Effectiveness of physical therapy treatment in addition to usual podiatry management of plantar heel pain: a randomized clinical trial
Abstract Background Many patients will seek care from a podiatrist for plantar heel pain (PHP), while few of these patients will also be seen by a physical therapist. Physical therapists can provide treatment that is not a part of routine podiatric care for PHP and may provide additional improvement...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-12-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-019-3009-y |
| _version_ | 1819072853777055744 |
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| author | Shane M. McClinton Bryan C. Heiderscheit Thomas G. McPoil Timothy W. Flynn |
| author_facet | Shane M. McClinton Bryan C. Heiderscheit Thomas G. McPoil Timothy W. Flynn |
| author_sort | Shane M. McClinton |
| collection | DOAJ |
| description | Abstract Background Many patients will seek care from a podiatrist for plantar heel pain (PHP), while few of these patients will also be seen by a physical therapist. Physical therapists can provide treatment that is not a part of routine podiatric care for PHP and may provide additional improvement. Therefore, the purpose of this study was to examine the effects of interdisciplinary care for PHP that incorporated physical therapy treatment after initiating podiatric treatment. Methods Eligible individuals with PHP that presented to a podiatrist were randomized to receive usual podiatric care (uPOD) or usual podiatric care plus physical therapy treatment (uPOD+PT). The primary outcome was change in foot and ankle ability measure (FAAM) at 6-months. Secondary outcomes included change in numeric pain rating scale (NPRS), patient-reported success, and 6-week and 1-year endpoints. Patient-reported success was defined as the top two global rating of change scale rankings. Primary analysis was intention-to-treat (ITT) using analysis by covariance adjusted to baseline scores, and a secondary per-protocol (PP) analysis was performed analyzing only those who completed treatment. Results Ninety-five individuals participated and were included in the ITT analysis, and 79 were included in the PP analysis. For the primary outcome of FAAM change from baseline to 6-months, both groups improved significantly (uPOD+PT: 26.8 [95% CI 21.6, 31.9]; uPOD: (20 [15.6, 24.4]), but there was no between-group difference (4.3 [− 1, 9.6]). For secondary outcomes, the uPOD+PT group demonstrated greater improvement in NPRS at 6 weeks (0.9 [0.3, 1.4]) and 1 year (1.5 [0.6, 2.5]) in the ITT analysis. In the PP analysis, the uPOD+PT group demonstrated greater improvement in FAAM at 6 months (7.7 [2.1, 13.3]) and 1 year (5.5 [0.1, 10.8]), NPRS at 6 weeks (0.9 [0.2, 1.6]), 6 months (1.3 [0.6, 2.1]) and 1 year (1.3 [0.6, 2.1]), and in patient-reported success (relative risk [95% CI]) at 6 weeks (2.8 [1.1, 7.1]), 6 months (1.5 [1.1, 2.1]), and 1 year (1.5 [1.1, 1.9]). Conclusions There was no significant benefit of uPOD+PT in the primary outcome of FAAM change at 6 months. Secondary outcomes and PP analysis indicated additional benefit of uPOD+PT, mostly observed in individuals who completed treatment. Trial registration Prospectively registered May 24, 2013 at www.clinicaltrials.gov (NCT01865734). |
| first_indexed | 2024-12-21T17:44:20Z |
| format | Article |
| id | doaj.art-187cd19be95f4408a792bffb03956211 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-21T17:44:20Z |
