Psychosocial variables and presence, severity and prognosis of plantar heel pain: A systematic review of cross‐sectional and prognostic associations

Drake, Chris; Mallows, Adrian; Littlewood, Chris

doi:10.1002/msc.1246

Cited by 27 publications

(26 citation statements)

References 38 publications

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“…Future studies should also emphasise the importance of returning exercise diaries to monitor adherence [13]. Recently, several psychological and nutritional PHP risk factors have been identified, therefore future studies could investigate psychological and nutritional interventions alongside physiotherapy in a biopsychosocial treatment model [102][103][104][105][106][107][108][109][110]. ⨁⨁⨁⨁ HIGH *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).…”

Section: Implications and Recommendations For Practice And Researchmentioning

confidence: 99%

The effectiveness of combined extracorporeal shockwave therapy and exercise for plantar heel pain: A systematic review

Burton¹

2020

Preprint

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Background: Plantar heel pain (PHP) is a common musculoskeletal disorder, with both extracorporeal shockwave therapy (ESWT) and specific exercise such as plantar fascia specific stretching shown to be effective treatments. This review aimed to evaluate the effectiveness of combined ESWT and exercise interventions versus other interventions in treating PHP. Methods: A systematic review of effectiveness was conducted, adhering to the PRISMA guidelines. Five databases were searched for studies published between January 2000 and March 2020, with 12 studies meeting the inclusion criteria. The Grading of Recommendations Assessment Development and Evaluation (GRADE) framework was used to determine quality of recommendations. Results: The 12 included studies (n = 861) compared ESWT and stretching with various other treatments. Due to clinical and methodological heterogeneity, pooling of data was not possible, and a narrative synthesis of findings was provided. There was high quality evidence that combined ESWT and stretching interventions are more effective than those using either alone or botulinum toxin injections, and low-quality evidence of superiority versus ultrasound and stretching. There was moderate quality evidence that combined ESWT and stretching is no more effective than corticosteroid injection (CSI), and high quality evidence that the combination is no more effective than blood-derived injection therapies, custom orthotics or low-level laser therapy (LLLT) combined with stretching. There is high quality evidence that the use of topical corticosteroid or laser therapy in combination with ESWT and stretching increases effectiveness compared to ESWT and stretching alone, and moderate quality evidence for the additive effective of dry needling. Conclusions: Combined ESWT and stretching treatments are effective and may be recommended where they are available and practical to implement. Further high-quality studies with larger sample sizes and longer follow-up durations comparing combined interventions for PHP, including different exercise types such as resistance training are required.

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Section: Implications and Recommendations For Practice And Researchmentioning

confidence: 99%

The effectiveness of combined extracorporeal shockwave therapy and exercise for plantar heel pain: A systematic review

Burton¹

2020

Preprint

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“…Kinesiophobia or fear of movement was found to be present in 2 of every 3 patients in a consecutive cohort of adults with lower limb tendinopathy. Kinesiophobia, catastrophisation and depression were found to be positively associated with plantar heel pain (14) and with increased symptom severity in gluteal tendinopathy (15). When treating tendinopathy, evidence-based approaches to addressing psychosocial issues and chronic pain management may also be required as part of a multifaceted, patient-centred approach.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Australian Osteopaths Managing Tendinopathies: Analysis of a Nationally Representative Survey of 989 Practitioners

