Gait deviations associated with plantar heel pain: A systematic review. (February 2017)

• Record Type: Journal Article
• Authors: Phillips, Adam; McClinton, Shane
• Is Part Of: Clinical biomechanics. Volume 42(2017)
• Page Start: 55
• Page End: 64
• Publication Date: 2017-02
• Subjects: Plantar fasciitis -- Walking -- Gait analysis -- Motion analysis; Biomechanics -- Periodicals; Osteopathic medicine -- Periodicals; Biomechanics -- Periodicals; Osteopathic Medicine -- Periodicals; 612.76
• DOI: 10.1016/j.clinbiomech.2016.12.012
• Languages: English
• ISSNs: 0268-0033

Abstract

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. 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.