Predicting the outcome of plantar heel pain in adults: a systematic review of prognostic factors
Abstract Background Plantar Heel Pain (PHP) is a common disorder with many treatment pathways and is not self‐limiting, hence prognostic information concerning recovery or recalcitrance is needed to guide practice. In this systematic review, we investigate which prognostic factors are associated wit...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | Journal of Foot and Ankle Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13047-023-00626-y |
| _version_ | 1797321343336710144 |
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| author | Halime Gulle Dylan Morrissey Xiang Li Tan Matthew Cotchett Stuart Charles Miller Aleksandra Birn Jeffrey Trevor Prior |
| author_facet | Halime Gulle Dylan Morrissey Xiang Li Tan Matthew Cotchett Stuart Charles Miller Aleksandra Birn Jeffrey Trevor Prior |
| author_sort | Halime Gulle |
| collection | DOAJ |
| description | Abstract Background Plantar Heel Pain (PHP) is a common disorder with many treatment pathways and is not self‐limiting, hence prognostic information concerning recovery or recalcitrance is needed to guide practice. In this systematic review, we investigate which prognostic factors are associated with favourable or unfavourable PHP outcomes. Methods MEDLINE, Web of Science, EMBASE, Scopus and PubMed electronic bibliographic databases were searched for studies evaluating baseline patient characteristics associated with outcomes in prospective longitudinal cohorts or after specific interventions. Cohort, clinical prediction rule derivation and single arms of randomised controlled trials were included. Risk of bias was evaluated with method‐specific tools and evidence certainty with GRADE. Results The review included five studies which evaluated 98 variables in 811 participants. Prognostic factors could be categorised as demographics, pain, physical and activity‐related. Three factors including sex and bilateral symptoms (HR: 0.49[0.30–0.80], 0.33[0.15–0.72], respectively) were associated with a poor outcome in a single cohort study. The remaining four studies reported twenty factors associated with a favourable outcome following shockwave therapy, anti‐pronation taping and orthoses. Heel spur (AUC = 0.88[0.82–0.93]), ankle plantar‐flexor strength (Likelihood ratio (LR): 2.17[1.20–3.95]) and response to taping (LR = 2.17[1.19–3.90]) were the strongest factors predicting medium‐term improvement. Overall, the study quality was low. A gap map analysis revealed an absence of research that included psychosocial factors. Conclusions A limited number of biomedical factors predict favourable or unfavourable PHP outcomes. High quality, adequately powered, prospective studies are required to better understand PHP recovery and should evaluate the prognostic value of a wide range of variables, including psychosocial factors. |
| first_indexed | 2024-03-08T04:57:14Z |
| format | Article |
| id | doaj.art-2db3a8e5e46c4d20805cbac499f7755b |
| institution | Directory Open Access Journal |
| issn | 1757-1146 |
| language | English |
| last_indexed | 2024-03-08T04:57:14Z |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Foot and Ankle Research |
| spelling | doaj.art-2db3a8e5e46c4d20805cbac499f7755b2024-02-07T15:05:47ZengWileyJournal of Foot and Ankle Research1757-11462023-01-01161n/an/a10.1186/s13047-023-00626-yPredicting the outcome of plantar heel pain in adults: a systematic review of prognostic factorsHalime Gulle0Dylan Morrissey1Xiang Li Tan2Matthew Cotchett3Stuart Charles Miller4Aleksandra Birn Jeffrey5Trevor Prior6Sports and Exercise MedicineWilliam Harvey Research InstituteBart's and the London School of Medicine and DentistryQueen Mary University of LondonMile End HospitalBancroft RoadE1 4DGLondonUKSports and Exercise MedicineWilliam Harvey Research InstituteBart's and the London School of Medicine and DentistryQueen Mary University of LondonMile End HospitalBancroft RoadE1 4DGLondonUKDepartment of Rheumatology, MedicineAshford and St Peter's HospitalGuildford StKT16 0PZLyne, ChertseyUKDepartment of Physiotherapy, Podiatry, Prosthetics and OrthoticsLa Trobe UniversityMelbourneAustraliaSports and Exercise MedicineWilliam Harvey Research InstituteBart's and the London School of Medicine and DentistryQueen Mary University of LondonMile End HospitalBancroft RoadE1 4DGLondonUKSchool of Engineering and Materials ScienceInstitute of BioengineeringQueen Mary University LondonMile End, Bancroft RoadE1 4DGLondonUKConsultant Podiatric Surgeon Homerton University HospitalHomerton RowE9 6SRLondonUKAbstract Background Plantar Heel Pain (PHP) is a common disorder with many treatment pathways and is not self‐limiting, hence prognostic information concerning recovery or recalcitrance is needed to guide practice. In this systematic review, we investigate which prognostic factors are associated with favourable or unfavourable PHP outcomes. Methods MEDLINE, Web of Science, EMBASE, Scopus and PubMed electronic bibliographic databases were searched for studies evaluating baseline patient characteristics associated with outcomes in prospective longitudinal cohorts or after specific interventions. Cohort, clinical prediction rule derivation and single arms of randomised controlled trials were included. Risk of bias was evaluated with method‐specific tools and evidence certainty with GRADE. Results The review included five studies which evaluated 98 variables in 811 participants. Prognostic factors could be categorised as demographics, pain, physical and activity‐related. Three factors including sex and bilateral symptoms (HR: 0.49[0.30–0.80], 0.33[0.15–0.72], respectively) were associated with a poor outcome in a single cohort study. The remaining four studies reported twenty factors associated with a favourable outcome following shockwave therapy, anti‐pronation taping and orthoses. Heel spur (AUC = 0.88[0.82–0.93]), ankle plantar‐flexor strength (Likelihood ratio (LR): 2.17[1.20–3.95]) and response to taping (LR = 2.17[1.19–3.90]) were the strongest factors predicting medium‐term improvement. Overall, the study quality was low. A gap map analysis revealed an absence of research that included psychosocial factors. Conclusions A limited number of biomedical factors predict favourable or unfavourable PHP outcomes. High quality, adequately powered, prospective studies are required to better understand PHP recovery and should evaluate the prognostic value of a wide range of variables, including psychosocial factors.https://doi.org/10.1186/s13047-023-00626-yPrognosisOutcome predictorsPlantar heel pain |
| spellingShingle | Halime Gulle Dylan Morrissey Xiang Li Tan Matthew Cotchett Stuart Charles Miller Aleksandra Birn Jeffrey Trevor Prior Predicting the outcome of plantar heel pain in adults: a systematic review of prognostic factors Journal of Foot and Ankle Research Prognosis Outcome predictors Plantar heel pain |
| title | Predicting the outcome of plantar heel pain in adults: a systematic review of prognostic factors |
| title_full | Predicting the outcome of plantar heel pain in adults: a systematic review of prognostic factors |
| title_fullStr | Predicting the outcome of plantar heel pain in adults: a systematic review of prognostic factors |
| title_full_unstemmed | Predicting the outcome of plantar heel pain in adults: a systematic review of prognostic factors |
| title_short | Predicting the outcome of plantar heel pain in adults: a systematic review of prognostic factors |
| title_sort | predicting the outcome of plantar heel pain in adults a systematic review of prognostic factors |
| topic | Prognosis Outcome predictors Plantar heel pain |
| url | https://doi.org/10.1186/s13047-023-00626-y |
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