Predictive Measurement for Windlass Change in Length and Selected Treatment Outcomes in Chronic Plantar Fasciitis

Summary

This protocol presents an objective, easy, and economical method to measure the change in length of the windlass in plantar fasciitis and assess the effectiveness of a selected treatment procedure employed in this study over a one-month period.

Abstract

Approximately 10% of patients with plantar fasciitis experience persistent and often severe symptoms, though little is known about its etiology. The goal of this study was to employ an objective, simple, and economical approach to measure the change in length of the windlass and assess the efficiency of a specified therapy protocol applied in this study over a one-month period. Age, weight, normal foot type, and gender were employed as matching factors in a matched design. Fifty individuals diagnosed with unilateral plantar fasciitis and an equal number of healthy volunteers all fulfilled the inclusion criteria and took part in this research. Pain assessment utilized a visual analogue scale and the pain subscale of the foot function index, while a valid goniometric method was employed to evaluate weight-bearing windlass, dorsiflexion and plantar flexion ranges of motion. Additionally, foot plantar pressure (both static and dynamic measures) and tape measurement of windlass change in length were assessed. The assessment was completed by all patients before and after their treatment program. Normal subjects were evaluated for control. Treatment methods encompassed ultrasonic therapy, application of an electrical heating pad, utilization of a night splint, engagement in stretching activities for the plantar aponeurosis and Achilles tendon, as well as both extrinsic and intrinsic strengthening exercises. After one month, the patients were reassessed and compared to control volunteers. In those suffering from plantar fasciitis, a substantial link was found between clinical measurements (tape measurement, windlass range of motion) and foot plantar pressure, indicating improvement. The chosen treatment protocol was effective in 96% of patients. For windlass length change, the measurement technique was found to be valid and objective. The chosen therapy procedure was successful in treating persistent plantar fasciitis in patients.

Introduction

Plantar fasciitis is characterized as an overuse syndrome involving localized inflammation of the plantar aponeurosis at its anatomical origin on the medial tubercle of the calcaneus¹. Although the exact cause is unknown, the prevailing opinion suggests that it arises from repeated partial tears and persistent inflammation within the plantar aponeurosis at its attachment point on the medial tubercle of the calcaneus². Plantar fasciitis has been theorized to result from weak plantar intrinsic or extrinsic muscles, which fail to provide adequate dynamic truss support for the longitudinal arch, thereby transferring addition....

Protocol

All procedures conducted in this study adhered to the pertinent guidelines and regulations of Helsinki 2013. Ethical approval was obtained from Kasr Al-Aini Hospital's ethical committee. The informed consent form was prepared in accordance with the standards set by the Ethics Committee of the hospital and obtained from the patients by the hospital's secretary, who played no role in this trial. Eligible patients were thoroughly informed about the interventions before signing the consent form. All subjects provided written informed consent prior to participating in the study, in accordance with Cairo University's ethics policy.

Results

The Statistical Package for the Social Sciences (SPSS, see Table of Materials) was employed for all statistical procedures, as all outcome variables exhibited a normal distribution. Means, standard deviations, and standard errors were used as summary statistics. Analyses were conducted to examine differences in the general characteristics of participants (patients and control groups), including age, gender, weight, and body mass index. Differences in each dependent variable of interest (pain, windlass ch.......

Discussion

The outcomes for individuals with persistent plantar fasciitis are generally positive, with conservative therapy showing success rates ranging from 46% to 100%¹. Prolonged issues may lead to additional treatments, including surgery, but the recovery time is often lengthy and may not allow for full function²¹. Therefore, optimizing nonoperative therapy is crucial before considering surgical options. Despite its chronic nature, most nonoperative therapies for plantar fasciiti.......

Materials

Name	Company	Catalog Number	Comments
Electrical hot pad	koolpak.co.uk		Treatment by Heat; Reusable Hot & Cold Pack With Elasticated Strap & Physio Hot & Cold Pack
Goniometer	ASA TECHMED	ASATECHMED	Measure ROM; 6 Pcs 360° 12, 8 and 6 Inch Medical Spinal Goniometer Angle Protractor Angle Ruler
Pulsed ultrasonic	TAGWW		Ultrasonic-Personal-Massager-Spasmodic-Relaxation
Slant board	StrongTek		StrongTek Professional Wooden Slant Board, Adjustable Incline Board and Calf Stretcher, Stretch Board - Extra Side-Handle Design for Portability
SPSS software	IBM		https://www.ibm.com/products/spss-statistics?utm_content =SRCWW&p1=Search&p4 =43700078595923635&p5 =e&gclid=Cj0KCQiA2KitBh CIARIsAPPMEhJOBrK6zP 26critWGEWE_6CVZnZeG tXQmgdUh9Na0LgSspKzB Zg7vAaAvdIEALw_wcB&g clsrc=aw.ds
Tekscan software		version 5.20	https://www.tekscan.com/support/drivers