Highlights
- •A variety of foot-specific gait variables have been studied in plantar heel pain.
- •There was strong evidence stance phase duration is unchanged.
- •Reduced rearfoot loading early in stance resulted in variable compensations later.
- •Component measures of pronation provided conflicting evidence.
- •Further research will help determine clinical relevance of gait analysis/treatment.
Abstract
Background
Plantar heel pain is a common foot disorder associated with significant pain and gait-related
disability. The aim of this systematic review was to identify gait deviations associated
with plantar heel pain.
Methods
A systematic review of articles with quantitative gait variables in individuals with
plantar heel pain was conducted using the CINAHL, MEDLINE, Scopus, and Embase databases.
Methodological quality was assessed using the modified Downs and Black criteria and
used along with the number of studies per gait variable to determine level of evidence.
Findings
Nineteen articles were included. There was strong evidence that stance phase duration
is unchanged. There was moderate to strong evidence of decreased rearfoot center of
pressure duration, impulse, and peak vertical ground reaction force at loading response.
In compensation there was increased contact time of the midfoot and forefoot, increased
midfoot and forefoot impulse, delayed time to the mid-stance vertical ground reaction
force valley, and decreased peak force at terminal stance. The only quantitative measure
of pronation/supination included limited evidence of increased medial forefoot and
rearfoot inversion-eversion total mobility, and medial forefoot plantar flexion.
Interpretation
Studies included in this review identified specific foot and ankle gait deviations
in individuals with plantar heel pain compared to asymptomatic cases or limbs. The
variables identified in this review may be used to assist in identifying movement-related
gait dysfunction for treatment decisions or as outcome measures of recovery. Additional
research is needed to increase confidence and clinical relevance of gait variables
used to assess and treat individuals with PHP.
Keywords
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Article info
Publication history
Published online: December 24, 2016
Accepted:
December 21,
2016
Received:
March 20,
2016
Identification
Copyright
© 2016 Elsevier Ltd. All rights reserved.
