Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Clinical Professor Michael Kjær, University of Copenhagen, Denmark
- Second opponent: Senior Researcher Ida Svege, Nordic Institute for Studies in Innovation, Research and Education (NIFU), Oslo
- Third member and chair of the evaluation committee: Associate Professor Gilbert Moatshe, University of Oslo
Chair of the Defence
Professor Emeritus Lars Engebretsen, University of Oslo
Principal Supervisor
MD, PhD Aasne Fenne Hoksrud, Norwegian Olympic and Paralympic Committee and Confederation of Sports
Summary
Plantar fasciopathy is a musculoskeletal disorder causing heel pain, reduced function and health-related quality of life. The choice of best practice is debated.
The purpose of this thesis was to assess the effectiveness of radial extracorporeal shock wave therapy (rESWT), sham-rESWT or a standardised high-load strength training programme in combination with advice plus customised foot orthoses compared with advice plus customised foot orthoses alone. We conducted a randomised controlled trial where 200 patients were randomised to 4 groups. We used patient-reported outcome measures (PROMs) measuring heel pain during activity and rest, foot function and health-related quality of life. We also estimated and compared responsiveness characteristics of these PROMs. In addition, we assessed the time pattern of recovery in pain, function and health-related quality of life over 12 months and assessed whether demographic or clinical characteristics could influence these trajectories.
We found no additional effect of rESWT, sham-rESWT or a standardised high-load strength training programme compared to advice plus customised foot orthoses alone. All patients had significant reduction in pain and improved function over 12 months. Except for the sham-group, all patients had improved health-related quality of life over 12 months. All PROMs were responsive except for heel pain at rest. Bilateral plantar fasciopathy was associated with a differential time pattern of recovery compared to unilateral plantar fasciopathy.
The results indicate that adding rESWT, sham-rESWT or a high-load strength training programme to advice plus customised foot orthoses should not be recommended for patients with plantar fasciopathy. All PROMs, except for heel pain at rest, were responsive and can be used in future research on patients with plantar fasciopathy. Differential recovery trajectories may be important to consider when planning follow-ups in research and clinical settings.
Additional information
Contact the research support staff.