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A combined treatment approach emphasizing impairment-based manual physical therapy for plantar heel pain: a case
Brian Young1, Michael J Walker, Joseph Strunce
1Physical Therapy Department, Wilford Hall Medical Center, Lackland Air Force Base, TX, USA. brian.young@lackland.af.mil
Study Design:
Case series.
Objective:
To describe an impairment-based physical therapy treatment approach for 4 patients with plantar heel pain.
Background:
There is limited evidence from clinical trials on which to base treatment decision making for plantar heel pain.
Methods And Measures:
Four patients completed a course of physical therapy based on an impairment-based model. All patients received manual physical therapy and stretching. Two patients were also treated with custom orthoses, and 1 patient received an additional strengthening program. Outcome measures included a numeric pain rating scale (NPRS) and self-reported functional status.
Results:
Symptom duration ranged from 6 to 52 weeks (mean duration+/-SD, 33+/-19 weeks). Treatment duration ranged from 8 to 49 days (mean duration+/-SD, 23+/-18 days), with number of treatment sessions ranging from 2 to 7 (mode, 3). All 4 patients reported a decrease in NPRS scores from an average (+/-SD) of 5.8+/-2.2 to 0 (out of 10) during previously painful activities. Additionally, all patients returned to prior activity levels.
Conclusion:
In this case series, patients with plantar heel pain treated with an impairment-based physical therapy approach emphasizing manual therapy demonstrated complete pain relief and full return to activities. Further research is necessary to determine the effectiveness of impairment-based physical therapy interventions for patients with plantar heel pain/plantar fasciitis.