Clinical Research
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Hemiplejik hastalarda plantar fasya kalınlığının ultrasonografik değerlendirilmesi

Year 2023, Volume: 13 Issue: 3, 509 - 513, 31.05.2023
https://doi.org/10.16899/jcm.1244249

Abstract

Amaç: Hemiplejik hastalarda spastisite ve paralizi nedeniyle yük dağılımındaki değişiklikler bilateral plantar fasyada artan basınç ve biyomekanik problemlere bağlı travmaya neden olur. Bu çalışmanın amacı, hemiplejik hastalarda hem plejik hem de non-plejik taraftaki ve sağlıklı bireylerdeki plantar fasya kalınlığını ultrason ile değerlendirmektir.
Gereç ve Yöntemler: Bu kesitsel çalışmaya kronik hemiplejili (>6 ay) hastalar ve sağlıklı bireyler dahil edildi. Klinik ve demografik özellikler not edildi. Plantar fasya ultrason ile hiperekoik fibriller olarak görüntülendi. Kalkaneal bağlantıdan 1 cm sonra hemiplejik hastalarda ve sağlıklı bireylerde bilateral plantar fasya kalınlıkları ölçüldü.
Bulgular: Ortalama yaşı 58.60 ± 11.8 olan kırk hemiplejik hastayı (22 erkek, 18 kadın) ve yaş, cinsiyet ile vücut kitle indeksi (VKİ) uyumlu otuz altı sağlıklı bireyi dahil ettik. Plantar fasya kalınlık değerleri, plejik taraf (2.83 ± 0.6 mm) ve sağlıklı gruplar (sağ taraf:2.82 ±0,50; sol taraf: 2.81± 0,6) ile karşılaştırıldığında non-plejik tarafta (3.82 ± 0.1 mm) anlamlı olarak daha yüksekti (p<0,001).
Plejik taraf ve sağlıklı grup plantar fasya kalınlığı değerleri arasında ilişki bulunmadı (p>0,05). Non-plejik tarafın plantar fasya kalınlığı ile inme sonrası geçen süre (r=0.538, p<0.001) ve tonus (r=0.378, p=0.016) arasında anlamlı pozitif korelasyon bulduk.
Tartışma: Hemiplejik hastaların non-plejik tarafında plantar fasya kalınlığının plejik taraf ve sağlıklı bireylere göre artmış olduğu sonucuna varabiliriz.

Supporting Institution

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References

  • 1. Verdie C, Daviet JC, Borie MJ et al. Epidemiology of varus equinus one year after a hemispheral stroke. Ann Readapt Med Phys 2004;47:81–6.
  • 2. Norkin C Gait analysis. In: O’Sullivan SB and Schmitz TJ, Physica Rehabilitation: Assessment and treatment, 3rd ed. Philadelphia: FA DAVIS, 1994. pp 167–91.
  • 3. Baxter DE The heel in sport. Clin Sports Med 1994;13: 683–93.
  • 4. Wall JC, Turnbull GI. Gait asymmetries in residual hemiplegia. Arch Phys Med Rehabil 1986;67: 550–3. 5. Karabay N, Toros T, Hurel C. Ultrasonographic evaluation in plantar fasciitis. J Foot Ankle Surg 2007;46: 442–6.
  • 6. Roxas M. Plantar fasciitis: diagnosis and therapeutic considerations. Altern Med Rev 2005;10: 83–93. 7. Ogden JA, Alvarez RG, Marlow M. Shockwave therapy for chronic proximal plantar fasciitis: a meta-analysis. Foot Ankle Int 2002; 23: 301–8.
  • 8. Groshar D, Alperson M, Toubi A, Gorenberg M, Liberson A, Bar-meir E, Plantar fasciitis: detection with ultrasonography versus bone scintigraphy. Foot 2000;10: 164-8.
  • 9. Brown C. A review of subcalcaneal heel pain and plantar fasciitis. Aust Fam Physician 1996;25: 875–881, 884–5.
  • 10. Buchbinder R, Ptasznik R, Gordon J, Buchanan J, Prabaharan V, Forbes A, Ultrasound-guided extracorporeal shock wave therapy for plantar fasciitis: a randomized controlled trial. JAMA 2002;288: 1364–72.
  • 11. Viosca E, Lafuente R, Martínez JL, Almagro PL, Gracia A, González C. Walking recovery after an acute stroke: assessment with a new functional classification and the Barthel Index. Arch Phys Med Rehabil 2005;86(6):1239–44.
  • 12. Chen G, Patten C, Kothari DH, Zajac FE. Gait differences between individuals with post-stroke hemiparesis and non-disabled controls at matched speeds. Gait Posture. 2005;22(1):51–6.
  • 13. Nardone A, Galante M, Lucas B, Schieppati M. Stance control is not affected by paresis and reflex hyperexcitability: the case of spastic patients. J Neurol Neurosurg Psychiatry 2001;70: pp. 635-43.
  • 14. Laufer Y, Sivan D, Schwarzmann R, Sprecher E. Standing balance and functional recovery of patients with right and left hemiparesis in the early stages of rehabilitation. Neurorehabil Neural Repair 2003;17(4):207–13.
  • 15. Bensoussan L, Viton JM, Barotsis N, Delarque A. Evaluation of patients with gait abnormalities in physical and rehabilitation medicine settings. J Rehabil Med 2008;40: pp. 497-507.
  • 16. Eng JJ, Chu KS. Reliability and comparison of weight-bearing ability during standing tasks for individuals with chronic stroke. Arch Phys Med Rehabil 2002;83: pp. 1138-44.
  • 17. Wall J, Turnbull G. Gait asymmetries in residual hemiplegia. Arch Phys Med Rehabil 1986;67: pp. 550-3.
  • 18. Verdie C, Daviet JC, Borie MJ, et al. Epidemiology of varus equinus one year after a hemispheral stroke. Ann Readapt Med Phys 2004;47:81–6.
  • 19. Jomha NM, Pinczewski LA, Clingeleffer A, Otto DD, Arthroscopic reconstruction of the anterior cruciate ligament with patellar-tendon autograft and interference screw fixation: the results at 7 years. J Bone Joint Surg Br 1999;81:775–9.
  • 20. Kuan TS, Tsou JY, Su FC. Hemiplegic gait of stroke patients: the effect of using a cane. Arch Phys Med Rehabil 1999 Jul;80(7):777-84.
  • 21. JW Park, SH Park, MH Ko, Change of plantar fascia thickness in hemiplegic patients. J Kor Soc Phys Ther 2009;21:41-6.
  • 22. DL Riddle, M Pulisic, P Pidcoe, RE Johnson, Risk factors for Plantar Fasciitis: a matched case -control study. J Bone Joint Surg Am 2003;85:872-7.
  • 23. DB Irving, JL Cook, HB Menz, Factors associated with chronic plantar heel pain: a systematic review. J Sci Med Sport 2006;9:11-22.
  • 24. F Sorentino, A lovance, A Vestro, A Caccari, R Mantia, M Midiri, Role of high-resolution ultrasound in guiding treatment of idiopathic plantar fasciitis with minimally invasive techniques. Radiol Med 2008;113:486-95.
  • 25. CF Hyer, R Vancourt, A Block, Evaluation of ultrasound-guided extracorporeal shock wave therapy (ESWT) in the treatment of chronic plantar fasciitis. J Foot Ankle Surg 2005;44:137-43.
  • 26. Kim Tae-Gon, Sim Ki-Cheol, Kim Kyung-Yoon, A Study on Change of Plantar Fascia Thickness in Chronic Stroke Patient Based on Spasticity. Journal of Korea Academia-Industrial cooperation Society 2013;14:5723-9.

