Evaluation of balance and fall risk in patients with plantar fasciitis syndrome

Abstract

P lantar fasciitis (PFs) is one of the most common causes of plantar heel pain. [1] PFs is also named as painful heel syndrome, heel spur syndrome, runner heel, subcalcaneal pain, calcaneodine, plantar fasciosis and calcaneal periostitis. With the presence of triggering factors, repetitive movements, such as walking and running, may result in micro-tears in the plantar fascia. In biopsy samples of affected tissue, degenerative changes in the fascia can be seen with or without fibroblastic proliferation and chronic inflammation. [2] Although PFs is more common in physically active people, such as runners and military personnel, it is especially com-mon in women between the ages of 40-60. [3] Decreased ankle dorsiflexion, increased body mass index and prolonged standing time are among the risk factors. [4] Clinical diagnosis is based on anamnesis and physical examination. Typical pain presents as the pain starts after inactivity, especially in the first steps in the morning or after long-term rest, is alleviated by activity, but towards the end of the day, the pain increased concerning the load on the heel, in the form of deep heel pain. Diagnostic imaging is generally not needed for the initial evaluation and treatment but may be useful for differential diagnosis. Direct ra-Objectives: In this study, we aimed to investigate plantar fasciitis syndrome on balance and the risks of the falls. Methods: Fifty patients with clinical diagnosed plantar fasciitis participated in this study. Patients were evaluated using the visual analog scale (VAS) for pain. Balance and fall risk were measured with the biodex balance system. Postural stability and fall risk were measured with total score (TS), antero-posterior (AP) and mediolateral (ML) as statically and dynamically at 2. and 8. degrees. Nineteen healthy volunteers with no active complaints and no previous plantar fasciitis/calcaneal spur were included in this study as a control group. Results: The mean VAS value in the patient group was 6.65±1.84. There was no statistical difference between the mean age and body mass index of patients and control groups. A statistically significant difference was found between the group in TS2 (p=0.005), TS8 (p=0.009), AP2 (p=0.006), AP8 (p=0.018), DR2 (p=0.01) and DR8 (p=0.002) in favor of the control group. There was no statistical difference between the groups in the static and dynamic mediolateral balance evaluations. Conclusion:The findings demonstrated that postural balance, especially in the antero-posterior plane, was impaired in patients with plantar fasciitis syndrome and increased risk of falls.

Comparison of Dynamic Balance between East Java Puslatda Athletes with Plantar Fasciitis and without Plantar Fasciitis

“…Exercise results in peripheral and central release of beta-endorphins that have been associated with changes in pain sensitivity. This study is not in line with a study conducted by Agirman (2018) which assessed that there are differences in dynamic balance in 50 patients with plantar fasciitis compared to 19 controls 13 . The research by Agirman was different in the types of research subjects, namely the subjects who were not athletes.…”

Greater Postural Sway and Tremor during Balance Tasks in Patients with Plantar Fasciitis Compared to Age-Matched Controls

“…Sample size was determined using G power 3.0.1 (Heinrich-Heine-University Dusseldorf, Dusseldorf, Dusseldorf, Germany). A sample size of 64 participants, with 32 subjects per group, was estimated using an effect size of 0.63 from a previous study [42] with difference between two independent means, level of significance of 0.05, and power of 0.80.…”

Impact of plantar fasciitis on postural control and walking in young middle-aged adults

“…Overall, the main physical limitations are associated with fasciitis and muscular weakness [12], reduction of fascia elasticity [13], and finally tension in the Achilles tendon [14]. These limitations can further cause proprioception impairment and, consequently, poor postural balance, increasing the risk of falls in older people [12,13,15].…”

“…Overall, the main physical limitations are associated with fasciitis and muscular weakness [12], reduction of fascia elasticity [13], and finally tension in the Achilles tendon [14]. These limitations can further cause proprioception impairment and, consequently, poor postural balance, increasing the risk of falls in older people [12,13,15]. In fact, in the presence of plantar fasciitis, thickening of the fascia leads to a loss of elasticity, which directly interferes with the transfer of forces from the back to the front of the foot, consequently affecting proprioception and balance performance [13].…”

“…In fact, in the presence of plantar fasciitis, thickening of the fascia leads to a loss of elasticity, which directly interferes with the transfer of forces from the back to the front of the foot, consequently affecting proprioception and balance performance [13]. Therefore, increased tension in the Achilles tendon can affect the plantar fascia, due to reduced height of the arch and increased pressure on the forefoot [14].This phenomenon can impact both static and dynamic balance control [12,13,15].…”