Lower-limb biomechanical alterations in patients with plantar fasciitis during walking and running: A systematic review with meta-analysis

Objective To identify the differences in three-dimensional kinematic and kinetic gait characteristics in individuals with plantar fasciitis (PF) compared to healthy controls. Methods Searches were performed at CINAHL, Cochrane Library, Embase, Europe PMC, MEDLINE, SciELO, and Scopus databases. Studies comparing kinetic and/or kinematic aspects of gait between patients with plantar fasciitis and a control group were included. Data regarding the main characteristics and results of each study were extracted. The Newcastle-Ottawa Scale for Non-randomized Trials was used for quality assessment. The review was registered at PROSPERO (omitted for review). A meta-analysis was performed when two or more studies presented similar variables. Results Eleven studies fulfilled the inclusion criteria with both male and female participants (294 subjects, mean age 21-59 years). The PF group presented greater forefoot plantarflexion at initial contact (IC) during gait. Concerning kinetic forces, there was a statistically significant increase in peak instantaneous vertical impact load rate in runners with a history of plantar fasciitis. There were no significant differences in spatiotemporal parameters. The main limitation of the review is the considerable variability among studies regarding foot segmentation methods and variables assessed. Conclusion Plantar fasciitis may lead to increased forefoot plantarflexion at IC during gait as a compensatory mechanism to avoid greater strain at the plantar fascia; additionally, runners with plantar fasciitis exhibit increased vertical impact load rate.