The assessment of plantar pressure distribution in plantar fasciitis and its relationship with treatment success and fascial thickness

Abstract

Aim: Patients with plantar fasciitis modify their gait patterns due to the heel pain. We aimed to investigate whether there was a significant difference in the plantar pressure distribution after pain relief due to successful treatment response in plantar fasciitis. Methods: 49 patients diagnosed with chronic unilateral plantar fasciitis received a 3-week physical therapy intervention and home exercises. Visual analog scale, plantar pressure measurement by pedobarographic assessment and magnetic resonance imaging were performed before and 1 month after the intervention. At the 1-month follow up, participants were divided into 2 groups according to successful or poor response to treatment. The treatment's success criteria was defined as a percentage decrease in heel pain exceeding 60% compared to the baseline, assessed one month after the initiation of treatment. Results: A total of 44 subjects successfully completed the study. In group 1, characterized by successful responders, there were 24 subjects, while group 2, comprising poor responders, included 20 subjects. After treatment in group 1, the dynamic plantar pressure on the medial forefoot showed a significant increase (p = 0.015). However, there was no significant change in plantar pressure in the poor responders. Plantar fascia thickness correlated positively with thumb dynamic pressures (coronal p = 0.03 r = 0.434, sagittal r = 0.451 p = 0.02). Conclusion: The results suggest that fascial thickness and dynamic forefoot plantar pressures may be related. Medial forefoot plantar pressures increased as a result of gait restoration with significant pain reduction in adults.