ULTRASONOGRAPHIC MEASUREMENT OF PLANTAR FASCIA THICKNESS IN PATIENTS WITH HEMIPLEGIA

Year 2023, Volume: 13 Issue: 3, 509 - 513, 31.05.2023
https://doi.org/10.16899/jcm.1244249

Abstract

Aims: In hemiplegic patients, changes in load distribution due to spasticity and paralysis cause trauma due to increased pressure and biomechanical problems in the plantar fascia on both sides. The aim of this study was to evaluate the plantar fascia thickness on both plegic and non-plegic sides by ultrasound in hemiplegic patients.
Material and Methods: This cross-sectional study included patients with chronic hemiplegia (>6 months) and healthy control individuals. Clinical and demographic features were noted. Plantar fascia was visualized as hyperechoic fibrils by ultrasound. The thickness was measured in both sides and at one cm after the calcaneal connection.
Results: We included forty hemiplegic patients (22 males, 18 females) with a mean age of 58.60 ± 11.8 years; and thirty-six age, sex, and body mass index (BMI) matched healthy subjects. Plantar fascia thickness values were significantly higher on the non-plegic side (3.82 ± 0.1 mm) compared to that of plegic side (2.83 ± 0.6 mm) and healthy groups sides ( (right side:2.82 ± 0,50; left side: 2.81 ± 0,6) (p<0,001). There was no relationship found between plegic and healthy group sides (p>0,05). We also found significantly positive correlation between plantar fascia thickness of the non-plegic side and time since stroke (r=0.538, p<0.001) with tonus (r=0.378, p=0.016).
Conclusion: We can conclude that, plantar fascia thickness seems to be increased on the non-plegic side of patients