| publishDate | 2019-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-187cd19be95f4408a792bffb039562112022-12-21T18:55:32ZengBMCBMC Musculoskeletal Disorders1471-24742019-12-0120111410.1186/s12891-019-3009-yEffectiveness of physical therapy treatment in addition to usual podiatry management of plantar heel pain: a randomized clinical trialShane M. McClinton0Bryan C. Heiderscheit1Thomas G. McPoil2Timothy W. Flynn3Doctor of Physical Therapy Program, Des Moines UniversityDepartments of Orthopedics & Rehabilitation and Biomedical Engineering, and Doctor of Physical Therapy Program, University of Wisconsin-MadisonSchool of Physical Therapy, Regis UniversitySchool of Physical Therapy, South CollegeAbstract Background Many patients will seek care from a podiatrist for plantar heel pain (PHP), while few of these patients will also be seen by a physical therapist. Physical therapists can provide treatment that is not a part of routine podiatric care for PHP and may provide additional improvement. Therefore, the purpose of this study was to examine the effects of interdisciplinary care for PHP that incorporated physical therapy treatment after initiating podiatric treatment. Methods Eligible individuals with PHP that presented to a podiatrist were randomized to receive usual podiatric care (uPOD) or usual podiatric care plus physical therapy treatment (uPOD+PT). The primary outcome was change in foot and ankle ability measure (FAAM) at 6-months. Secondary outcomes included change in numeric pain rating scale (NPRS), patient-reported success, and 6-week and 1-year endpoints. Patient-reported success was defined as the top two global rating of change scale rankings. Primary analysis was intention-to-treat (ITT) using analysis by covariance adjusted to baseline scores, and a secondary per-protocol (PP) analysis was performed analyzing only those who completed treatment. Results Ninety-five individuals participated and were included in the ITT analysis, and 79 were included in the PP analysis. For the primary outcome of FAAM change from baseline to 6-months, both groups improved significantly (uPOD+PT: 26.8 [95% CI 21.6, 31.9]; uPOD: (20 [15.6, 24.4]), but there was no between-group difference (4.3 [− 1, 9.6]). For secondary outcomes, the uPOD+PT group demonstrated greater improvement in NPRS at 6 weeks (0.9 [0.3, 1.4]) and 1 year (1.5 [0.6, 2.5]) in the ITT analysis. In the PP analysis, the uPOD+PT group demonstrated greater improvement in FAAM at 6 months (7.7 [2.1, 13.3]) and 1 year (5.5 [0.1, 10.8]), NPRS at 6 weeks (0.9 [0.2, 1.6]), 6 months (1.3 [0.6, 2.1]) and 1 year (1.3 [0.6, 2.1]), and in patient-reported success (relative risk [95% CI]) at 6 weeks (2.8 [1.1, 7.1]), 6 months (1.5 [1.1, 2.1]), and 1 year (1.5 [1.1, 1.9]). Conclusions There was no significant benefit of uPOD+PT in the primary outcome of FAAM change at 6 months. Secondary outcomes and PP analysis indicated additional benefit of uPOD+PT, mostly observed in individuals who completed treatment. Trial registration Prospectively registered May 24, 2013 at www.clinicaltrials.gov (NCT01865734).https://doi.org/10.1186/s12891-019-3009-yExerciseManual therapyPhysiotherapyPlantar fasciitisPodiatrist |
| spellingShingle | Shane M. McClinton Bryan C. Heiderscheit Thomas G. McPoil Timothy W. Flynn Effectiveness of physical therapy treatment in addition to usual podiatry management of plantar heel pain: a randomized clinical trial BMC Musculoskeletal Disorders Exercise Manual therapy Physiotherapy Plantar fasciitis Podiatrist |
| title | Effectiveness of physical therapy treatment in addition to usual podiatry management of plantar heel pain: a randomized clinical trial |
| title_full | Effectiveness of physical therapy treatment in addition to usual podiatry management of plantar heel pain: a randomized clinical trial |
| title_fullStr | Effectiveness of physical therapy treatment in addition to usual podiatry management of plantar heel pain: a randomized clinical trial |
| title_full_unstemmed | Effectiveness of physical therapy treatment in addition to usual podiatry management of plantar heel pain: a randomized clinical trial |
| title_short | Effectiveness of physical therapy treatment in addition to usual podiatry management of plantar heel pain: a randomized clinical trial |
| title_sort | effectiveness of physical therapy treatment in addition to usual podiatry management of plantar heel pain a randomized clinical trial |
| topic | Exercise Manual therapy Physiotherapy Plantar fasciitis Podiatrist |
| url | https://doi.org/10.1186/s12891-019-3009-y |
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