Figure 2: Differential Diagnosis for Plantar Fasciitis
Source : Created by author.
Foot health status questionnaire (FHSQ) This is a self-administered test that consists of 13 questions in four different categories. Foot pain (four questions), foot function (four questions), footwear (three questions), and general foot health (two questions). Each question is scored from 1-5 with scores of 1 indicating no pain or disability and scores of 5 indicating severe pain and disability. The primary use of this test is as an outcome measure for the clinician (Palomo-Lopez et al., 2019). Foot and ankle ability measure (FAAM) This test consists of two sets of questions. The first has 21 questions that relate to how the foot functions in various daily activities (i.e., How well can you walk for five minutes or less?). The second set of eight questions specifically focuses on how the foot functions in sports-related activities (i.e., Because of your foot pain, how much difficulty do you have with running?). Each question is scored from a 4, indicating no difficulty, to a 0, indicating inability to do the task. There is also the option of N/A. The higher the score, the better the patient feels the foot is functioning. To score this measure, the examiner should add up the total points and divide it by the number of points available for each subscale (84 for activities of daily living [ADL] and 32 for the sports subscale) and then multiply this answer by 100. This is a good self- administered test to show a patient their self-perceived progress (Martin et al, 2005). Visual analog scale As many patients primarily seek treatment for the pain associated with plantar fasciitis, one outcome measure can simply be the visual analog scale (VAS). This is a 10-cm-long line which the patient is asked to mark where they feel most represents their pain. The length between the beginning of the line and the patient’s mark is then measured, and a number from 0-10 can be assigned depending on what centimeter the mark is closest to. A successful course of physical therapy for plantar fasciitis will decrease the patient’s pain.
The foot posture index (FPI) test The FPI test is used to quantify the amount of pronation or supination of the foot. Neutral positioning is scored with a zero, pronated positions are scored with positive numbers and supinated positions are scored with negative numbers (Redmond et al., 2006). Scoring is completed for the following six items: 1. Talar head palpation. 2. Supra and infra lateral malleolar curvature. 3. Calcaneal frontal plane position. 4. Prominence in the region of the talonavicular joint. 5. Congruence of the medial longitudinal arch. 6. Abduction/adduction of the forefoot on the rear foot Scores can range from -12 to 12. If there is genuine doubt about how high or low to score an item always use the more conservative score. See Table 1 for detailed scoring information. Features commensurate with an approximately neutral foot posture are graded as zero, while pronated postures are given a positive value, and supinated features as negative value. When the scores are combined, the aggregate value gives an estimate of the overall foot posture. High positive aggregate values indicate a pronated posture, significantly negative aggregate values indicate a supinated overall foot posture, while for a neutral foot the final FPI aggregate score should lie somewhere around zero (Physiopedia, 2019). Heel tap test In this test, the patient either lays supine or sits with the knee extended and the foot off the mat. Therapists should stabilize the lower leg with one hand and tap the calcaneus two to three times with progressively more force. A positive test is pain in the area of complaint and can indicate a possible fracture.
EliteLearning.com/ Physical-Therapy
Book Code: PTCA2624
Page 175
Powered by FlippingBook