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Plantar Fasciopathy Treated with Dynamic Splinting

A Randomized Controlled Trial

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  • 1 Musculoskeletal Services, Kaiser Permanente, Sacramento, CA.
  • | 2 Lopez Podiatry, Ft Worth, TX.
  • | 3 Orlando Foot and Ankle Clinic, Orlando, FL.
  • | 4 Ankle Foot Centers, Marietta, GA.
  • | 5 Health Sciences, University of Phoenix: Axia College, Phoenix, AZ; Clinical Research, Dynasplint Systems Inc, Severna Park, MD.
  • | 6 School of Health Administration, Texas State University–San Marcos, San Marcos, TX.
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Background: Plantar fasciopathy (or plantar fasciitis) is considered to be one of the most common foot abnormalities, affecting up to 2 million Americans each year, and the chief complaint is acute heel pain. Therapeutic protocols for this condition have included stretching exercises, corticosteroid injections, physical therapy, and foot orthoses, but a single modality has not been found to be universally effective. We sought to determine the efficacy of stretching with dynamic splinting for the treatment of plantar fasciitis.

Methods: Sixty patients (76 feet) were enrolled in this 12-week study from four different clinics across the United States. Patients were randomly categorized into experimental and control groups. All of the patients received nonsteroidal anti-inflammatory drugs, orthoses, and corticosteroid injections if needed. Thirty experimental patients also received dynamic splinting for nightly wear to obtain a low-load, prolonged-duration stretch with dynamic tension. The dependent variable was change from baseline in Plantar Fasciopathy Pain/Disability Scale score, and the independent variable was group (experimental versus control).

Results: Two-sample t tests were calculated, and there was a significant difference in the mean change scores of experimental versus control patients (−33 versus −2 points, P < .0001).

Conclusions: Dynamic splinting was effective for reducing the pain of plantar fasciopathy, and this modality should be included in the standard of care for treating plantar fasciopathy. (J Am Podiatr Med Assoc 100(3): 161–165, 2010)

Corresponding author: F. Buck Willis, PhD, PO Box 1735, San Marcos, TX 78667. (E-mail: buckphd@yahoo.com)