37 prefabricated orthosis,15 16 20–22 29–31 33 34 37 EZ Step,26 orthosis with magnetic properties,27 36 heel cup,20 25 static ankle brace,24 Airheel Cast22 and an antipronatory pad 23. The studies also differed in time of follow-up, outcome measures and control interventions applied.…”

Effect of shoe insole for prevention and treatment of lower extremity injuries

“…( Table 5) Other disease patients. In addition to articles about the effect of the insole on pain (back pain 31) , heel pain 32,33) , rheumatoid arthritis [RA] 34) , overuse injuries and tibial stress syndrome 35) , lower extremity musculoskeletal pain 36) and apophysitis calcanei 37) ) the effect of the insole on fractures 38) , stroke 39,40) , myofascial pain syndrome and functional ankle instability were also reported. A reduction in symptoms such as pain or numbness resulted from the use of an insole.…”

Update on Evidence‐Based Treatments for Plantar Fasciopathy

“…Wearing a night splint benefits patients who report pain in the heel in the morning [39,40]. To achieve that benefit, the splint usually must be worn for 1‐3 months.…”

“…In another study by Al‐Bluwi et al [40], a total of 198 patients with plantar fasciopathy were randomized into 3 groups: group 1, group 2A, and group 2B. Group 1 (the study group) received NSAIDs for 4‐6 weeks and also wore an EZ Step splint (Medtech Orthopedics, Lawrenceville, GA).…”