References

  • 1. Verdie C, Daviet JC, Borie MJ et al. Epidemiology of varus equinus one year after a hemispheral stroke. Ann Readapt Med Phys 2004;47:81–6.
  • 2. Norkin C Gait analysis. In: O’Sullivan SB and Schmitz TJ, Physica Rehabilitation: Assessment and treatment, 3rd ed. Philadelphia: FA DAVIS, 1994. pp 167–91.
  • 3. Baxter DE The heel in sport. Clin Sports Med 1994;13: 683–93.
  • 4. Wall JC, Turnbull GI. Gait asymmetries in residual hemiplegia. Arch Phys Med Rehabil 1986;67: 550–3. 5. Karabay N, Toros T, Hurel C. Ultrasonographic evaluation in plantar fasciitis. J Foot Ankle Surg 2007;46: 442–6.
  • 6. Roxas M. Plantar fasciitis: diagnosis and therapeutic considerations. Altern Med Rev 2005;10: 83–93. 7. Ogden JA, Alvarez RG, Marlow M. Shockwave therapy for chronic proximal plantar fasciitis: a meta-analysis. Foot Ankle Int 2002; 23: 301–8.
  • 8. Groshar D, Alperson M, Toubi A, Gorenberg M, Liberson A, Bar-meir E, Plantar fasciitis: detection with ultrasonography versus bone scintigraphy. Foot 2000;10: 164-8.
  • 9. Brown C. A review of subcalcaneal heel pain and plantar fasciitis. Aust Fam Physician 1996;25: 875–881, 884–5.
  • 10. Buchbinder R, Ptasznik R, Gordon J, Buchanan J, Prabaharan V, Forbes A, Ultrasound-guided extracorporeal shock wave therapy for plantar fasciitis: a randomized controlled trial. JAMA 2002;288: 1364–72.
  • 11. Viosca E, Lafuente R, Martínez JL, Almagro PL, Gracia A, González C. Walking recovery after an acute stroke: assessment with a new functional classification and the Barthel Index. Arch Phys Med Rehabil 2005;86(6):1239–44.
  • 12. Chen G, Patten C, Kothari DH, Zajac FE. Gait differences between individuals with post-stroke hemiparesis and non-disabled controls at matched speeds. Gait Posture. 2005;22(1):51–6.
  • 13. Nardone A, Galante M, Lucas B, Schieppati M. Stance control is not affected by paresis and reflex hyperexcitability: the case of spastic patients. J Neurol Neurosurg Psychiatry 2001;70: pp. 635-43.
  • 14. Laufer Y, Sivan D, Schwarzmann R, Sprecher E. Standing balance and functional recovery of patients with right and left hemiparesis in the early stages of rehabilitation. Neurorehabil Neural Repair 2003;17(4):207–13.
  • 15. Bensoussan L, Viton JM, Barotsis N, Delarque A. Evaluation of patients with gait abnormalities in physical and rehabilitation medicine settings. J Rehabil Med 2008;40: pp. 497-507.
  • 16. Eng JJ, Chu KS. Reliability and comparison of weight-bearing ability during standing tasks for individuals with chronic stroke. Arch Phys Med Rehabil 2002;83: pp. 1138-44.
  • 17. Wall J, Turnbull G. Gait asymmetries in residual hemiplegia. Arch Phys Med Rehabil 1986;67: pp. 550-3.
  • 18. Verdie C, Daviet JC, Borie MJ, et al. Epidemiology of varus equinus one year after a hemispheral stroke. Ann Readapt Med Phys 2004;47:81–6.
  • 19. Jomha NM, Pinczewski LA, Clingeleffer A, Otto DD, Arthroscopic reconstruction of the anterior cruciate ligament with patellar-tendon autograft and interference screw fixation: the results at 7 years. J Bone Joint Surg Br 1999;81:775–9.
  • 20. Kuan TS, Tsou JY, Su FC. Hemiplegic gait of stroke patients: the effect of using a cane. Arch Phys Med Rehabil 1999 Jul;80(7):777-84.
  • 21. JW Park, SH Park, MH Ko, Change of plantar fascia thickness in hemiplegic patients. J Kor Soc Phys Ther 2009;21:41-6.
  • 22. DL Riddle, M Pulisic, P Pidcoe, RE Johnson, Risk factors for Plantar Fasciitis: a matched case -control study. J Bone Joint Surg Am 2003;85:872-7.
  • 23. DB Irving, JL Cook, HB Menz, Factors associated with chronic plantar heel pain: a systematic review. J Sci Med Sport 2006;9:11-22.
  • 24. F Sorentino, A lovance, A Vestro, A Caccari, R Mantia, M Midiri, Role of high-resolution ultrasound in guiding treatment of idiopathic plantar fasciitis with minimally invasive techniques. Radiol Med 2008;113:486-95.
  • 25. CF Hyer, R Vancourt, A Block, Evaluation of ultrasound-guided extracorporeal shock wave therapy (ESWT) in the treatment of chronic plantar fasciitis. J Foot Ankle Surg 2005;44:137-43.
  • 26. Kim Tae-Gon, Sim Ki-Cheol, Kim Kyung-Yoon, A Study on Change of Plantar Fascia Thickness in Chronic Stroke Patient Based on Spasticity. Journal of Korea Academia-Industrial cooperation Society 2013;14:5723-9.
There are 24 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research
Authors

Sıdıka Şen 0000-0003-1084-4226

Publication Date May 31, 2023
Acceptance Date April 20, 2023
Published in Issue Year 2023 Volume: 13 Issue: 3

Cite

AMA Şen S. ULTRASONOGRAPHIC MEASUREMENT OF PLANTAR FASCIA THICKNESS IN PATIENTS WITH HEMIPLEGIA. J Contemp Med. May 2023;13(3):509-513. doi:10.16899/jcm.1244249