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      Electroacupuncture versus manual acupuncture in the treatment of plantar heel pain syndrome: study protocol for an upcoming randomised controlled trial

      protocol

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          Abstract

          Introduction

          Plantar heel pain syndrome(PHPS) is a common cause of heel pain. It may worsen a patient’s quality of life, and potentially lead to knee, hip or lower back problems. Previous studies have shown that electroacupuncture (EA) and manual acupuncture (MA) are effective treatments for relieving pain in patients with PHPS. However, little evidence supports the use of one intervention over the other.

          Methods and analysis

          A total of 92 patients diagnosed with PHPS will be recruited and randomly assigned to an EA group or an MA group at a ratio of 1:1. Patients in both groups will receive a 30 min acupuncture treatment (three times per week) for a total of 12 sessions over 4 weeks. The primary outcome will be the proportion of patients with at least 50% reduction from baseline in the worst pain intensity measured by visual analogue scale (0–100, higher scores signify worse pain) at first steps in the morning after 4-week treatment. The secondary outcomes will include change in worst pain intensity at first steps in the morning, change in mean pain intensity at first steps in the morning, change in worst pain intensity during the day, change in mean pain intensity during the day, change in the pressure pain threshold, change in ankle-dorsiflexion range of motion, change in Foot and Ankle Ability Measure total score and subscale scores, patients’ global improvement assessment, patients’ expectations for acupuncture and safety evaluation. We will perform all statistical analysis following the intention-to-treat principle.

          Ethics and dissemination

          The study has been approved by our ethics review board (Protocol Approval No. 2018–010-KY). The study findings will be disseminated through presentation at a high-impact medical journal, with online access. We also to plan to present it in select conferences and scientific meetings.

          Trial registration

          ChiCTR-1800016531; Pre-results.

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          Most cited references20

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          Risk factors for Plantar fasciitis: a matched case-control study.

          Daniel Riddle, Matthew Pulisic, Peter Pidcoe … (2003)
          Plantar fasciitis is one of the more common soft-tissue disorders of the foot, yet little is known about its etiology. The purpose of the present study was to use an epidemiological design to determine whether risk factors for plantar fasciitis could be identified. Specifically, we examined the risk factors of limited ankle dorsiflexion with the knee extended, obesity, and time spent weight-bearing. We used a matched case-control design, with two controls for each patient. The matching criteria were age and gender. We identified fifty consecutive patients with unilateral plantar fasciitis who met the inclusion criteria. The data that were collected included height, weight, whether the subject spent the majority of the workday weight-bearing, and whether the subject was a jogger or runner. We used a reliable goniometric method to measure passive ankle dorsiflexion bilaterally. The main outcome measure was the adjusted odds ratio of plantar fasciitis associated with varying degrees of limitation of ankle dorsiflexion, different levels of body mass, and the subjects' reports on weight-bearing. Individuals with 10 degrees of ankle dorsiflexion. Individuals who had a body-mass index of >30 kg/m (2) had an odds ratio of 5.6 (95% confidence interval, 1.9 to 16.6) when compared with the referent group of individuals who had a body-mass index of 30 kg/m (2) are also at increased risk for the development of plantar fasciitis. Reduced ankle dorsiflexion, obesity, and work-related weight-bearing appear to be independent risk factors for plantar fasciitis. Reduced ankle dorsiflexion appears to be the most important risk factor.
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            Pressure algometry in manual therapy.

