The Effect Of Home Rehabilitation Exercises And Minimalist Shoes On Impact Forces And Pain

Plantar fasciopathy (PF) occurs when the plantar fascia is mechanically overloaded due to increased weight or activity, leading to foot pain while weight-bearing. Impact forces (IF) at initial contact while walking are decreased in individuals with PF compared to healthy individuals, likely due to pain. Interventions to strengthen the foot such as rehabilitation or wearing minimalist shoes (MS) have been prescribed for PF, but it is unknown how they affect gait and whether pain plays a role. PURPOSE: To investigate the effects of 8 weeks of exercise and wearing minimalist shoes on IF at initial contact while walking in individuals with PF, and to determine if the changes are influenced by pain. METHODS: Twelve individuals (n = 9 female) with unilateral PF who underload the injured limb (1.05 N ± 0.09) compared to the healthy limb (1.18 N ± 0.07) volunteered for this study (age: 46.1 ± 10.4, height: 166 ± 9.15, weight: 74.7 ± 8.86). Participants recorded their average first-step pain over the past week using a 100 mm visual analog scale. Participants walked on a treadmill at a self-selected pace with force-sensing insoles in their conventional shoes of choice at both baseline and follow-up. Peak IF were measured and normalized to body weight (% BW). Participants wore MS with progressing daily wear time during the intervention, and were instructed in home rehabilitation exercises including massage ball myofascial release, toes elevated calf-raises, calf and foot stretches. Changes in pain and IF symmetry over time were assessed using t-tests. Linear regression was used to evaluate the association between changes in pain and IF symmetry from baseline to follow-up. RESULTS: From baseline to follow-up there were no significant changes in IF symmetry (p = 0.46, baseline: 88.80% ± 6.06, follow-up: 90.63% ± 9.89). Decrease in pain was significant (p < 0.001, baseline: 49.30 mm ± 15.40, follow-up: 23.50 mm ± 16.80) and significantly predicted change in symmetry (p < 0.001, adjusted R2 = 0.77, B = -0.49), showing that every 1 unit decrease in pain led to a 0.49% increase in peak IF symmetry. CONCLUSION: Individuals with PF did not experience significant changes in symmetry of IF, after 8 weeks of exercise and minimalist shoes. However, increases in symmetry and decreases in pain levels were highly related. Supported by: Xero Shoes' Minimal Footwear Research Grant