Fysioterapeutisk behandling av plantar fascit - en litteraturöversikt
Hagelstam, Eva (2010)
Hagelstam, Eva
Arcada - Nylands svenska yrkeshögskola
2010
All rights reserved
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:amk-2010092613228
https://urn.fi/URN:NBN:fi:amk-2010092613228
Tiivistelmä
Plantar fascit är ett smärttillstånd i hälen och räknas till en av de vanligaste orsakerna till fotsmärta. Smärtan orsakas sannolikt av en inflammation i fästet av den plantara fascian, som är en stödstruktur i fotbottnet. Behandlingen av plantar fascit är vanligtvis konservativ och inom fysioterapin behandlas det med olika metoder. Syftet med detta arbete är att sammanställa forskningsresultat gällande fysioterapeutisk behandling av plantar fascit, klargöra vilka behandlingsmetoder som ger bästa resultat och utreda om behandlingarna i fråga har en kortvarig eller långvarig effekt. Arbetet är gjort som en systematisk litteraturöversikt. Litteratursökning utfördes under hösten 2009 i 8 olika databaser och resulterade i 17 inkluderade studier som kvalitetsgranskades med en modell av Forsberg & Wengström (2008). I arbetet inkluderades studier som handlar om följande behandlingsmetoder: stretching av vadmuskulatur, stretching av den plantara fascian, ledmobilisering/manipulering, tejpning samt användning av nattskena och individuellt formade respektive standardformade stödsulor. Forskningsresultaten summerades och slutsatsernas evidensstyrka graderades med hjälp av SBU:s rekommendationer. De effektivaste behandlingarna vid plantar fascit är stretching av den plantara fascian, användningen av nattskena samt både individuellt formade- och standardformade stödsulor över en behandlingperiod på 1-3 månader. Vid jämförelse verkar dessa metoder lika effektiva. Stödande av foten med hjälp av tejpning i 1-7 dygn lindrar också hälsmärtan. På basen av de inkulderade artiklarna kan inga fasta slutsatser dras om effekten av vadmuskelstretching och ledmobilisering. Det skulle behövas mera forskning med längre uppföljning. Plantar fasciitis is a paincondition in the heel and one of the most common causes of
footpain. The pain is probably caused by an inflammation in the plantar fascia, which is a
supporting structure in the sole. The treatment is usually conservative and in
physiotherapy different methods are used. The aim of this thesis is to compile
researchresults regarding physiotherapy methods for plantar fasciitis, investigate which
treatments plantar fasciitis responds best to and clarify if the treatments have a shortterm
or longterm effect.
Method used is literature review. Relevant papers were identified by searching 8 different
databases during autumn 2009. Researcharticles concerning the following methods were
inculded in the review: stretching of the calfmuscles, stretching of the plantar fascia,
nightsplinting, jointmobilization/manipulation, taping and customized or prefabricated
footorthosis. Based on these criteria 17 articles were included and their quality was
assessed by using a model created by Forsberg and Wengström (2008).
Research results were summarised and the level of evidence of each conclusion was
assessed based on the recommendations by SBU. Plantar fasciitis responds well to
treatment with plantar fascia stretching, both prefabricated- and customized foot orthosis
and nightsplinting over a treatmentperiod of 1-3 months. None of these methods seem
superior over the other. Supporting the foot by taping from 1 to 7 days also relieves the
heelpain. Based on the inculded articles, no firm conclusions can be drawn concerning
the effectiveness of calfmuscle stretching and jointmobilization. More comprehensive
research with longer follow-up is required.
footpain. The pain is probably caused by an inflammation in the plantar fascia, which is a
supporting structure in the sole. The treatment is usually conservative and in
physiotherapy different methods are used. The aim of this thesis is to compile
researchresults regarding physiotherapy methods for plantar fasciitis, investigate which
treatments plantar fasciitis responds best to and clarify if the treatments have a shortterm
or longterm effect.
Method used is literature review. Relevant papers were identified by searching 8 different
databases during autumn 2009. Researcharticles concerning the following methods were
inculded in the review: stretching of the calfmuscles, stretching of the plantar fascia,
nightsplinting, jointmobilization/manipulation, taping and customized or prefabricated
footorthosis. Based on these criteria 17 articles were included and their quality was
assessed by using a model created by Forsberg and Wengström (2008).
Research results were summarised and the level of evidence of each conclusion was
assessed based on the recommendations by SBU. Plantar fasciitis responds well to
treatment with plantar fascia stretching, both prefabricated- and customized foot orthosis
and nightsplinting over a treatmentperiod of 1-3 months. None of these methods seem
superior over the other. Supporting the foot by taping from 1 to 7 days also relieves the
heelpain. Based on the inculded articles, no firm conclusions can be drawn concerning
the effectiveness of calfmuscle stretching and jointmobilization. More comprehensive
research with longer follow-up is required.