Analysis Of Plantar Pressure Distribution In Patients With Plantar Fasciitis

Background: Plantar fasciitis(PF)is the main cause of heel pain and is common in clinic.The main symptoms of PF is foot pain,which usually occurs on the first step in the morning or standing after sitting for a long time,while after a few steps or within a few hours the pain may have some improvement,but it often increases as the day progresses.The relapse of the disease seriously affects the patient's quality of life,so it is concerned.At present,although the exact mechanism of PF is not well understand,most scholars claim that the biomechanics abnormality of the foot is the main mechanism.For PF patients,we mainly use pain rating scale and foot movement function correlation scale to evaluate the pain level,motor function and efficacy.Plantar pressure analysis can better show the distribution of plantar pressure,but there are relatively few studies on the distribution of plantar pressure in PF patients.Objective: To observe the plantar pressure distribution of PF patients and compare with normal people.To analyze the relationship between pain degree and plantar pressure distribution.Methods: We use Foot Scan system to collect and analysis the plantarpressure parameters of the 18 PF patients(12 patients are unilateral and 6are bilateral,total 24 pain feet)and 13 no-pain subjects(26 healthy feet).The plantar pressure parameters include mean pressure,peak pressure,percentage of area pressure,gait cycle and foot external rotation Angle.We use NRS to evaluate the pain level,then analysis the relationship between NRS value and plantar pressure.Results: Dynamic plantar pressure analysis: there has no significant difference in plantar pressure distribution of the two feet in the no-pain group,while there has a significant difference in the PF group.Compared with the no-pain group,the PF group's two forefoot's total percentage of pressure have a significant increase(P < 0.05),but the decline of the two rearfoot's total percentage has no statistical significance(P > 0.05).Compared with the healthy group,the mean pressure and peak pressure of the pain group are significantly decreased(P < 0.05).In the four-zone method,there is no significant difference in the total percentage of single foot between the pain group and the healthy group(P > 0.05),however,the pain group's forefoot percentage has an increase and rearfoot percentage has an decrease,and have statistically significant(P < 0.05).In the ten-zone method,compared with the healthy group,the percentage of heel area decreases and the percentage of toe area increases in the pain group,which are statistically significant(P < 0.05).Static plantar pressure analysis: there have no significant difference of the two feet's pressuredistribution in the bilateral pain PF group and no-pain group,while there have a significant difference in the unilateral pain PF group.Compared with the healthy group,the pain group's forefoot percentage and rearfoot percentage have not significant difference(P>0.05),but the total percentage of single foot significantly decreases(P<0.05).The NRS is negatively correlates with the mean pressure,peak pressure,the total percentage of pain foot,and the correlation has statistically significant(P<0.05).Conclusions: The distribution of plantar pressure in patients with PF has changed,which is shown by the decrease of the pressure on the heel area of the pain foot,the increase of the pressure on the forefoot and(or)the increase of the pressure of the healthy foot.Pain degree can affect the distribution of pressure.The more pain,the less pressure on the painful area.