            L. Vanderweeën, W Duquet, R. A. B. Oostendorp … (1996)
            SUMMARY. The pressure pain threshold (PPT), i.e. the least stimulus intensity at which a subject perceives pain, was studied in 30 patients with chronic unilateral pain in the shoulder and arm region.Fourteen trigger points were investigated on both sides of the body using pressure algometry. Eight paravertebral points and six points in the shoulder and arm region were evaluated. Each location was examined twice. The patients were tested by one examiner.The intraobserver reliability of PPT measurements was considered to be good. The Intraclass Correlation Coefficients of reliability (ICC), based on two repeated PPT measurements varied between 0.64 and 0.96. The painful side of the body was found to be more sensitive than the non-painful side, although there was not always a significant difference at the 0.05 level. The PPT was found to be higher in males than in females (P < 0.05). Females demonstrated lower PPTs than males at each trigger point. It was established that pressure tenderness varies over individual trigger points. Significant regional differences in PPT values were observed (P < 0.05). PPT values decreased in a cranial direction in the spine and in a caudal direction in the upper limb.Although the authors expected to find segmentally reduced PPT values on the painful side of the body, a generalized reduction of PPT values was present at all peripheral and spinal segmental sites. Some correlations between segmentally related trigger points were found by factor analysis. Copyright 1996 Harcourt Publishers Ltd.
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              Conservative treatment of plantar heel pain: long-term follow-up.

              Skylar Cook, Amy C. Graham, Patrick D. Mauldin … (1994)
              In order to evaluate the long-term results of patients treated conservatively for plantar heel pain, a telephone follow-up survey was conducted. After eliminating those patients with worker's compensation-related complaints and those with documented inflammatory arthritides, data on 100 patients (58 females and 42 males) were available for review. The average patients was 48 years old (range 20-85 years). The average follow-up was 47 months (24-132 months). Clinical results were classified as good (resolution of symptoms) for 82 patients, fair (continued symptoms but no limitation of activity or work) for 15 patients, and poor (continued symptoms limiting activity or changing work status) in 3 patients. The average duration of symptoms before medical attention was sought was 6.1, 18.9, and 10 months for the three groups, respectively. The three patients with poor results all had bilateral complaints, but had no other obvious risk factors predictive of their poor result. Thirty-one patients stated that, even with the understanding that surgical treatment carries significant risk, they would have seriously considered it at the time medical attention was sought; twenty-two of these patients eventually had resolution of symptoms. Although the treatment of heel pain can be frustrating due to its indolent course, a given patient with plantar fasciitis has a very good chance of complete resolution of symptoms. There is a higher risk for continued symptoms in over-weight patients, patients with bilateral symptoms, and those who have symptoms for a prolonged period before seeking medical attention.
              Article 0 comments Cited 51 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): BMJ Open
                Journal ID (iso-abbrev): BMJ Open
                Journal ID (hwp): bmjopen
                Journal ID (publisher-id): bmjopen
                Title: BMJ Open
                Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                ISSN (Electronic): 2044-6055
                Publication date Collection: 2019
                Publication date (Electronic): 3 April 2019
                Volume: 9
                Issue: 4
                Electronic Location Identifier: e026147
                Affiliations
                [1 ] departmentDepartment of Acupuncture , Guang’anmen Hospital, China Academy of Chinese Medical Sciences , Beijing, China
                [2 ] departmentInstitute of Basic Research in Clinical Medicine , China Academy of Chinese Medical Sciences , Beijing, China
                [3 ] departmentAcupuncture and Moxibustion Department , Guang’anmen Hospital Affiliated to China Academy of Chinese Medical Sciences , Beijing, China
                Author notes
                [Correspondence to ] Dr. Zhishun Liu; zhishunjournal@ 123456163.com
                Article
                Publisher ID: bmjopen-2018-026147
                DOI: 10.1136/bmjopen-2018-026147
                PMC ID: 6500181
                PubMed ID: 30948595
                SO-VID: 23400145-4035-4c3f-852d-db6e8f83e4c0
                Copyright © © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
                License:

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                Date received : 19 August 2018
                Date revision received : 7 January 2019
                Date accepted : 14 February 2019
                Categories
                Subject: Complementary Medicine
                Subject: Protocol
                Subject: 1506
                Subject: 1685
                Custom metadata
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                ScienceOpen disciplines: Medicine
                Keywords: acupuncture,randomized controlled trial,plantar heel pain syndrome,protocol
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: acupuncture, randomized controlled trial, plantar heel pain syndrome, protocol

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