Vaughan

Fleischmann

Mest

et al. 2021

Muscle Ligaments and Tendons J

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Background. Tendinopathies are a common complaint presenting to health professionals, including osteopaths. Evidence supports the use of exercise rehabilitation, with a potential role for manual therapy. This study sought to profile the practice and clinical management characteristics of Australian osteopaths who often treat tendinopathies. Methods. The study was designed as a cross-sectional survey of Australian osteopaths. Participants were Australian osteopaths who were members of the Osteopathy Research and Innovation Network (ORION)-the Australian professions' practice-based research network. Participants were invited to complete a 27-item practice and clinical management characteristic questionnaire. The questionnaire asked participants to identify demographic, practice and clinical management characteristics associated with their practice. Regression modelling was used to identify significant characteristics associated with often treating tendinopathies. Results. Nine hundred and eighty-nine osteopaths responded and over 41% (n = 410) reported often treating tendinopathies. This group were more likely to be female (ORa 1.5), often treat patients with chronic pain (ORa 3.8) and sports injury (ORa 2.5) and often use exercise prescription (ORa 1.6) in patient care. Conclusions. Australian osteopaths who often treat tendinopathies demonstrate different clinical practice and management characteristics compared to their colleagues who do not often treat this complaint. Research into patient outcomes and cost-effectiveness of osteopathy care for the management of tendinopathies is now required.

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“…Previous systematic reviews [21,22] concluded that there was a conflicting evidence-base for the association of psychological factors and clinical outcome in people with tendinopathy. Several factors have been highlighted as potential explanations for the conflicting evidence base, such as, variance in population, heterogeneity of outcome measures and differing cognitive factors [21,22]. Despite the ambiguity, previous reviews suggest specific psychological variables may be associated with tendinopathy and suboptimal outcomes.…”

Section: Introductionmentioning

confidence: 99%

The strength of association between psychological factors and clinical outcome in tendinopathy: A systematic review

et al. 2020

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Objective Tendinopathy is often a disabling, and persistent musculoskeletal disorder. Psychological factors appear to play a role in the perpetuation of symptoms and influence recovery in musculoskeletal pain. To date, the impact of psychological factors on clinical outcome in tendinopathy remains unclear. Therefore, the purpose of this systematic review was to investigate the strength of association between psychological factors and clinical outcome in tendinopathy. Methods A systematic review of the literature and qualitative synthesis of published trials was conducted. Electronic searches of ovid MEDLINE, ovid EMBASE, PsychINFO, CINAHL and Cochrane Library was undertaken from their inception to June 2020. Eligibility criteria included RCT’s and studies of observational design incorporating measurements of psychological factors and pain, disability and physical functional outcomes in people with tendinopathy. Risk of Bias was assessed by two authors using a modified version of the Newcastle Ottawa Scale. High or low certainty evidence was examined using the GRADE criteria. Results Ten studies of observational design (6-cross sectional and 4 prospective studies), involving a sample of 719 participants with tendinopathy were included. Risk of bias for the included studies ranged from 12/21 to 21/21. Cross-sectional studies of low to very low level of certainty evidence revealed significant weak to moderate strength of association (r = 0.24 to 0.53) between psychological factors and clinical outcomes. Prospective baseline data of very low certainty evidence showed weak strength of association between psychological factors and clinical outcome. However, prospective studies were inconsistent in showing a predictive relationship between baseline psychological factors on long-term outcome. Cross sectional studies report similar strengths of association between psychological factors and clinical outcomes in tendinopathy to those found in other musculoskeletal conditions. Conclusion The overall body of the evidence after applying the GRADE criteria was low to very low certainty evidence, due to risk of bias, imprecision and indirectness found across included studies. Future, high quality longitudinal cohort studies are required to investigate the predictive value of baseline psychological factors on long-term clinical outcome.

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Psychosocial variables and presence, severity and prognosis of plantar heel pain: A systematic review of cross‐sectional and prognostic associations

Abstract: In light of this review, the association of psychosocial variables and plantar heel pain cannot be ruled out. Given recommendations to adopt an individualized and stratified approach to other musculoskeletal conditions, clinicians should remain vigilant to their presence.

Cited by 27 publications

References 38 publications

The effectiveness of combined extracorporeal shockwave therapy and exercise for plantar heel pain: A systematic review

The effectiveness of combined extracorporeal shockwave therapy and exercise for plantar heel pain: A systematic review

Characteristics of Australian Osteopaths Managing Tendinopathies: Analysis of a Nationally Representative Survey of 989 Practitioners

The strength of association between psychological factors and clinical outcome in tendinopathy: A systematic review

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