Development of a foot and ankle strengthening program for the treatment of plantar heel pain: a Delphi consensus study
Abstract Background People with plantar heel pain (PHP) have reduced foot and ankle muscle function, strength and size, which is frequently treated by muscle strengthening exercises. However, there has been little investigation of what exercises are used and there is no sound evidence base to guide...
| 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/s13047-023-00668-2 |
| _version_ | 1797321381079154688 |
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| author | John W. A. Osborne Hylton B. Menz Glen A. Whittaker Karl B. Landorf |
| author_facet | John W. A. Osborne Hylton B. Menz Glen A. Whittaker Karl B. Landorf |
| author_sort | John W. A. Osborne |
| collection | DOAJ |
| description | Abstract Background People with plantar heel pain (PHP) have reduced foot and ankle muscle function, strength and size, which is frequently treated by muscle strengthening exercises. However, there has been little investigation of what exercises are used and there is no sound evidence base to guide practice. This study aimed to develop a consensus‐driven progressive muscle strengthening program for PHP. Methods Thirty‐eight experts were invited to participate in the study over three rounds. Round 1 was an open‐ended questionnaire that provided the core characteristics of progressive strengthening programs designed for three different adult patient types with PHP (younger athletic, overweight middle‐aged, older), which were presented as vignettes. In Round 2, experts indicated their agreement to the proposed exercises and training variables. In Round 3, experts were presented with amendments to the exercises based on responses from Round 2 and indicated their agreement to those changes. Consensus was achieved when > 70% of experts agreed. Results Two experts were ineligible and 12 declined, leaving 24 (67%) who participated in Round 1. Eighteen (75%) completed all three rounds. From Round 1, progressive strengthening programs were developed for the three vignettes, which included 10 different exercises and three training variables (sets / repetitions, weight, and frequency). In Round 2, 68% (n = 17) of exercises and 96% (n = 72) of training variables reached consensus. In Round 3, only exercise changes were presented and 100% of exercises reached consensus. Conclusions This study provides three progressive strengthening programs agreed to by experts that can be used in future clinical trials to determine the effectiveness of muscle strengthening for PHP. In addition, clinicians could use the programs as part of a rehabilitation strategy with the caveat that they may change as more research is conducted. |
| first_indexed | 2024-03-08T04:57:45Z |
| format | Article |
| id | doaj.art-bbd95db2b62b4c94953ac5fd7c7f3d4a |
| institution | Directory Open Access Journal |
| issn | 1757-1146 |
| language | English |
| last_indexed | 2024-03-08T04:57:45Z |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Foot and Ankle Research |
| spelling | doaj.art-bbd95db2b62b4c94953ac5fd7c7f3d4a2024-02-07T15:05:47ZengWileyJournal of Foot and Ankle Research1757-11462023-01-01161n/an/a10.1186/s13047-023-00668-2Development of a foot and ankle strengthening program for the treatment of plantar heel pain: a Delphi consensus studyJohn W. A. Osborne0Hylton B. Menz1Glen A. Whittaker2Karl B. Landorf3Discipline of PodiatrySchool of Allied HealthHuman Services and SportLa Trobe University3086VictoriaAustraliaDiscipline of PodiatrySchool of Allied HealthHuman Services and SportLa Trobe University3086VictoriaAustraliaDiscipline of PodiatrySchool of Allied HealthHuman Services and SportLa Trobe University3086VictoriaAustraliaDiscipline of PodiatrySchool of Allied HealthHuman Services and SportLa Trobe University3086VictoriaAustraliaAbstract Background People with plantar heel pain (PHP) have reduced foot and ankle muscle function, strength and size, which is frequently treated by muscle strengthening exercises. However, there has been little investigation of what exercises are used and there is no sound evidence base to guide practice. This study aimed to develop a consensus‐driven progressive muscle strengthening program for PHP. Methods Thirty‐eight experts were invited to participate in the study over three rounds. Round 1 was an open‐ended questionnaire that provided the core characteristics of progressive strengthening programs designed for three different adult patient types with PHP (younger athletic, overweight middle‐aged, older), which were presented as vignettes. In Round 2, experts indicated their agreement to the proposed exercises and training variables. In Round 3, experts were presented with amendments to the exercises based on responses from Round 2 and indicated their agreement to those changes. Consensus was achieved when > 70% of experts agreed. Results Two experts were ineligible and 12 declined, leaving 24 (67%) who participated in Round 1. Eighteen (75%) completed all three rounds. From Round 1, progressive strengthening programs were developed for the three vignettes, which included 10 different exercises and three training variables (sets / repetitions, weight, and frequency). In Round 2, 68% (n = 17) of exercises and 96% (n = 72) of training variables reached consensus. In Round 3, only exercise changes were presented and 100% of exercises reached consensus. Conclusions This study provides three progressive strengthening programs agreed to by experts that can be used in future clinical trials to determine the effectiveness of muscle strengthening for PHP. In addition, clinicians could use the programs as part of a rehabilitation strategy with the caveat that they may change as more research is conducted.https://doi.org/10.1186/s13047-023-00668-2Delphi studyFeetLower extremityMuscle strengthStrength trainingPlantar fasciitis |
| spellingShingle | John W. A. Osborne Hylton B. Menz Glen A. Whittaker Karl B. Landorf Development of a foot and ankle strengthening program for the treatment of plantar heel pain: a Delphi consensus study Journal of Foot and Ankle Research Delphi study Feet Lower extremity Muscle strength Strength training Plantar fasciitis |
| title | Development of a foot and ankle strengthening program for the treatment of plantar heel pain: a Delphi consensus study |
| title_full | Development of a foot and ankle strengthening program for the treatment of plantar heel pain: a Delphi consensus study |
| title_fullStr | Development of a foot and ankle strengthening program for the treatment of plantar heel pain: a Delphi consensus study |
| title_full_unstemmed | Development of a foot and ankle strengthening program for the treatment of plantar heel pain: a Delphi consensus study |
| title_short | Development of a foot and ankle strengthening program for the treatment of plantar heel pain: a Delphi consensus study |
| title_sort | development of a foot and ankle strengthening program for the treatment of plantar heel pain a delphi consensus study |
| topic | Delphi study Feet Lower extremity Muscle strength Strength training Plantar fasciitis |
| url | https://doi.org/10.1186/s13047-023-00668-2 |
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