A Novel Approach to Plantar Fasciitis in the Aging Population The NAPA trial

治疗老年人足底筋膜炎的新方法 NAPA 试验

• 批准号: 10689012
• 负责人: IRENE S DAVIS
• 金额: $ 52.68万
• 依托单位: UNIVERSITY OF SOUTH FLORIDA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10689012
• 关键词: Adult; Age; Aging; Atrophic; Chronic; Cumulative Trauma Disorders; Drug Prescriptions; Elderly; Equilibrium; Exercise; Exhibits; Foot Pain; Goals; Incidence; Individual; Intervention; Knee Osteoarthritis; Laboratories; Measures; Mental Depression; Methods; Monitor; Muscle; Muscle Weakness; Muscular Atrophy; Older Population; Orthotic Devices; Outcome Assessment; Outcome Measure; Pain; Participant; Patients; Physical Function; Plantar Fasciitis; Plantar fascia structure; Population; Quality of life; Questionnaires; Randomized; Recurrence; Research; Resolution; Risk; Risk Reduction; Shoes; Site; Stretching; Symptoms; Testing; Time; Training; Walking; aging population; comparison intervention; design; experience; flexibility; follow-up; foot; functional outcomes; improved; improved outcome; muscle strength; novel; novel strategies; programs; recruit; resilience; standard of care; ultrasound; walking speed

Plantar fasciitis, a repetitive strain injury, is one of the most common causes of foot pain. Ten percent of aging adults experience plantar fasciitis with 50% of the cases being disabling. Foot pain can lead to other problems such as reduced mobility, depression and prescription medication use, leading to a reduced quality of life. Relationships have been established between foot pain and weakness, reduced static and dynamic balance, and reduced walking speed in aging adults. The standard of care for plantar fasciitis is to brace the foot with foot orthoses and supportive shoes. However, chronic support of the arch has been shown to lead to intrinsic foot muscle atrophy. As plantar fasciitis is associated with this atrophy, treating it with chronic arch support only increases the risk for recurrence. In fact, there is a 50% recurrence rate and a 45.6% risk of having plantar fasciitis 10 years after the onset of symptoms in older adults. Minimal shoes are designed to allow the foot to function naturally, as if barefoot. They have already been successfully implemented in older adults for the treatment of knee osteoarthritis. Minimal shoes are highly flexible and lack the support of conventional footwear. This places greater demand on the foot muscles which promotes strengthening. Stronger foot intrinsic foot muscles have been shown to reduce the strain on the plantar fascia with each step, thereby reducing the risk of developing plantar fasciitis. Long-term Goal: To improve treatment interventions for plantar fasciitis in aging adults. Specific Aims: 1. Compare pain and physical function between the minimal footwear (MF) and the foot orthotic (FO) groups at the 3 and 6 month follow-up, 2. Compare changes in intrinsic foot muscle size and strength between MF and FO groups at the 3 and 6 month follow-up, and 3. Compare the incidence of recurrence of plantar fascial pain between the MF and FO groups at the 12 month follow-up Methods: 120 participants with plantar fasciitis (>6 mos.) will be recruited from 2 sites. They will be randomized into a minimal footwear (MF) and foot orthotic (FO) group. Baseline measures of foot muscle size and strength, static and dynamic balance, 6 min. walk test and two functional outcome questionnaires will be obtained. The MF group will receive 2 pair of minimal shoes, and the FO group will receive 2 pair of supportive shoes and prefabricated foot orthoses. The MF group will be given a 4-week program of foot strengthening and flexibility exercises, while the FO group will only receive the flexibility exercises. Both groups will be given an 8-week footwear transition program based upon their individual baseline step counts. They will return to the laboratory to repeat the baseline measures at 3 and 6 mos. Plantar fascial pain and daily step counts will be monitored over the course of the year. Comparisons in outcome measures as well as plantar fasciitis recurrence will be compared between the groups.

足底筋膜炎是一种重复的应变损伤，是脚痛最常见的原因之一。衰老的百分之十 成年人患有足底筋膜炎，其中50％的病例正在致残。脚痛会导致其他问题 例如降低移动性，抑郁和处方药的使用，导致生活质量降低。 脚痛和无力之间已经建立了关系，静态和动态平衡减少， 并降低了衰老成年人的步行速度。足底筋膜炎的护理标准是用 脚矫形器和支撑鞋。但是，已证明对弓的慢性支撑导致固有 脚肌肉萎缩。由于足底筋膜炎与这种萎缩有关，因此用慢性弓支持治疗 只会增加复发的风险。实际上，有50％的复发率和45.6％的风险 老年人症状发作10年后的足底筋膜炎。 最小的鞋子的设计旨在使脚自然运作，好像赤脚一样。他们已经去过 在老年人中成功实施，用于治疗膝盖骨关节炎。最小的鞋子很高 灵活，缺乏传统鞋类的支持。这使脚部肌肉的需求更大 促进加强。已经证明，脚部固有的脚部更强，可以减少 足底筋膜每一步，从而降低了患上足底筋膜炎的风险。 长期目标：改善衰老成年人的足底筋膜炎的治疗干预措施。 具体目的：1。比较最小鞋类（MF）与脚矫形器之间的疼痛和身体功能 （FO）在3个月和6个月的随访中组2。 在3个月和6个月的随访中，MF组和FO组之间，以及3。 在12个月的随访中，MF和FO组之间的足底筋膜疼痛 方法：将从两个地点招募120名具有足底筋膜炎的参与者（> 6个月）。他们会的 随机分为最小的鞋类（MF）和脚矫形器（FO）组。脚肌肉大小的基线测量 力量，静态和动态平衡，6分钟。步行测试和两项功能性结果问卷将是 获得。 MF组将获得2双最小鞋子，FO组将获得2对支持 鞋子和预制的脚矫形器。 MF组将获得4周的脚步计划 和灵活性练习，而FO组只会获得灵活性练习。两组将被给予 一个为期8周的鞋类过渡计划，基于其各自的基线步骤计数。他们将返回 实验室以3和6 MOS重复基线测量。足底筋膜疼痛和每日步骤计数 在一年中进行监控。比较结果指标以及足底筋膜炎 两组之间将比较复发。