Predicting the outcome of plantar heel pain in adults: a systematic review of prognostic factors.

IF 2.5 3区医学 Q1 ORTHOPEDICS

Journal of Foot and Ankle Research Pub Date : 2023-05-12 DOI:10.1186/s13047-023-00626-y

Halime Gulle, Dylan Morrissey, Xiang Li Tan, Matthew Cotchett, Stuart Charles Miller, Aleksandra Birn Jeffrey, Trevor Prior

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引用次数: 2

Abstract

Background: Plantar Heel Pain (PHP) is a common disorder with many treatment pathways and is not self-limiting, hence prognostic information concerning recovery or recalcitrance is needed to guide practice. In this systematic review, we investigate which prognostic factors are associated with favourable or unfavourable PHP outcomes.

Methods: MEDLINE, Web of Science, EMBASE, Scopus and PubMed electronic bibliographic databases were searched for studies evaluating baseline patient characteristics associated with outcomes in prospective longitudinal cohorts or after specific interventions. Cohort, clinical prediction rule derivation and single arms of randomised controlled trials were included. Risk of bias was evaluated with method-specific tools and evidence certainty with GRADE.

Results: The review included five studies which evaluated 98 variables in 811 participants. Prognostic factors could be categorised as demographics, pain, physical and activity-related. Three factors including sex and bilateral symptoms (HR: 0.49[0.30-0.80], 0.33[0.15-0.72], respectively) were associated with a poor outcome in a single cohort study. The remaining four studies reported twenty factors associated with a favourable outcome following shockwave therapy, anti-pronation taping and orthoses. Heel spur (AUC = 0.88[0.82-0.93]), ankle plantar-flexor strength (Likelihood ratio (LR): 2.17[1.20-3.95]) and response to taping (LR = 2.17[1.19-3.90]) were the strongest factors predicting medium-term improvement. Overall, the study quality was low. A gap map analysis revealed an absence of research that included psychosocial factors.

Conclusions: A limited number of biomedical factors predict favourable or unfavourable PHP outcomes. High quality, adequately powered, prospective studies are required to better understand PHP recovery and should evaluate the prognostic value of a wide range of variables, including psychosocial factors.

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预测成人足底跟痛的结果:对预后因素的系统回顾。

背景:足底跟痛(PHP)是一种常见的疾病，有许多治疗途径，并不是自限性的，因此需要有关恢复或顽固性的预后信息来指导实践。在这篇系统综述中，我们调查了哪些预后因素与有利或不利的PHP结果相关。方法:检索MEDLINE, Web of Science, EMBASE, Scopus和PubMed电子书目数据库，以评估前瞻性纵向队列或特定干预后与结果相关的基线患者特征。包括队列、临床预测规则推导和单组随机对照试验。偏倚风险用方法专用工具评估，证据确定性用GRADE评估。结果:本综述包括5项研究，评估了811名参与者的98个变量。预后因素可分为人口统计学、疼痛、身体和活动相关。在单队列研究中，性别和双侧症状(风险比分别为0.49[0.30-0.80]、0.33[0.15-0.72])三个因素与预后不良相关。其余四项研究报告了20个因素与冲击波治疗、抗旋前带和矫形器后的良好结果相关。足跟骨刺(AUC = 0.88[0.82-0.93])、踝关节跖屈肌力量(似然比(LR): 2.17[1.20-3.95])和对胶布的反应(LR = 2.17[1.19-3.90])是预测中期改善的最强因素。总体而言，研究质量较低。差距图分析显示，缺乏包括心理社会因素在内的研究。结论:有限数量的生物医学因素预测了有利或不利的PHP结果。需要高质量、充分有力的前瞻性研究来更好地了解PHP的恢复情况，并应评估包括社会心理因素在内的一系列变量的预后价值。

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来源期刊

Journal of Foot and Ankle Research ORTHOPEDICS-

CiteScore

4.50

自引率

10.30%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Foot and Ankle Research, the official journal of the Australian Podiatry Association and The College of Podiatry (UK), is an open access journal that encompasses all aspects of policy, organisation, delivery and clinical practice related to the assessment, diagnosis, prevention and management of foot and ankle disorders. Journal of Foot and Ankle Research covers a wide range of clinical subject areas, including diabetology, paediatrics, sports medicine, gerontology and geriatrics, foot surgery, physical therapy, dermatology, wound management, radiology, biomechanics and bioengineering, orthotics and prosthetics, as well the broad areas of epidemiology, policy, organisation and delivery of services related to foot and ankle care. The journal encourages submissions from all health professionals who manage lower limb conditions, including podiatrists, nurses, physical therapists and physiotherapists, orthopaedists, manual therapists, medical specialists and general medical practitioners, as well as health service researchers concerned with foot and ankle care. The Australian Podiatry Association and the College of Podiatry (UK) have reserve funds to cover the article-processing charge for manuscripts submitted by its members. Society members can email the appropriate contact at Australian Podiatry Association or The College of Podiatry to obtain the corresponding code to enter on submission.